Practice Life Magazine Issue 15 March/April 2017 by The Magazine Production Company

March/April 2017

THE MAGAZINE OF SPVS AND VPMA

Practice Standards Hot Topic How a management Scheme special approach may help Gaining PSS Awards

Preparing your team for inspection Celebrating wellbeing

retain VNs in the profession

DISPUTE RESOLUTION What are the alternatives to court?

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EDITORS’ LETTERS

Editors’ Letters

here’s a lot of “newness” going on around here at the minute. Our congress will be a memory by the time this edition arrives in your practice; however I have to say that our two “new to” streams in Newport were, in my opinion, absolutely fantastic and achieved what they needed to. However, if they didn’t for you, do let us know! Congress was another total success, equipping practice owners and managers with tools to do the job. It’s always great to meet up with friends and colleagues from across the industry and network with new faces. Our veterinary industry is thriving and buoyant despite European and global uncertainty and there is nothing to hold practices back from being diverse and individual in their daily pursuits. Indeed, my own practice won a couple of local business awards recently just for being noticed and nominated by clients as doing something “new”. After a decade of being away from radio broadcasting, I’ve decided to become involved again with my local community station and bring a new approach to my

elcome to 2017, where the real world has started to feel like a strange kind of dystopia, but SPVS and VPMA leavened the January mood with our biggest and best congress to date. Keystone Events did us proud at Celtic Manor again and the speakers and streams were excellent and had something for everyone. I spent a lot of time in the Mind Matters stream and was delighted to be there for the awarding of the inaugural SPVS Wellbeing Awards, which we cover in this issue on p24. Much scribbling down of inspirational ideas to take home was seen. As SPVS Past-president Nick Stuart commented, “prevention is better than cure” and we have spent a lot of time studying the problems and are now finding and celebrating the solutions, which will be crucial to the development of the profession. Another future-proofing stream considered “Why women leaders are different”. If the veterinary leaders

longstanding interest in keyboard music (there’s a piece on p32 on how this came about). Like many, three months down the road, my “new” year resolutions have gone out of the window! All except one. I’m not an avid reader but was impressed by a challenge by one well-known globetrotting American veterinarian, to read one book every week throughout 2017. I know that may be a pretty easy target for some, but (while not managing to read War and Peace in seven days, I have made much better progress than I thought possible. Anyway, you could start with devouring this latest issue of your member benefit magazine! I leave you with this thought: “True education is a kind of never ending story – a matter of continual beginnings, of habitual fresh starts, of persistent newness” (JRR Tolkien).

Ian Wolstenholme, VPMA editor

of the future are going to be vets, it follows that they are going to be women, so Fiona Briault articulated some of the ways we can rethink leadership roles to account for different styles. I was pleased to be able to take my Harrogate team a fantastic present, namely a book by Adi Nell and Erwin Hohn called How to Manage Despite your Boss! Congress really does create a buzz and the camaraderie we have as a profession is very special indeed. There may be no happier place in the world than the dance floor at Celtic Manor when the Bogus Brothers are doing their stuff. Big thanks to Steph for her fantastic leadership this year and her tremendous support with Practice Life, and good luck to Brian as you start your presidential year.

Leigh-Anne Brown, SPVS 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

February/March 2017 z Practice Life

Contents g

UPDATE: NEWS & VIEWS 5

Leigh-Anne Brown, MRCVS

SPVS NEWS

VPMA

Communicating as a team, Leadership academy

Editors SPVS

Ian Wolstenholme, Practice Manager Publisher Mojo Consultancy Ltd Suite 15, STANTA Business Centre 3 Soothouse Spring, St. Albans Herts AL3 6PF Tel +44 (0) 1727 859259 info@mojoconsultancy.com www.mojoconsultancy.com Advertising and Sales Enquiries Libby Sheridan MVB MRCVS Tel:01727 859259 Sales Administrator Eva Lambe Practice Life is the magazine of the Society of Practising Veterinary Surgeons and the Veterinary Practice Management Association. It is distributed quarterly to the members of both associations as well as a wider mailing list of veterinary practices annually. www.spvs.org.uk www.vpma.co.uk The magazine contains articles on veterinary business and management as well as other topical updates and relevant features. The information contained within these articles is intended for general information only and does not replace the need for advice from qualified professionals in the relevant field. Articles and photographs are welcomed for submission, though publication is not guaranteed and is at the discretion of the editors.

VPMA NEWS

Vetfest, mental health for managers g

NURSE TALK

15 19

Animal welfare coalition g

COLLEGE CORNER

The road to Brexit g

VDS

Expert sense of balance g

HOT TOPIC

Retaining veterinary nurses g

WELL-BEING

Reviews the SPVS award winners g

MANAGING PEOPLE

17 28

Preparing for PSS g

CLIENT CARE AND MARKETING

The mythical millenniall g

BUSINESS HEALTH AND FINANCE

Alternatives to court g

PRACTICE DEVELOPMENT

New to PSS g

CPD SHARED

Congress reviewed g ÂŠ 2017 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.

CPD DIARY

Focus on Practice Finance g

WHATâ&#x20AC;&#x2122;S COMING UP

Details the 2017 CPD programme

46 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 February/March 2017

News & Views

Vets take on a MARATHON challenge! welfare charity dedicated to improving the lives of working horses, donkeys and mules, as well as those who care for them. Brian and Carolyne are aiming to raise £10,000 for the Brooke and, as Practice Life went to press, they were nearing the £4,000 mark. See below for details of how you can donate to the Ten2London challenge.

Two vets are taking on an extreme challenge – to literally ‘run the country’ by taking on 10 marathons in as many days around the UK. Carolyne Crowe and Brian Faulkner will run a marathon on each of 10 consecutive days in April, starting in John O’Groats on April 14 and ending by completing the London Marathon on April 23. The pair will also pop by Land’s End on the way to add in another 26-mile run there before heading to London for their final two marathons. The pair are taking on the Ten2London challenge to raise money and awareness of the work of the Brooke, an international animal

The pair’s itinerary takes in the following dates: • Friday 14 April 2017 – John O’Groats • Saturday 15 April 2017 – Orkney • Sunday 16 April 2017 – Loch Ness • Monday 17 April 2017 – Edinburgh • Tuesday 18 April 2017 – Cookstown, County Tyrone • Wednesday 19 April 2017 – Galway • Thursday 20 April 2017 – Gloucestershire • Friday 21 April 2017 – Lands End • Saturday 22 April 2017 – Thames • Sunday 23 April 2017 – London Marathon For more information visit the website http://www.ten2london.co.uk/ To donate, visit the Virgin Money giving page http://uk.virginmoneygiving.com/team/ten2london.co.uk

ALL THE PRESIDENT’S WOMEN! For a female-dominated profession such as ours, it may not be a surprise to see so many female heads of associations in one place – but this year saw the highest ever. In fact there was only one male president – BCVA’s Andrew Cobner. The photo was taken during SPVS-VPMA Congress in January.

From left: Sam Morgan BVNA Vicky Nicholls BEVA Gudrun Ravetz (BVA) Stephanie Writer-Davies (SPVS) Susan Dawson (BSAVA) Renay Rickard (VPMA)

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 info@mojoconsultancy.com

February/March 2017 z Practice Life

SPVS News President’s Welcome Brian Faulkner Hello and greetings as the SPVS President for 2017. My guiding theme for my presidency is simply the same as my guiding theme for my work as a vet and a veterinary practice owner, which is to help SPVS members in their pursuit of good outcomes with respect to three critical areas that deliver the triple bottom line of veterinary success: patients, people, profit. It is important and entirely appropriate that we, SPVS, retain a voice in order to support clinical progress as well as leveraging our leadership status within our practices to ensure that important initiatives actually result in improved patient outcomes instead of getting drowned or disregarded amid the daily urgency of veterinary practice. Secondly, people. Business leaders are often heard to say that ‘people are our greatest assets’ but the dearth of veterinary surgeons available to veterinary employers, compounded by the unwelcoming message of Brexit, is a growing challenge. No doubt 2017 will bring new challenges if / when Article 50 is invoked. SPVS will be involved and pushing to influence these issues that directly affect the wellbeing of our members. And finally profit. I want to help our members who wish to improve their veterinary organisation’s profitability – not for reasons of greed, but for reasons that better profitability brings better choices. Better profitability reduces financial uncertainty and fosters autonomy, key variables in wellbeing. We launched our profitability survey in 2016 and we need more participants to make the numbers even more meaningful and I would be grateful if everyone who reads this contributes in 2017. In 2017 I am launching the inaugural SPVS Leadership Academy; a four-day CPD course exclusive to SPVS members. This will be delivered as two back-to-back days in March and May at the Walton Hotel and Spa in Warwickshire. Visit www.spvs.org. uk or call the office on 01926 840318 for details. Snowscene this year is in March at Les Arcs and my CPDproviding guests are both non-clinical speakers: HR specialist James Cronin and tax specialist Dan Clay. Contact us for details. So 2017 will be a big year and these are just some of the ways and initiatives that we have to keep SPVS relevant in a world where many of our traditional membership bases are being absorbed into corporate organisations. Like any organisation or society, though, if we clearly add and represent value we will always have our place in the world. It may mean that we have to continue to adapt and change, but that’s okay, and I will do my best to steer SPVS through 2017, my year of stewardship. Brian Faulkner, SPVS President

SPVS Dates For Your Diary 2017 April 5-6 Officer and Council meetings

NEW FOR 2017: March 22-23 SPVS Leadership Academy part one May 10-11 SPVS Leadership Academy part two July 7-9 Your First Job, Lancaster Thirtieth anniversary special with a whole day for employers on how to look after new graduates.

July 17-18 Officer and Council meetings If you require further information about any SPVS events or have a general query, contact the SPVS office for details. Email office@spvs.org.uk or telephone 01926 840 318.

HOW TO MENTOR YOUR NEW GRADUATE July 8, 2017 Chaired by Robin Hargreaves, this day at Lancaster University, backed and built by SPVS, BVA and RCVS, will include sessions on mentoring, building resilient teams and helping with each PDP. There will be a panel of recent graduates, a session on how millennials are different, and how to match a graduate to your practice. This session will run alongside the 30th “Your first job” seminar for students and, to celebrate, there will be a gala dinner. Speakers will include Lizzie Lockett from the RCVS, former Life Coach of the Year Carolyne Crowe, Nick Steele from Zoetis and other leaders in their field. SPVS and VPMA members will receive a discount and delegates will have priority for tickets for the gala dinner.

Practice Life z March/April 2017

SPVS NEWS

COMMUNICATING AS A TEAM SPVS’ Leigh-Anne Brown reports on the interactive event Communicating as a Team she attended recently

he joint CPD programme between SPVS and VPMA is one of our great successes and never more so than at the “Communicating as a Team” event run by the VDS. This day-long event is designed for the whole team and is richly interactive. The morning comprises lectures and interactive cases with convincing actors playing the vets, nurses, practice manager and clients, and the delegates are given packs containing realistic patient histories so they can see how quickly things can unravel despite the best intentions of everyone involved. Scenarios include a young, inexperienced vet under pressure, a distracted and jaded senior partner, a practice manager who had been promoted above her peers by virtue of being in a relationship with the boss, a nursing team who resent that promotion, and a succession of cases that just don’t pan out as smoothly as they should. Add into the mix clients with their own experiences, eccentricities and agendas, phoning the practice owner at home on their day off (cue a groan of recognition from all delegates) some slap-dash note and message taking, and things quickly go awry for the imaginary practices.

Brought to life The VDS uses actors in its communications skills seminars to bring them to life. In the scenarios, the delegates are able to interject, heckle, ask questions and to cause the actors to ad lib in real time. There’s a huge amount of humour involved, with a healthy dose of cringing when the actors are improvising. Angela Rowland, who plays a worried pet parent called Mrs Mayhame (a client who is aptly named) in one scenario and boss’s love interest/practice manager in another sketch, talked me through the work the actors do before they deliver the CPD. Angela is self-employed and came originally from the legal profession. She started in amateur dramatics, won a best actress award soon after starting out, was spotted from there and managed to turn a hobby into her full time career. A cat owner herself, she can see the point of view from each side of the consulting room table. Just before our session, her cat Kempa, an elderly tortie, had been diagnosed with diabetes. Angela was learning how to inject Kempa at home shortly before presenting us with an imaginary diabetic to manage in “our” clinic. She had been to see her own vet shortly before we spoke and was pleased to report that her communication skills were excellent – a relief to the vet she sees, who must value the feedback!

Strong acting For each scenario a lengthy script is produced, with 35 or more pages of detail, background information and characterisation. A great deal of effort goes into the actors getting to know their characters, as they have to improvise extensively on the day. Angela’s best time for learning lines is just before going to sleep,

March/April 2017 z Practice Life

Angela in character, being questioned by vets Helen Trory from York, and Lianne Young from Settle

as it seems to get processed overnight and stick in her head, she says. For the purposes of the training, everyone is slightly hyperreal, maybe even eccentric, while being horribly familiar to anyone in practice. This is a polite way of saying the clients played are everyone’s worst nightmare, and the comedy of recognition is paired with genuinely sharp comic timing from the actors to make sure everyone is engrossed and cringing along. The VDS hosts, Geoff Little and Christine McGrath, chair the day and also join in with the dramatics. Although the setting in a hotel conference room is very standard for CPD, the scenarios are vividly brought to life. Fiona Willis, head receptionist at Vets4Pets in Harrogate, found the day educational and entertaining. She told us: “It made me realise the pressures the vets and nurses are under and I could see vets and nurses in the room realise what the front desk can be like from our point of view”. RVN Tammy Tartaglia enjoyed speaking to people from other practices and contributing to discussions, giving and receiving hints and tips. She found the “cringe factor” helped the learning to stick. The organisers were careful to put us into groups of people we didn’t know prior to the meeting and I ended up on a predominantly “vet” table when the actors came round in character to allow us to ask more questions about the poorly pet scenario we were dealing with. Angela at this point had donned a smart body-con dress to be the strident yet ineffectual practice manager and we managed to see her character’s human side; she felt ostracised by her former friends and peers when she was promoted and felt they didn’t respect her. Then we got to talk to the nursing team and realised that a sit down together and a little compassion for each other could easily have built bridges long before resentment built up. Reflecting on the day a few weeks later, Fiona said she found it the most worthwhile day she has spent on CPD: “I still reflect on it every day to smooth the waters in practice. It was really good fun, especially the way everyone threw themselves into their acting roles, and we all learned a lot from each other.”

SPVS NEWS

SPVS Leadership Academy launched New SPVS President, Brian Falkner, tells all about his new initiative, The SPVS Leadership Academy

he aim of the Academy is to enable SPVS members to improve knowledge about a range of practice management systems with a view to improving profitability and to demonstrate the practical applications of the various SPVS surveys, especially the profitability survey. Attendees must be SPVS members and CPD certificates will be provided. The course consists of a pair of two-day meetings, to be held at the Mercure Warwickshire Walton Hall Hotel and Spa, Wellesbourne, Warwick. The venue enables delegates to combine a CPD course with a little R&R, having a pool, spa and gym facilities, and there will be a group meal each evening. The first two-day meeting will be held March 22-23. Day One Introducing and measuring the proactive pursuit of four outcomes I believe that in order to be successful, every veterinary surgeon must pursue and contribute to four outcomes in veterinary practice – every case, every species, every time. These four outcomes are: • Clinical resolution • Client satisfaction • Financial resolution • Colleague satisfaction Clinical resolution refers to the prevention and resolution of clinical disease. I have observed more than 2,000 consultations over the past five years and I can tell you there is a significant spectrum of attitudes with respect to clinical proactivity within the practices I coach and work with. I will discuss some of the simple measurements and dashboards that I use to track clinical proactivity. Client satisfaction is an emotion that occurs when a client feels that what he or she has been told and sold, is the right thing for a fair price. It’s entirely possible for a client to have been given the best evidence-based technical advice and yet be doubtful, or even dissatisfied, with that advice because it doesn’t fit with their assumptions and beliefs about what’s actually wrong with their pet or what, in their opinion, should be done about it. And once again I will discuss some of the simple measurements and dashboards that I use to track client activity and client satisfaction. The third outcome, financial resolution, relates to discussions about money during our dealings with clients. I will look at ways to track and measure productivity in the consultation room and profitability. I will also look at some of the psychological reasons why some vets just don’t like talking about money – I call this econophobia – and the reasons behind this.

The fourth outcome, colleague satisfaction, means performing our work in a way that (i) doesn’t lead to a build-up of tension and stress within ourselves and thus compromise our own wellbeing, and (ii) in a way whereby our actions and behaviours don’t impact negatively on the morale of people we work with. I have found this is usually less to do with personality types than simply poor management systems. Stress = uncertainty x urgency. If we do manage our businesses and our colleagues without attempting to contain potential overwhelming uncertainty and urgency, we will endanger wellbeing and invite stress, fatigue and exhaustion issues. The second day will take a closer look at financial productivity. We will look at how to drive financial productivity in the consultation room. In other words, you can’t make profit out of turnover you don’t have. The second half of this day will focus on understanding the profit and loss sheet and using it to drive improvements in profitability. The second two-day session is on May 10-11, same location On day three we look at strategic marketing. The single most effective thing you can do to improve your marketing is measure your active client numbers and the average amount of money each client spends at your practice per annum. Everything else you do is simply a tactic to achieve your active client numbers and yield objectives. The biggest mistake I see many practices making is using the wrong tactics within their philosophy. This is like using a Toyota wheel on a BMW. Both good wheels but if they aren’t designed to complement the system they are being used with, sooner or later trouble will arise. So this day will be spent looking at understanding client numbers, marketing strategies and practice differentiation followed by a group meal. On the final day, Thursday May 11, we will look at recruiting, inducting, training, appraising and removing members of staff. Virtually every practice I work with is feeling the strain of dry recruitment pipelines – at least for experienced vets. I think we have to accept the reality that we are less and less likely to hire the finished product from the vet-shop. We are going to have to get more creative about how to attract, induct, mentor and train vets to work within our systems. And we are going to have to think about the reasons why vets don’t stay. Remember that stress = uncertainty x urgency. We have to look at ways to help buffer our recruits through the inevitable uncertainty and urgency that is inherent in veterinary practice. • The course costs £1,000 including all tuition and meals. • Accommodation is extra and a special rate of £120 per night has been arranged. • Maximum 20 attendees

Practice Life z February/March 2017 z www.practicelife.biz

SPVS NEWS

Vets: help raise standards in pet advertising Peter Brown, SPVS Junior Vice-president, takes up the reins to raise awareness of PAAG and classified advertising of pets to help improve animal welfare and breeding practices

AAG. It’s one of those acronyms, a little like SPVS, that isn’t particularly euphonious and I must admit that I had not heard of the Pet Advertising Advisory Group until an invitation to a breakfast at the House of Commons arrived at the SPVS office. PAAG was created in 2001 to combat the growing concern among animal welfare organisations about the unethical classified advertising of pets. The breakfast meeting I attended was to announce the launch of PAAG’s new minimum standards for online advertising of pets. It was reassuring to note that the initiative has the support of Government and many national animal charities. The meeting was addressed by the Minister for Animal Welfare,

Vet Trust collaborates with VPMA and SPVS Vet Trust is a charitable not-for-profit CPD provider based in Scotland. It gives support to local CPD groups, awards grants for CPD for vets and nurses who require financial assistance to comply with RCVS regulations or are studying something novel to improve animal welfare. The Trust particularly supports rural remote practice and vets returning to work after ill health. How does Vet Trust raise funds to give these awards? Through holding an annual CPD event in Stirling. It is the only multi-discipline event in Scotland and this year we are delighted to be supported by both SPVS and VPMA on the introduction of our business stream. This is especially exciting as it coincides with the Trust’s 25th anniversary. We also have nursing, companion animal, equine and farm animal clinical streams. If you are interested in finding out more visit the website where you will find the programme for the event, to be held June 6-7, 2017, and details of how to book www.vettrust.co.uk

March/April 2017 z Practice Life

Lord de Mauley and Clarissa Baldwin from Dogs Trust who is also PAAG chairman. The explosion in online sales has magnified the problems already familiar to most vets, where puppies and kittens are prematurely separated from their mother and sold by individuals purporting to be breeders, often resulting in their new owners having to deal with a pet with all manner of health issues. Although the standards are voluntary, they are supported by many websites carrying classified adverts, such as Gumtree, Loot and Preloved, and there were plenty of examples of websites removing non-compliant advertisements in response to reports from volunteer moderators. I believe it would be very useful to raise awareness of PAAG’s initiative among clients in the hope that we can reach more potential pet owners before they turn up at the surgery with their pet purchase. The PAAG website contains a poster suitable for displaying in practice and is a useful resource to which clients can be directed. www.paag.org.uk

SPVS’ “CROOKED PUTTER” GOLF DAY

The SPVS Golf Day 2017, sponsored by Shire Veterinary Insurance and Finance Brokers and Hazlewoods Accountants, will be held on Tuesday 13th June at the Forest of Arden Golf Club near Meriden. Located in the heart of the Midlands amongst the rural Warwickshire countryside, the Forest of Arden is recognised as one of the premier golf destinations in the UK and this networking day is highly recommended for all golfers. For more information please contact Keith Dickinson, email: Keith.Dickinson@ shireinsurance.co.uk

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VPMA News President’s Welcome By the time this column goes to press, Congress will have come and gone... but I am currently writing my speeches and hoping that it all goes as planned. This year has been a real team effort, and I would like to thank Keystone and everyone involved in making sure our Congress is a success year on year – and its still growing. Luckily for us, the great location at Celtic Manor is growing with us! Our event is firmly on the calendar across the whole industry; the management of veterinary businesses is something more and more of us are involved with on a daily basis as the role of the traditional manager evolves. I have been lucky to be given the opportunity to represent the VPMA as president for a second year – I felt one year was not long enough to see some of the projects develop, and being a typical practice manager I wanted to see them through! One of these was to support new managers and to provide some valuable resources. So I am very proud of our “New to Management” webinar series that we have launched this year. Please let us know of further areas you would like to see covered that would be useful to new managers as they join our profession... although I think there will be something in there for even the most experienced among us! Keep your eye out also for VPMA regional meetings in your area as we have introduced some new organisers over the past few months who are raring to go... please support your regions! They are the backbone of our association. We will be rolling out some joint meetings through the regions with the RCVS Mind Matters team on “Mental health for Managers” . They will look at ways we can, as managers, support our teams through mental health issues, and raise a general awareness of people we work with every day who may need our support in this area. I’m looking forward to another year representing you all and getting stuff done! Renay Rickard RVN CVPM VPMA President

March/April 2017 z Practice Life

MENTAL HEALTH FOR MANAGERS Helen Sanderson, VPMA Board member, reports on the inaugural Mental Health for Managers session. The irony of the dark and gloomy weather for the first Mind Matters Initiative (MMI)/ VPMA Mental Health for Managers training day wasn’t lost on those who attended this event in Swindon. However, the course itself couldn’t have been further from the gloomy weather outside. Gavin and Andrea from ‘Connecting with People’ delivered the course and started by discussing the drivers of wellbeing, which are similar to the five freedoms we apply to our animal patients. These are as follows: • Exercise • Sleep • Recovery time • Food • Shelter We discussed how each of these elements could affect us when they are done or missing from our lives, as well as the impact this can have. The course also covered the following topics: • Mental health awareness • HR employment regulations and the law • The role of the line manager in supporting someone with poor mental health • Making reasonable adjustments • Planning ‘return to work’ • Designing and putting in place wellbeing action plans The individuals who attended the course had various roles in practice and all found the course to be very beneficial. The small group format (only 21 people) also allowed for good discussion opportunities. We will be running more of these training days across the UK, so look out for future announcements.

NEW TO MANAGEMENT WEBINAR SERIES

Are you moving into management but finding it a bit daunting? Are you a clinical team member taking on some people management responsibilities, and not sure where to start? Appraisals, difficult team members, time management, client communication and dealing with complaints will all be covered. Each webinar is FREE to members or £15 to non-members. Online booking is now open! Register at www.events-by-vpma.co.uk

FEATURING LIVE MUSIC ON FRIDAY NIGHT

THE UK’s ONLY OUTDOOR CPD FESTIVAL 9-10 JUNE 2017, LOSELEY PARK, SURREY Nurses Trail -

denotes lectures we suggest may be suitable for nurses ASSOCIATION SPONSOR:

FRIDAY 9TH JUNE

TIME

ORTHOPAEDICS

NEUROLOGY

ONCOLOGY AND SOFT TISSUE

NURSING

09:30 09:40

09:45 10:30

10:40 11:25

ENDOCRINOLOGY AND CARDIOLOGY

REPRODUCTION, EXOTICS & BEHAVIOUR

WELLNESS AND TEAM BUILDING

VETFEST™ INTERACTIVE

Conference Welcome: Noel Fitzpatrick

Stuart Carmichael Overview of arthritis

Jeremy Rose Approach to the emergency spinal case

Laurent Findji Surgery of oral tumours: What have we learnt?

Lucy Montague Being a nurse in soft tissue and cancer referral practice; you are good enough!

11:35 12:20

12:30 13:15

Gordon Blunn Stem cells in human arthritis

Colin Driver Emergency management of meningoencephalitis and CNS neoplasia

13:25 14:10

Brian Saunders Stem cells in canine arthritis

14:20 15:05

15:15 16:00

Brian Saunders Work-up and decision making: Hip Dysplasia

Colin Driver Emerging spinal diseases you should know about

16:10 16:55

Noel Fitzpatrick Work-up and decision making: Elbow Dysplasia

Gary Ellison Small intestinal biopsy and surgery: Tips and tricks to stop the surgical site leaking

Kieran Borgeat Nursing a broken heart

Stijn Niessen Endocrinology: What vet school did not tell you about feline acromegaly; 1 in 4 diabetic cats!

Tim Hackett Treating shock: Part one

Matthew Fiddes Rabbit and rodent anaesthesia: Maximising success in practice

Carolyne Crowe Robust resilience; coping with curve balls

Gary England Parturition and decision making in dystocia

Andy McCreadie Culture Crisis workshop

Laura Woodward Mindfulness and emotional intelligence for vets: Part one

Matthew Fiddes Spurs and abscesses: Tips for rabbit and rodent dentistry

Stijn Niessen Endocrinology: Finally diagnosing hyperadrenocorticism with confidence

Kate Murphy Leptospirosis: An update for 2017

Carolyne Crowe Spotting threats to our resilience: Teams, time and tipping points

Matthew Fiddes Getting things moving: Managing gut stasis in rabbits and rodents

Gary England Parturition, dystocia and neonatal care

Gary Ellison Intestinal surgery in cats: How does it differ?

Gary England Reproductive physiology and the optimal time to breed

Stijn Niessen Endocrinology: Hyperthyroid decision time; radioactive iodine, surgery, pills or diet

Tim Hackett Treating shock: Part two

Tim Hackett Cardiopulmonary resuscitation

Tim Hackett Metabolic disasters; Addison’s and diabetes; causes, complications and cures

Laurent Findji Complications: The great taboo…

Jeremy Rose Emerging brain diseases you should know about

Stijn Niessen Endocrinology: Essential lessons for diabetic success in the dog and cat

Tim Hackett Post-operative critical care for nurses

Gerard McLaughlin Scoping the GI tract; how, why and to what end?

Jeremy Rose Managing spinal cord trauma

Kate Murphy Portosystemic shunts: Diagnosis and medical management Kieran Borgeat Minimally invasive occlusion of portosystemic shunts: Surgery for the medics

Laurent Findji How to be a better soft tissue surgeon: Philosophy and practice

Noel Fitzpatrick Options for joint replacement in dogs and cats

Colin Driver Managing head trauma and elevated intracranial pressure

17:05 17:50

INTERNAL MEDICINE

18:00 18:45

Conference Keynote

18:45 22:30

VETFestTM Party Night

Jon Bowen Noise fears and phobias in dogs

Jon Bowen Aggression toward strangers

Kieran Borgeat Gland on heart: The cardiac effects of endocrine diseases

Kate Murphy When a poke with a ‘scope is a good thing

Laura Woodward Mindfulness and emotional intelligence for vets: Part two; abolishing stress

Carolyne Crowe Practical coping strategies to turn surviving into thriving in practice

Laura Woodward Emotional intelligence and the management of conflict

Laura Woodward You are not alone: Text and answer session

10:35 - 11:35 Gerard McLauchlan These Bloods are weird! Should I just try steroids? Bring the lab results -Discuss the mystery

11:40 - 12:40 Jeremy Rose Suspected spinal problems USB Stick Consultation

12:45 - 13:45 Pádraig Egan So you’re less than five years graduated: What path to take? Practice? Internship? Specialisation?

13.55 - 14.55 Noel Fitzpatrick Common orthopaedic conditions USB Stick Consultation

15:05 -16:05 Kieran Borgeat Cardiology in primary care practice USB Stick Consultation

16:15 - 17:15 Colin Driver Is it a brain problem? USB stick consultation

DELEGATES CAN ATTEND ANY OF THE 10 EDUCATIONAL STREAMS ACROSS THE 2 DAYS NEW FOR

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DEDICATED NURSES’ TRAIL

‘WELLNESS’ THEME: FOCUSSING ON THE CLIENT, PET AND VET

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ASSOCIATION SPONSOR:

ORTHOPAEDICS

NEUROLOGY

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NURSING

INTERNAL MEDICINE

ENDOCRINOLOGY AND CARDIOLOGY

FELINE MEDICINE & SURGERY

WELLNESS AND TEAM BUILDING

09:45 10:30

Stephen Kalff Pathophysiology of patellar luxation

Clare Rusbridge Acute disorders of cranial nerves/Horner’s syndrome

Nick Bacon Management of lower urinary tract trauma in cats

Fraje Watson Being a nurse in ortho and neuro referral practice; you are good enough!

Kate Murphy Hot dogs in cool clinics: Pyrexia of unknown origin

Kieran Borgeat How to approach heart murmurs in cats

Noel Fitzpatrick Trauma in cats: It’s not a small dog

Richard Nap Patient and client wellness: Why do people visit their veterinarian?

10:40 11:25

Sarah Girling How I perform: Patellar luxation surgery

Nick Bacon Cancer in cats: It’s not a small dog

Andy McCreadie Culture Crisis workshop

Jacques Penderis Blindness and the basics of neuroophthalmology

11:35 12:20

12:30 13:15

Sarah Girling How I perform: Examination and diagnostics for pelvic limb lameness

13:25 14:10

Brian Saunders How I perform: Examination and diagnostics for thoracic limb lameness

Clare Rusbridge Emergency seizure management: Clusters and status epilepticus

15:15 16:00

Brian Saunders How I treat traumatic elbow and hip luxations in dogs

16:10 16:55

Brian Saunders How I treat cruciate disease in dogs

Kate Murphy Friendly fire: What to do when the immune system attacks

Nick Bacon Tracheal collapse in the dog: What you need to know…

Miguel Solano How to triage acute trauma in cats and dogs

Gary Ellison GDV in practice: What can you do to improve your outcome?

Clare Rusbridge Approach to acute neuromuscular weakness

Tim Hackett Small animal trauma - medical: The essentials

Roberto La Ragione Infection control in your practice

Tim Hackett Respiratory emergencies

Lowri Davies When the drugs stop working; can rehabilitation be the answer?

Richard Nap Patient and client wellness: Optimal healthcare experience

Lowri Davies Where did I go wrong? Common pitfalls and how to avoid them

Betina Rama Team wellness: Coaching and mentoring

Felix Duerr Injury and arthritis prevention in the canine athlete

Kerry Simpson Mycobacterial disease in cats

Richard Nap How to market and sell your products and services part one

Felix Duerr Tricky performance dog injuries: Would you have made the diagnosis?

Roberto La Ragione Emerging infectious disease and AMR in cats

Betina Rama Team wellness: Conflict management

Kerry Simpson Pneumonia in the cat

Kerry Simpson Triaditis: Real diagnosis or distracting differential?

Ashley Saunders Interactive cardiology case study: The coughing dog; part two

Kieran Borgeat Tracheal, urethral and vascular stents: A framework for decision making

Lowri Davies Post-operative rehabilitation: How can I make a difference?

Fiona Doubleday Functional rehabilitation and core stability for the canine

Betina Rama Team wellness: Optimal team performance

Ashley Saunders Interactive cardiology case study: The coughing dog; part one

Sarah Girling Maximising diagnostic potential of radiographs in orthopaedics

Gary Ellison Canine otitis externa: Medical treatment vs surgical treatment

Ashley Saunders Cutting edge cardiology

Tim Hackett Monitoring the critical patient

Nick Bacon Metastatic disease: What are the options? Osteosarcoma, melanoma, anal sac carcinoma, mast cell tumour Jacques Penderis Surgical decision making in managing spinal fractures and luxations

Kieran Borgeat Pre-clinical treatment of heart disease: Placebo effect or proper medicine?

Pádraig Egan Specialist nursing; you are good enough! A vet perspective

Jacques Penderis Spinal pain: Causes, diagnosis and treatment

14:20 15:05

17:05 17:50

Gerard McLauchlan Minimally invasive options for urinary tract obstruction

REHABILITATION

SATURDAY 10TH JUNE

TIME

Kerry Simpson Feline myocarditis: Myth or missed diagnosis?

Richard Nap How to market and sell your products and services - part two

Felix Duerr The rehab advantage: How to capture clients and help pets by using your knowledge!

BOOK NOW: www.vetfestival.co.uk Programme correct at time of going to press.

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

Over the past few months, we have been working hard at securing new Regional Organisers across the country and are delighted to welcome on board five new members: Linda Mogford, Wales Region; Rebekka Fiorani, West Midlands Region; Siobhan Park, Kent Region; Michelle Southern, Southern Scotland Region and Jerry Crick, Chiltern Hills Region. We are also in discussions with a couple of VPMA members who are interested in running a Northern Scotland Region, and a member who is interested in running a West & East Sussex Region. All our Regional Organisers work tirelessly at hosting meetings, so please support them wherever you can by attending them. Regional Meetings are FREE OF CHARGE to VPMA members and cost just £24 including VAT to nonmembers. They are an ideal way to meet your fellow practice managers – and there is always the opportunity for an open floor discussion so you can listen, discuss, advise and learn from each other. At our VPMA Regional Organisers’ meeting held on January 28, we had a record total of 16 organisers attend. It was good to get so many in one room at the same time so we could discuss and share ideas, and talk about what works best at meetings. The VPMA would like to thank everyone for attending the meeting and for committing to holding meetings during 2017, details of which can be found on the VPMA website.

Renay Rickard – VPMA President & Regional Co-ordinator

CHESHIRE/DERBYSHIRE Kate Mincher Tel: 01663 745294 ro2@vpma.co.uk

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

CHILTERN HILLS Jerry Crick Tel: 07771 573762 ro24@vpma.co.uk

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

CORNWALL/DEVON Renay Rickard Tel: 01208 872254 ro21@vpma.co.uk EAST ANGLIA Cath Grimsey & Tamsin Swain ro6@vpma.co.uk EAST & WEST SUSSEX Liz Panter ro7@vpma.co.uk ESSEX REGION Liz La-Page Tel: 07772 382465 ro22@vpma.co.uk KENT REGION Siobhan Park Tel: 07849 773 152 ro23@vpma.co.uk

SCOTLAND SOUTH Michelle Southern Tel: 07972 918189 ro18@vpma.co.uk SOUTH WEST Suzanne Headington Tel: 01242 680000 ro20@vpma.co.uk WALES Linda Mogford Tel: 07891 176572 ro5@vpma.co.uk WEST MIDLANDS Rebekka Fiorani ro1@vpma.co.uk YORKSHIRE Lisa Winter  Tel: 0777 268 2617  ro8@vpma.co.uk

MEET YOUR NEW REGIONAL ORGANISERS Linda Mogford, Wales Region Email: ro5@vpma.co.uk Rebekka Fiorani, West Midlands Region Email: ro1@vpma.co.uk Siobhan Park, Kent Region Email: ro23@vpma.co.uk Michelle Southern, Southern Scotland Region Email: ro18@vpma.co.uk Jerry Crick, Chiltern Hills Region Email: ro24@vpma.co.uk For further information on meetings and for the contact details of your local regional group, please take a look at the VPMA website www.vpma.co.uk/about-the-vpma/the-regions.html.

Practice Life z March/April 2017

Nurse Talk

In association with

BVNA JOINS ANIMAL WELFARE COALITION As part of our commitment to animal welfare, BVNA has dedicated a council member, Megan Whitehead, to a new group, led by BVA, as it seeks to improve welfare as part of the Vet Futures project. The veterinary animal welfare coalition includes BVA, BVNA, BSAVA, BVZS and veterinary charities Blue Cross, PDSA and RSPCA.

BVNA is launching its collaboration to celebrate the 10th anniversary of the Animal Welfare Acts (November 8) and pet owners will be encouraged to talk to their veterinary practices about the five welfare needs. This means that you may start to receive questions from the petowning public about welfare needs and the coalition’s purpose. Two-thirds of pet owners are not familiar with their pet’s legal welfare needs. And yet research from the soon-to-be-launched PDSA Animal Welfare (PAW) report 2016

shows that pet owners who feel more informed about each of the five welfare needs are significantly more likely to provide preventive healthcare to their animals. RVNs are at the forefront of the pet and owner relationship. Together we want to raise public awareness and encourage owners to have a closer relationship with their vet practice for regular discussions about their pet’s welfare needs, as well as encouraging the 15% of pet owners not currently registered with a veterinary practice to start that relationship.

MANY REASONS TO WRITE FOR VNJ

You can support the campaign by using the hashtag #5petneeds and by sharing our Facebook and Twitter posts. We have put together a Q&A document to help support client conversations around the 10th anniversary of the Animal Welfare Acts and the five welfare needs. You can find the social media text and Q&A in the BVNA Members’ area, where you can share the resources you already use in practice too.

BVNA CONGRESS 2017 Outstanding CPD for the whole healthcare team Friday 6th to Sunday 8th October 2017 Telford International Centre, Shropshire

The Veterinary Nursing Journal is the official journal

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of the British Veterinary Nursing Association, published by Taylor and Francis.

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The journal has a double-blind peer-review process with an international editorial board. There are many benefits to writing articles, including getting paid once your article is published, bolstering your CV with peerreviewed publications, and it also counts as CPD! We are interested in many different topics, but we are currently are looking for articles on nurse consults and clinics, emergency and critical care, rabbits and nutrition. We would be delighted to hear from you! Email Sam McMillan at VNJeditorinchief@bvna.co.uk

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March/April 2017 z Practice Life

27/10/2016 15:35:11

06/02/17 14:34:14

NURSE TALK

WE WANT TO HEAR YOUR #VNVOICE! BVNA’s exciting new communication portal, #VNVoice, exclusively for members is going strong into 2017! This is your opportunity as veterinary nurses to have YOUR say on all topics that matter to YOU. Give us your opinion and help us to fully represent your views. So far, we have run polls on VNFutures, Schedule 3, behaviour and nurse consulting. These have yielded some very interesting results, which we have used to produce press releases and feedback to other associations with your views. The results of one poll question revealed that more than 90% of VNs had assisted in a euthanasia for behaviour reasons, which BVNA found alarming. As a result, BVNA will be working to deliver CPD for practices to offer behavioural advice and we will be running a behaviour symposium at our 2017 Congress to try to increase knowledge of preventive care for the future of our pets. We will also be working with Vetlife and Mind Matters on the impact that euthanasia of otherwise healthy animals has on our profession. So BVNA is asking all those in the profession to get involved in the #VNVoice campaign. The more voices we hear the better representation we can give! To join in just logon to the BVNA

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NEW

...complex problem, simple solution.

members’ area of our website and find the Communication Portal information block. Follow the instructions to get going. Welcome aboard! www.bvna.org.uk

Here are some other questions that have been answered in our #VNVoice Communication portal and the top-line results Are you aware of VN Futures? 62% yes 30% no Do you see yourself working within the veterinary nursing profession in 5 years’ time? 46% very likely There are 6 VN Futures ambitions, which ones(s) mean the most to you and why? 75% Structured and rewarding career path 65% Maximising nurses’ potential 63% Confident, resilient, healthy and supportive workforce

IN SUPPORT OF MEMBERS IN NEED BVNA President, Sam Morgan, is delighted to announce the association’s nominated charity of the year for 2016/2017 as the Daphne Shipman Benevolent Fund. The charity was founded in memory of Daphne Shipman, who was chief steward for BVNA during congress for many years. Daphne was loved by all who knew her and sadly lost her fight against cancer in June 1999.

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“BVNA feels it is important to give something back to its members at their time of need and so by nominating the Daphne Shipman Benevolent Fund (DSBF) we hope to raise awareness of the charity and vital funds to ensure that the charity can continue supporting those individuals facing hardship and difficult times for many years to come.” The DSBF has been made available to BVNA members with the objective of supporting them, their spouses, relations or dependents who are in need, hardship or distress. To find out more or to apply, visit www.bvna.org.uk

07/02/2017 15:00

Practice Life z March/April 2017

College Corner TACKLING UNCERTAINTY

ON THE ROAD TO BREXIT Ben Myring, Senior Policy Officer at the Royal College of Veterinary Surgeons (RCVS), looks at the actions the College is taking to prepare the profession for the potential impact of leaving the European Union.

RCVS President Chris Tufnell giving a presentation on Brexit at London Vet Show 2016.

t the time of writing, there are still many uncertainties surrounding how the Brexit negotiations will pan out, and what kind of relationship the United Kingdom will have with the remaining countries of the European Union once it leaves. However, here at the College, we have not been resting on our laurels and waiting for the Government to trigger Article 50 or set out its negotiating strategy. Instead, the College has been busy considering the impact of leaving the European Union on the UK veterinary profession, the relationship with our European colleagues and organisations, and the effect that leaving the EU may have in the regulatory sphere.

Brexit taskforce To consider the potential impact the College set up a Brexit Taskforce within days of the vote to consider how we can best work with the UK and devolved governments, March/April 2017 z Practice Life

â&#x20AC;&#x153;In total, around one-fifth of veterinary surgeons working in the UK are from an EU countryâ&#x20AC;? veterinary organisations and our partner countries to mitigate the risks posed by Brexit and maximise the opportunities. To date, five meetings of the group have taken place and these have covered a wide variety of issues such as the ramifications of several different post-Brexit scenarios, and the preparations that can be made for a potential shortfall in veterinary surgeon numbers once the UK leaves the EU. Potential impact on the mutual recognition of professional qualifications has been one of the issues discussed. For example, under current arrangements, the College is obliged to register a veterinary surgeon who has earned a veterinary degree in an

COLLEGE CORNER

EU country – even if that degree does not meet the standards set out by the European Association of Establishments for Veterinary Education. In time, Brexit could allow us to be more selective about which veterinary degrees we automatically accept and, therefore, exercise some greater quality control over EU graduates. We have also discussed how Brexit might provide an opportunity to extend our global reach, particularly by seeking to raise and harmonise global standards; our CEO and President recently visited veterinary authorities in India to begin the process of strengthening bilateral relations. Brexit also allows us to consider our approach to somewhat out-of-date legislation, such as the Veterinary Surgeons Act, and take a fresh look at how it should be reformed. The Taskforce has also agreed a proposal to carry out research with EU-graduated vets working in the UK about what impact the vote to exit the EU has had on their attitudes to working here and their future intentions and career plans. This research project is expected to get underway very soon.

Setting out the impact of Brexit Together with the British Veterinary Association (BVA), we have made the potential impact of Brexit on the veterinary profession clear in a joint letter sent to Theresa May (available to read at www.rcvs.org.uk/brexitletter). In this letter the College also expressed concern about how some of the rhetoric around Brexit could make EU-graduated vets feel unwelcome. The letter highlighted the fact that, in the previous

“In time, Brexit could allow us to be more selective about which veterinary degrees we automatically accept and, therefore, exercise some greater quality control over EU graduates.” registration year, vets who graduated from an EU country accounted for around half of all new registrants and that, in total, around one-fifth of veterinary surgeons working in the UK are from an EU country. This is particularly true of the meat trade and the public health sector, where some sources suggest that 85-95% of vets working in this area graduated from EU vet schools. We were very pleased to receive a reply from the Home Office’s Minister for Immigration, Robert Goodwill MP, which acknowledged the role played by EU vets in clinical practice, academic research and public health. He explained that the Government intended to reach an agreement on the status of EU nationals as soon as possible while also welcoming the input of BVA and RCVS into this important issue and forthcoming results of research by both organisations.

Impact on the food chain

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As mentioned previously, there is some anxiety that Brexit could potentially lead to a shortfall in veterinary surgeons working in the meat trade, and how this could compromise the food chain and disease control. To gauge the industry’s concerns, last year the College and BVA held a roundtable event with stakeholders in that sector. It was agreed that more work would be done in this area to measure potential impact. The RCVS has considered similar concerns in the public health sector, which is heavily dominated by European graduates.

Inviting readers’ views A list of ‘Brexit principles and policies’ developed by the Brexit Presidential Taskforce will be going before RCVS Council on March 2, where Council members will be asked to approve a broad strategy on how we will approach the changes that Brexit will bring. We will be discussing this strategy and asking for the profession’s views at a special session being held at the British Small Animal Veterinary Association (BSAVA) Congress on April 7, 2017. The session starts at 8.30am (pastries and coffee available) with the talk itself taking place between 8.45am and 9.30am with time for questions following the talk. Considerations around the impact of Brexit, and the opportunities it brings for widening our global reach, have also been incorporated into our strategic plan for 2017-2019, which was published in January. You can view and download this document from www.rcvs.org.uk/publications Practice Life z March/April 2017

VDS News

AN EXPERT SENSE OF BALANCE... Or, ‘leave it to the experts’ warns the Veterinary Defence Society

fter a busy day at the coal face, Fred collapsed thankfully into his armchair, remedial glass in hand, and sorted through the avalanche of junk mail awaiting him, offering him such opportunities as stone cladding for his Cotswold cottage or CPD in Outer Mongolia. One letter caught his eye, bearing the crest of the RCVS. So, having poured himself another slug of wine, he ripped open the envelope, digested the contents and slumped back into his chair, crestfallen. Forget microlax enemas, liquid paraffin, or syrup of figs – Fred fully appreciated why a formal complaint from the ‘Beak’ was considered the best possible laxative for any professional. The bullet point unnerved him, an allegation made by Trading Standards that he failed to act with impartiality, honesty and integrity in his role as an expert witness. It made it sound like he should be locked up. Fred recalled how flattered he had been receiving the solicitor’s letter seeking his assistance as a veterinary expert in a criminal case. The lawyer’s client had been found in possession of two Amazon parrots, believed by Trading Standards to have been illegally imported from South America. The defendant claimed he purchased the birds from a breeder and it appeared to Fred all he was required to do was to confirm this was a case of mistaken identity, by confirming the leg ring and microchip numbers. Despite his lack of parrot knowledge, the task appeared simple enough and 72 hours later he arrived at the local police station, as requested, with an air of self-importance. He took a seat in the waiting room, instantly picking up a whiff of l’eau d’ne’er-do-well from his fellow visitors. Distracted by the unexpected sounds of the jungle filling the silence, he soon realised the chap sitting next to him had a noisy cardboard box containing Fred’s witness evidence, albeit only just, given the natural lack of resistance of cardboard to parrot beaks. Accompanied by a detective, Fred examined the birds in the less than salubrious surroundings of a police cell, thereby reducing their chances of escape. Fred suffered numerous bites and indignities for his trouble, but eventually confirmed the presence of rings and microchips on both birds. The defendant’s solicitor was delighted to hear the news and asked Fred to compile an expert report ‘rubbishing the prosecution’s case’. Puffed up with the adulation bestowed by the lawyer, he readily agreed, although later the same evening, having spent several hours on internet research regarding expert reports, he rather regretted his gung-ho decision. However, he provided a report, although acknowledged the £300 remuneration went nowhere, if he calculated the many hours spent agonising over the content and the stationery costs of the numerous drafts sitting in his wastepaper basket. Nine months later, he received another friendly letter from the solicitors seeking his attendance at court. Reading the details, March/April 2017 z Practice Life

he discovered the prosecution had instructed two experts, the first a veterinary surgeon who had disputed Fred’s evidence and his stomach flipped as he realised his opposite number was a parrot specialist. Moreover, despite a frustrating phone call with the solicitor seeking further explanation, Fred was none the wiser as to why the prosecution had also instructed an expert in Portuguese dialects! Fred arrived at the Magistrates’ Court resplendent in his best suit, but his outwardly confident façade faltered slightly on his entry into the witness box as he stumbled through his own evidence and crumbled completely, when the prosecution barrister stood up menacingly to cross-examine him. Each probing enquiry chipped away at the reliability of Fred’s evidence and once released from the witness box, he was visibly sweating and had conceded two major points. First, he accepted his colleague’s opinion that split rings or microchips can be placed at any stage so convey little legal provenance of ownership. Second, the birds were undoubtedly wild caught, given their fluent Portuguese dialect, which Fred now knew was only found in certain areas of South America rainforest and certainly not Birmingham, where the birds were supposedly born and bred. The case was lost. He rang VDS for advice. The consultant was immediately reassuring, but explained the Society had considerable experience of similar complaints involving members whose desire to play the role of Kavanagh QC had only managed to get them into hot water. In addition, due to a recent seismic change in the legal system, experts can now be sued if the other side can demonstrate the evidence was ill-conceived and led to wasted costs. The Society assisted Fred with his response to the RCVS, accepting he had become too deeply involved, but pointing out that the judge had made no criticisms of his evidence. In time, the RCVS closed the complaint with the inevitable advice ‘to always work within your areas of competence’. Delighted, Fred informed the Society and the consultant explained the trick is to remember, irrespective of which side instructs you as an expert, you are solely providing an opinion to assist the Court, a concept difficult to comprehend for many, not least as we run an adversarial legal system. The temptation is sometimes too strong to assist risking losing impartiality in the process, especially if an ingratiating RSPCA inspector or solicitor is breathing down your neck. This is increasingly important now as experts can even have claims brought against them for wasted legal costs if they are considered to have overstepped the line. Fred was directed towards the College and Society website sections explaining the role of expert witnesses in detail, but he admitted that going through the Court mangle once was quite enough for him. In future, he’d leave it to the experts!

HOT TOPIC

RETAINING OUR VETERINARY NURSES: a management perspective Retention of veterinary nurses within the profession has been on the agenda for some time, and, while the figures are ambiguous, it seems the profession faces a continuing shortage of veterinary nurses in practice, impacting the service practices are able to offer the public, and even the future of the vet nursing profession itself. Jill Macdonald investigates.

hether nurses adhere to their choice of vocation is a multi-faceted issue and there are many components that will influence a VN’s choice to leave practice, or the profession altogether. The purpose of this article is to briefly explore how certain practice management activities and considerations can have a positive influence.

Practice and nurse figures While the number of registered veterinary nurses continues to increase (from 12,670 in March 2015 to 14,319 in January 2017; RCVS figures) so does the number of practices (up from 4,926 in 2010 to 5,679in 2016), thus effectively diluting the number of nurses available on a per practice basis. Also, while nurses continue to remain on the RCVS Register of Veterinary Nurses, many may not be practising or available to work in the profession. Of the 14,319 nurses on the register, the work status of 2,400 is unknown (Grainger, 2017).

Impact on practice

Fig. 1. Changes to the practice team can have a big impact

Experienced ‘clinical coach’ nurses are also integral to bringing new nurses into the profession, and to fulfil ambitions such as those laid out in the VN Futures project, in ‘creating a sustainable workforce’ (VN Futures Action Group, 2016).

Let’s be clear – a lack of veterinary nurses has an enormous What happens when VNs leave? impact on veterinary practice. Veterinary practice has moved When veterinary nurses leave a practice, this has an impact forward in the level of service offered to clients and their on far more than just the hours that they contribute to the pets, in terms of the complexity of procedures performed on rota (Fig. 1.). They take with them their skills, expertise, animals (that veterinary nurses are integral in assisting with), experience and knowledge; and, if they’ve been at the practice the standard of veterinary care, such as inpatient and emergency for a while, this may be considerable in terms of understanding and critical care, and client support and procedures available in nursing Frequency % consultations and clinics. 3,644 85.8 Without experienced nurses to perform Better pay/remuneration More responsibility 828 19.5 this work, the service will suffer. The Less out-of-hours/on call 555 13.1 shortage of nurses in practice and, Better work-life balance 1,616 38.0 therefore, the understaffing of many 607 14.3 practices has a further confounding effect, Flexible working hours 280 6.6 in making the working lives of those who Shorter hours Less regulation/bureaucracy 353 8.3 are still in practice much tougher. Longer 547 12.9 hours, lack of colleague support, stress, and More support staff 1,943 45.7 not being able to work at the desired level More respect/recognition from the public Better opportunities for career progression 1,388 32.7 will be the resulting impact, which will 76 1.8 ultimately also drive many of these nurses Other out of practice too. Fig. 2 Data taken from the 2014 RCVS Survey of the Veterinary Nursing Profession Practice Life z March/April 2017

HOT TOPIC

Get vets to do what only vets can do

Many vets in practice will perform nursing tasks, which not only costs more, but takes responsibilities (and job satisfaction) away from nurses. Leaving vets to the diagnosing, treating sick animals and surgery, and encouraging more delegation to the nursing team is a positive and financially beneficial move. Use nurses to full potential

Minor surgery, dental hygiene procedures and nurse clinics – as examples – are tasks that nurses are qualified to perform, and yet often do not. Fig. 4, with data taken from the 2014 Survey of the Veterinary Nursing Profession, demonstrates figures for the three procedures mentioned above. Fig. 3. Clear leadership structure in practice is important

Apply pricing structure for nurse consultations

of that practice in particular. When ‘replacing’ staff, recruitment is difficult, lengthy, time-consuming and expensive. There may well be an upset to the practice team and stability – both when a team member leaves and when another is recruited. Keeping hold of your team members is important for so many reasons!

How many practices charge for nurse consults? If not, why not? This is a professional service that should be charged in the same way as any other, taking into account the costs of providing the service, and also what the client will be willing to pay. Nurses running a whole list of nurse consults at no charge is never going to provide a solution to poor remuneration.

Why are VNs leaving?

Be a ‘part of the business’

If we take a look at the latest RCVS Survey of the Veterinary Nursing Profession (Williams and Robinson, 2014), in terms of retention, the most useful table of data to examine shows responses to ‘What would, for you, make the profession a better place in which to work?’ (Fig. 2) The four highest scoring responses are highlighted. All of these factors may have solutions, or at least partial solutions, available via an approach from a management perspective.

Involving nurses in discussions on costs, and what needs to happen to make the practice succeed as a business, will help develop financial awareness. Nurses have lots of wonderful revenue-creating ideas – they just need to be given the opportunity to share them.

Fundamentals Often lacking in practice is a clear management structure that offers team members leadership, definition, and clear processes in practice for dealing with the many complex issues they may face (Fig. 3.) While this cannot be easily resolved it is worthy of mention. Those practices with a clear team structure, a strong team ethos, and processes in place to support and help teams progress, are surely more likely to have much higher staff retention rates.

Pay and remuneration While a complex topic that cannot be addressed in a few sentences, there are simple ways in which practices can use nursing expertise to the practice’s best advantage, and using team members more appropriately will be more cost effective while also providing greater work satisfaction.

Work-life balance Too much focus on work with not enough time dedicated to life outside work has obvious implications, and activities such as time with family and friends, and being able to ‘develop and maintain close personal relationships’ are a significant contributor to wellbeing. (Bartrum and Boniwell, 2007). Poor work-life balance has many root causes, one of them being poor staffing levels; however, there are some principles that can be instilled into practice ‘ethos’ that can help. Flexibility with working hours

While we need a rota to ensure that cover is consistent, applying a little flexibility can go a long way in improving working life for staff, such as working longer shifts on some days and having a half day off, or allowing time off when the practice is quiet. Instil principles of boundaries

For a healthy life, boundaries must exist for when work ends and home life starts. This is something that can be discussed

‘Please indicate which of the following clinical and non-clinical work you undertake in practice, and how often’ Every day (%) Several times Once per week Rarely (%) Never (%) N= per week (%) or less (%) Nursing clinics/counselling Performing minor surgical procedures Dental hygiene work

28.9 3.7 4.9

28.7 3.7 15.7

Fig. 4. Indication of frequency of certain nursing tasks (Williams and Robinson, 2014) March/April 2017 z Practice Life

14.8 9.3 23.9

14.2 13.5 4,174 29.6 53.7 4,173 26.8 28.7 4,172

HOT TOPIC

with the team, allowing them to consider ideas such as banning work emails at home, not texting each other with work problems, and management not contacting staff when they are on leave. Helping staff to deal with emotionally challenging situations, and providing support, so ‘work’ is not taken home, will also contribute. Recognition from the public

Improving public recognition of the veterinary nursing profession is the responsibility of the whole profession; however, I believe this starts in practice. Practice image

Having a clear ‘practice ethos’, and considering how the practice is portrayed to the public, including how it values its nursing team, is imperative. Consider how nursing staff are spoken to, spoken about, given responsibility – by vets and managers. Website

Veterinary practice websites vary tremendously in quality and content, but astoundingly, many sites do not include the nurses when listing their team members. Consider how this looks and feels to the nurses on the team and also the public. Not including nurses on the practice website is not an option!

Career progression The veterinary nursing profession currently has a rather undefined career structure. While many opportunities for different careers and further educational qualifications do exist, these are not necessarily overt or available to many nurses in veterinary practice. As the Vet Nursing Futures Project Report discusses, ‘survey work suggests that it is ‘opportunities for career progression’... that are the biggest determinant of whether

career expectations when entering the profession are met or not,’ and there are ways in which practices can help nurses identify and follow career options. Regular appraisal and CPD planning

Performance appraisal allows team leaders to identify team members’ aspirations, and construct a mutually agreed plan to best enable career desires to be met. Recent proposals from the RCVS on CPD development, suggesting ‘planning, doing, recording and reflecting’ (RCVS, 2016) also align with the concept that CPD should be planned and part of a holistic picture, rather than isolated learning that may not help the team member (or the practice) in their everyday role or career plan.

Leadership While leadership skills are vital for those in a senior position in practice they are also of great value to any team member. Learning skills such as time management, delegation, effective communication in difficult situations, coaching skills and self-motivation will improve any team member’s performance, outlook and resilience in practice.

Summary The picture of veterinary nurse retention in the profession is complex. The approach to address this needs to be from both ends of the veterinary nurse journey – in encouraging new nurses into the profession and supporting training, and in keeping them in nursing, and in encouraging return to the profession after career breaks. Those managing staff have a duty to ensure that as many opportunities as possible are explored that provide a supportive and nurturing environment, upholding job and career fulfilment, and in keeping our nurses in nursing.

References are available for this article – email helen@mojoconsultancy.com or visit www.mojoconsultancy.com

WHAT THE ASSOCIATIONS SAY ABOUT RETAINING VETERINARY NURSES What the BVNA says... It is certainly not a new issue that there is a lack of RVNs available in the recruitment pool; however, there are many RVNs qualifying each year. The problem lies in the retention of all these RVNs within the profession. BVNA’s VN Voice poll suggested that around 15% of respondents were unsure whether they would be in the profession in five years’ time, for example. When speaking to BVNA members, the problem is not flagged as being all about pay, although of course that is mentioned (especially the wide variation in regional pay), along with a lack of differentiation between qualification levels and number of years qualified. To retain RVNs within practice we need to think how we can develop and use

the individual’s skills that will add value to their job role as well as to the practice. In a separate VN Voice survey, 24% of respondents cited that feeling unappreciated/undervalued for the work RVNs do causes them to leave the profession. Similar figures were also seen for the hours an RVN works, and these hours not being flexible or family-friendly. BVNA does hear about practices not being able to accommodate flexible working; for example, only 5% of veterinary nurses return to work after maternity leave. There will of course be other reasons, besides children, for RVNs wanting the ability to alter working patterns. Becoming a qualified veterinary nurse involves much ‘pain and stress’ and there is a certain expectation about career progression for a profession such as this; however, once qualified, there are limited opportunities to progress or take on more responsibility with the role in practice. It is understandable that nurses leave the profession in our view.

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HOT TOPIC

VPMA President Renay Rickard says... When I talk to nurses who have left the profession, the main reason they give for leaving is that they did not feel valued and could see no way to progress. There has to be a shift away from practices seeing nurses as a “cost” and move them into the fee-earning profit area of the balance sheet. Nurses are professionals and their time should be charged for, and, therefore, seen as valued. Widen the services your nurses offer to clients, and make sure

you develop them! Clients will ask nurses things they feel too stupid to ask a vet... so raise the profile of practice nurses and let them run their own consults... there are benefits all round. The business will see increased revenue, the nurse will see development of his or her role and the development of their own client base. Clients will see an increase in services, which are charged for but affordable, and animals will benefit as they receive the best level of care provided by the whole practice team.

Liz Cox RVN, Chair of VN Council and co-chair of the VN Futures Action Group, says... The research we conducted ahead of the publication of the VN Futures Report suggested that there are two key reasons why veterinary nurses leave the profession: lack of career development and opportunities and also not feeling well supported or used within their role.

For the latter issue, solutions could include providing better mental health support, flexible working so that family and other demands can more easily fit around working life, and making sure there are development opportunities so that veterinary nurses do not feel ‘stuck in a rut’.

For the former we identified the need for veterinary nurses to receive more leadership and management training so that they feel confident to move into managerial positions and have the knowledge and the skillset to meet the challenges that this can bring, as well as providing greater support for nurses in areas such as continuing professional development.

Key to all of this is to make sure there is a working relationship and that, through processes such as regular appraisals and one-to-one meetings, veterinary nurses feel willing and able to talk about their career ambitions and whether they are finding work and managers and employers are willing to listen and act on concerns and suggestions.

On nurse retention, SPVS says... There is no doubt RVNs are valuable assets to veterinary practices and it is concerning that many of them, sadly, choose to leave after only a relatively short time in the job. RVNs are highly trained professionals and capable of fulfilling many and varied roles within practice, and the development of such staff is to be encouraged. Veterinary practice owners are in a position to influence RVN numbers, not only by being involved in training, but also by helping to promote veterinary nurses within practices in terms of individual career progression as well as enhancing of the value of RVNs to clients – and of course making clear the distinction between those

March/April 2017 z Practice Life

who are qualified RVNs and non-qualified staff. Additionally, being prepared to look at working patterns that fit in with family life is important, although that requires a reasonable approach by all parties. SPVS is working with the VN Futures group in areas related to training, career development and leadership, but is also looking at ways to encourage practices to really make the most of their RVNs – such as making them into fee-earners and considering putting a real financial value on veterinary nursing time; charging appropriately for the services of our co-professionals ought to improve profitability and, potentially, allow enhanced remuneration which, in turn, should improve retention.

WELL-BEING

SPVS WELLBEING AWARDS 2016 Winners of the inaugural SPVS Wellbeing Awards, run in partnership with the RCVS Mind Matters Initiative, were announced during the joint SPVS-VPMA Congress held in January this year. Emma Dahm reports. Wellbeing Award winners, from left: Ed Newbould, Hamish and Rachel Duncan, Ryan Jones, Nichi Tanner and Beckie Chandler.

he Wellbeing Awards acknowledge veterinary 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, bringing the concept of wellbeing in practice to the fore. There are three categories practices may enter, based on the number of full time equivalent employees. The winners for 2016 are as follows. • Large Practice (51 or more staff ) – White Cross Vets, which employs 175 people across 16 sites around the country; • Medium Practice (between 16 and 50 staff ) – Valley Vets in Cardiff; and • Small Practice (up to 15 staff ) – 387 Veterinary Centre in Walsall, West Midlands. The judging panel scored practices for internal communication, opportunities for training and development, team building and networking, and initiatives to reduce stress and promote wellbeing and resilience.

Nick Stuart, SPVS Wellbeing Awards Lead and MMI Task Force Member, is keen to highlight how the awards focus on practices that are doing great things to motivate and engage their teams already on a day-to-day basis, and to use these to showcase to other practices gestures and processes that help reduce stress for staff and increase engagement. He says: “The winners all clearly demonstrated the importance of engaging with their teams. Clear values and protocols were backed up with effective training and mentoring to produce engaged and productive teams. It was fantastic to see how much time they have invested into making their practices fun places to work.” Stephanie Writer-Davies, outgoing SPVS president, presented the awards during the opening ceremony of VPMA/SPVS Congress 2017 at Celtic Manor near Newport on January 27. The winners then shared their best ideas at a panel discussion in the Mind Matters Initiative lecture stream, chaired by Dr Radha Modgil, GP and co-host of Radio 1’s The Surgery. Practice Life z March/April 2017

WELL-BEING

SMALL PRACTICE WINNER 387 VETERINARY CENTRE IN WALSALL, WEST MIDLANDS

387 team from left: Jo Civil, Jodie Barnfield, Nicky Smith, Hamish and Rachel Duncan.

387 Veterinary Centre won the Small Practice category.

Owners of 387 Veterinary Centre, veterinary surgeon Hamish Duncan, and his wife and practice manager, Rachel, believe that good communication and mutual appreciation is key to wellbeing in the practice. The centre has grown from a one-vet, one-nurse, part-time receptionist start-up in 2007 to a 12-strong team. With that growth the team dynamics have changed. Rachel explains: “Excellent communication is so important. We’ve discussed as a team how to ensure all staff are well informed, be they part-time or full-time, clinical or nonclinical. We hold bi-monthly practice, clinical, nursing and vet meetings to share learnings and discuss issues. All staff are encouraged to add to the agendas and contribute ideas or knowledge, and we nurture a culture where everyone’s voice is equally valuable. “We introduced a ‘gratitude board’ to encourage team members to appreciate each other more, and for vets and nurses to share positive feedback from clients. It has had quite an impact and I hear people saying thank you to each other around the practice much more now.” The directors were inspired to take action and improve wellbeing in their practice after attending the VPMA/SPVS Congress last year. As a starting point they arranged one-to-one mentoring for their head nurse with Carolyne Crowe to help with time management, team motivation and inclusivity. This, they said, noticeably reduced the stress associated with managing the nursing team.

March/April 2017 z Practice Life

Going further Other initiatives taken by the 387 team include the following. • DISC profiling – to aid understanding and acceptance of different working approaches towards a common goal; • Staff members sent on a Managing Difficult Situations course to learn how to handle conflict effectively; • Directors undertook Myers Briggs training to learn how to encourage different personalities to gel; • Mindfulness webinar series purchased for all staff; • Whole team bereavement and end-of-life compassion training; • Introduction of ‘significant events’ meetings after an unexpected clinical case outcome, where staff can review the events with colleagues and share thoughts and feelings, to help reduce the risk of compassion fatigue; • Investors in People accredited since 2013, using the framework to drive leadership, motivation and support strategy; • Six-monthly appraisals and reviews of personal growth and training opportunities; • Staff encouraged to nurture their areas of expertise to develop a sense of ownership, pride and client bonding; • Portfolio of social events, including Christmas meals, celebratory get-togethers and less formal events such as a skin care party; and • Accommodating work-life balance on request from the nurses by changing the rota to four-day working weeks.

WELL-BEING

MEDIUM PRACTICE WINNER VALLEY VETS, CARDIFF Valley Vets is an established practice, having provided veterinary care in south Wales for over six decades, but have always strived for improvement and progress. The team is very loyal and most have worked with the practice for many years. Nichi Tanner, RVN and practice manager at Valley Vets, said: “We recognise that the very nature of our work is highly emotional and this can be exacerbated by our personal lives, the volume and complexity of our work and our own mental resilience at any one time. “We foster a culture of communication and support. We celebrate our successes with one another by feeding back positive comments from our clients and other staff members to the team. We also publicise our successes on our social media pages and website.” A strong ‘no blame’ culture is encouraged in the practice, which acknowledges that people may make mistakes, but that it is important to turn each incident into a learning opportunity. Any trends are investigated, but staff are able to openly discuss mishaps with colleagues. It is well recognised, says Nichi, that raised awareness and a willingness to talk results in reduced stigma and increased capacity to recognise early signs of stress. “It took a while to get away from the ‘telling someone off’ culture when something went wrong, but now we have feedback sessions as to why we all think it went wrong and where improvements could be made to learn from for future. “We are all here to do a good job; if we do something wrong we feel badly enough about it as it is. The ‘no blame’ culture and open discussion helps people not to go home with things on their mind or feeling they will be in trouble,” says Nichi. Maintaining good communication within the teams and branches is a recurring theme for Valley Vets. The sharing of CPD training courses among staff is also encouraged, with the course attendee writing up a report that is then put on the intranet, and discussed at meetings. Other initiatives by Valley Vets to encourage wellbeing include the following. • Regular 1-2-1 conversations, branch meetings, team meetings and use of the intranet;

Nichi Tanner of Valley Vets (centre), winners of the Medium Practice category.

• Active social calendar, funded by the company, including summer and Christmas parties and events such as hiring speed boats and a one off trip to Paris; • Attending a Mind Matters roadshow, which led to the whole team undergoing similar training with a Mental Health First Aid England trainer; • ‘One team’ approach with no hierarchy, so vets, VNs, ACAs and receptionists are equally respected; and • Focus on everyone being approachable so that no one feels unable to say sorry, and every member of the team feels respected and valued.

FUTURE OF THE AWARDS The SPVS Wellbeing Award winners all clearly demonstrate how they are promoting wellbeing in practice, but it doesn’t stop there – much is to be learned from the highly commended entries too, all of whom presented novel and innovative ways to engage, motivate and acknowledge staff contribution. Nick says: “A key objective of the awards is to share what our winners and highly commended entries are doing well. The best ideas will be posted on our website and shared through various

events and via the other veterinary associations throughout the year.” The inaugural Wellbeing Awards proved a huge success and plans for the 2017 awards are already underway. Take-home messages from the winning practices are clear and anyone can introduce small gestures and processes within practice, so why not give it a try? Visit the website for details www.spvs.org.uk Practice Life z March/April 2017

WELL-BEING

LARGE PRACTICE WINNER WHITE CROSS VETS

White Cross Vets employs 172 people across 16 sites around the country and has one support office in Leeds. The culture at White Cross Vets is based on their four cornerstones of communication, wellbeing, reward and recognition, and life experiences. Communication sits at the heart of White Cross Vets’ strategy and has led in no small part to the group winning the SPVS Wellbeing Award for the large practice category. Being acknowledged for great leadership and team satisfaction, however, is not a new experience as White Cross Vets is the only veterinary practice to achieve three stars in the list of the Sunday Times’ ‘100 Best Companies to Work For’ – and for five years straight. Tim Harrison, managing director of White Cross Vets, admits that not all their ideas promoting wellbeing in practice were self-generated. He says: “The idea of a day off on your birthday and a birthday cake came from Timpsons, the shoe repair and key cutting chain. Initiatives like that cost very little but mean a lot to your team. “It’s not just about how employers should behave morally, however, it makes pure business sense in a people-led profession where there is a shortage of vets and nurses. If you look after your team you will reduce turnover and that’s good for morale, good for your clients and, ultimately, good for your profitability.”

Communication Keeping in touch across 16 practices as well as between team members within each one calls for a robust communications strategy, which is, appropriately, headed up by an e-newsletter Briefly Connected and twice-yearly printed magazine Connected. Running alongside are twice-yearly ‘Voice’ meetings where representatives from each practice discuss where and how improvements may be made, along with ‘Ask Tim’ sessions which encourage team members to question the managing director with no topic off limits.

Wellbeing White Cross Vets is keen to acknowledge that work-life balance is key to wellbeing so offers a comprehensive benefits package to their team, including a day off for birthdays, CPD leave, a sickness scheme, and donation days, along with incentives for physical wellbeing, such

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Ed Newbould (centre) receives the award for White Cross Vets, winners of the Large Practice category.

as a contribution towards gym membership. Each team member has been funded to complete a series of mindfulness webinars, along with the leadership team undergoing training to understand mental health, to ensure that mental health is in the forefront of people’s minds and help and support is available.

Reward and recognition Team members undergo training alongside mandatory clinical CPD, including completion of the ILM certificate for all leaders, and the NVQ programme for client care coordinators (receptionists). An annual congress features an awards dinner to thank the team for their hard work. White Cross Vets has introduced its own currency, known as the ‘Alfie’ (courtesy of Tim’s whippet). Each team member receives five Alfies per month, which are given out to colleagues as a recognition and a thank you. The vouchers can be donated to charity or exchanged for shopping vouchers.

Life experiences The above and beyond element of working for White Cross Vets has to be the investment in building the culture through travel incentives, such as funded CPD trips to Monaco and Nice, a team raffle for six places at the NAVC in Florida, the ‘Dream Location’ draw where the winner will spend two weeks in any worldwide destination – this year the winner is visiting Australia.

MANAGING PEOPLE

PREPARING THE TEAM FOR PSS ACCREDITATION Taking on the RCVS’ Practice Standards Scheme accreditation process is no mean feat and Stuart Saunders, practice manager and VPMA board member, reveals how his team coped with the challenge and came out smiling

ur practice has been a member of the PSS scheme for a very long time – almost from the scheme’s inception, I believe. We are a mixed practice of more than 60 staff in total and consist of a hospital, a core-standard branch and a GP-standard farm and equine department. The partners, staff and I think it is really important that we maintain our status as a hospital as it gives our clients some feeling that they are coming to something that has a status, that is independently audited, and so means something. And our staff have a huge sense of pride that they work in a PSSaccredited practice. As we are a reasonably large mixed practice we have the inspection over two days, which fell in January this year. I am sure that every PM will say whatever the time scale was, it wasn’t ever enough! We have had a series of conversations with the RCVS as we have undergone a huge amount of change this year, so it was always going to be tricky to achieve. But, realistically, we have had six months to get ourselves together for it.

Planning for inspection No matter how far in advance you know about the inspection, there will always be last-minute preparation to do – new staff joining will not be as familiar with everything as the old hands, for example. That being said, the old hands need a refresher too. Some of the stuff we had loaded up initially was then out of date when we reviewed it. All our service dates and PAT testing fall in December so where we thought we were ahead of the game there is a sudden sinking feeling that you are behind the curve again, but it really is as simple as starting at the beginning and being methodical! This is ‘only’ my third PSS visit so it isn’t quite so daunting this time. The guidance from the RCVS is reasonably clear – it is important to read the manual properly a number of times just to make sure you understand what is required, but there isn’t much room for ‘interpretation’.

Tips for practices going into PSS If you are a practice manager, you may feel you need to take on the full burden of the PSS. Don’t try to do it all yourself – it is too big a task and it is meaningless if done that way. Everyone should understand what it is about and the best way to get it to work is to involve as many people as possible. As a practice manager, there are sections which I feel definitely fall to me to complete, but there are others where I think it is my job just to pull the information together from the rest of the team. It’s helpful to bear in mind that joining the PSS can be a positive experience – the inspectors do not want

to trip you up – they want you to pass and they will make themselves available for advice prior to the meeting. The point of going through the process is to recognise the things you are doing well and show you where you may need to improve – usually through some small tweaks rather than wholesale reorganisation. The VPMA forum is a hugely helpful resource containing boundless information from those who have gone through PSS and are currently going through it.

Engaging the team I am not saying the way we did it would work for everyone, but it started with a meeting between myself and my head nurse – we looked at what was involved and then we looked at the team and discussed who would be best at each particular section. Sometimes we chose just one person, such as for the imaging element, but other sections had two or even three people involved. Each person had the rest of their Practice Life z March/April 2017

MANAGING PEOPLE

team to help them if they needed it. We had this meeting early on in the process and then, as the team worked through the requirements, they emailed me the bits that they had completed. The head nurse and I had a meeting with all the vets and nurses where we talked about the PSS and we also checked that the people we were going to assign areas of responsibility to understood what was expected of them and the timescales involved. I was very lucky in that I have a colleague, Alison Daubney, who took on the farm and equine side of things, allowing me to concentrate on the hospital and the branch. There are some protocols, such as lone working, that we reviewed and worked on together, but there were others where we just stuck to our own teams. I work very closely with Alison on a day-to-day basis and am lucky to have someone of her talent watching my back and making sure I don’t drop the ball when it comes to these things.

The pinch points Even though we split the work up among the team, it was sometimes difficult not to feel swamped. It is a lot of work and it is always better to do it in bite-size pieces, then go back to review it closer to the end of the process. I would say the biggest issue for us was time management. I don’t have a full-time small animal partner on site, so all non-clinical decisions sort of end up with me. So juggling that with the other projects alongside the PSS has been a little tricky and, in hindsight, I could have

managed it all a little better by not bringing in so many projects at the same time.

Summary I hope that by involving more of the team than I have previously, they are all more onboard with what it means to be a hospital. They are a fantastic team and they have been through a tricky year of change, with a new PMS, health plans, insurance, interest-free loans, some staff changes and expansion, building works as well as a fire, powercuts and lightning strikes! When I think of the year that they have had I think they will find the inspection a doddle. I am now looking forward to next year where I can really focus on the staff again.

The follow-up The inspection was, as suspected, stressful. There were a few bits and pieces to tidy up on but the inspector said we were as good a practice as he had seen and that he has never passed anyone without some bits to do. Most of the suggested changes were completed before the inspector left – with the exception of the periodic electrical inspection, which was booked in but hadn’t taken place. The inspector suggested the practice should put in for some of the Practice Standards Scheme Awards too.

Stuart Saunders Stuart Saunders has been a practice manager for veterinary practices since 2007 and looks after a three-branch mixed practice in Devon, Coombefield Vets. Prior to that he had a long career as a broker in the City of London and Hong Kong, trading in both European and Far East markets. Stuart is hugely motivated by the veterinary industry – but not from a clinical point of view – his passion is the team and the service they can deliver to clients. March/April 2017 z Practice Life

CLIENT CARE & MARKETING

It’s time to do a millennial (v.)

rather than be a Millennial (n.) The mythical ‘Millennial client’ is putting the wind up many a veterinary practice, but there is no mystery behind how to please them, explains Alison Lambert, MD at Onswitch.

arketers and social commentators have been talking about the Millennial generation for a while now; young people reaching adulthood in the 2000s. Understanding how these bright young things act and behave has become a huge focus for research agencies and business strategists, and, to date, this knowledge seems to have boiled down to the fact that they use the internet, like, all the time. Nobody would disagree that the internet plays a central role in modern life, especially social media and mobile connections: the statistics speak for themselves. According to 2016 research published by Go-Gulf, every 60 seconds online the following happens: • Google processes 2,315,000 searches • 300+ hours of videos are uploaded to YouTube • More than 3,000,000 posts are shared on Facebook • 26 new reviews posted on Yelp • More than 150,000,000 emails are sent • 430,000 tweets are generated on Twitter • 44,000,000 messages are delivered on WhatsApp • 48,000 iPhone applications are downloaded, along with 95,000 Android apps • 100 new domain names are registered And yet these behaviours don’t just belong to the younger generations, as wide-ranging research commissioned by Metro and MailOnline (who together claim to reach 80% of Millennial customers every month) finds there’s not such a big difference in how the different age groups behave. For example, when asked whether they agreed with the statement, “I genuinely enjoy online research as part of the shopping experience”, 68% of younger Millennials agreed, as did 67% of (older) Generation X (source: www.millennialrules.co.uk).

Millennial is doing, not being I’d like to propose that we review how we, as business owners, practice managers and sometime marketers view the changing demographics of our clientele. Inevitably your client base will begin to shift towards the younger age groups as the years relentlessly march on. And inevitably you should be using different language and communication routes from those you used 10 years ago with older customers who had no idea what Facebook was (not that we could blame them, it was only two years old at the time.) But you shouldn’t view or treat them any differently from non-Millennial clients, because we’re all millennial now. Being

Are Millennials really any different from us old codgers, asks the author

‘Millennial’ isn’t a demographic grouping, it’s a lifestyle choice that we’re all making. Googling new practices, shopping online, arranging dates through apps and checking Trip Advisor before booking a weekend away or a meal out. These are behaviours that all your clients have embraced, so your practice marketing must do the same.

Communicating millennially It goes without saying that you should have a practice website. It should go without saying that it ought to be refreshed regularly – monthly blogs, links to Facebook posts, team updates and seasonal focus all show the casual internet browser that your business is fresh and forward-thinking. ‘Latest news’ that relates to 2015 gives the impression that you don’t quite get it. Instead, allocate someone responsibility for keeping your website refreshed with new content, be it patient stories, competitions, practice news, local issues or seasonal topics. Practice Life z March/April 2017

CLIENT CARE & MARKETING

New content is one of the factors that Google’s search algorithm looks for when prioritising rankings, so you’ll also be ensuring that your practice pops up in the top search results when potential new clients look for ‘vets in [my town]’. It’s also important to make sure that your website is optimised for viewing on mobile devices – if not, visitors will soon give up trying to make sense of pages that scroll down forever and sentences that jump about on the screen. Any local web designer can sort this out for you, but don’t be tempted to think it doesn’t matter. Ofcom data shows that 66% of people use their mobile to access the internet (up from 57% in 2014 and 61% in 2015). This proportion is only going to increase further (source: media.ofcom.org.uk/facts). Get social. You simply have to be on Facebook at the very least, but as with your website, having a Facebook page but never using it speaks volumes about how your practice feels. Onswitch business metrics recommend recruiting 1,000 Facebook friends for every Full Time Equivalent vet at your practice in order to benefit from their word of mouth recommendation and active engagement with your team. With the average UK Facebook user having 155 friends, it’s easy to see how every one of their likes and posts on your page get your practice seen by many hundreds of potential new clients. So post cute pictures, fun facts and inspiring stories that people will want to share. You can also pay for targeted Facebook advertising in order to maximise your social media presence; I know from personal experience just how cost-effective and immediate this is and so I would highly recommend setting this up. Speak your clients’ language. (And I’m not talking going all YOLO and FOMO here). The internet has made us all experts, but with constant access to spin and marketing we have also become a little cynical and harder to please. Keep your online communications friendly and warm but professional. Show that you really care with examples of the services you offer rather than the number of letters after your name. Opening late and at weekends, letting working clients drop their pre-operative pets off the night before and having a truly open-door policy for anyone wishing to pop in and look round all demonstrate that you really understand. Make life easier. Contactless payments are now hugely popular, yet how many of you offer them? Smaller impulse treats and toys at the reception desk, not to mention worming tablets and flea treatments, can be bought quickly and easily in this way (think WHSmith’s £1 chocolate offers at the till). Offering clients the ability to shop for food online with you, and have the large bags delivered for free, will be hugely appealing to dog owners and the goodwill it generates is impossible to put a price on. Collect patients or offer home visits in the evenings – anything you can do to deliver convenience (the number-one factor when it comes to choosing a practice) and stand out from the crowd. Branding is key. When there’s so much choice available to owners and potential clients, the customer experience becomes

Millennials are uber-connected to the digital world

a real differentiator. Your logo may look minimalist and modern, but if your customer care is stuck in the dark ages your brand is devalued. Conversely, if your team are amazing but your signage is scuffed and faded, passers by won’t look twice at you. Millennials (and that’s all of us, remember) expect consistency in the brands we use. John Lewis does this brilliantly, online and in store are integrated seamlessly both visually and in terms of the user experience.

We’re all millennials now I hope I’ve shown that there’s no need to be wary of the Millennial customer; she’s not a secretive person you can’t identify with, she’s me, and you. Marketing to millennials simply means communicating in a millennial way – using online and social media naturally and cohesively to deliver your practice branding and client communications consistently and clearly. Just don’t try to be too clever; we’ll see through it and it will put us off. Show us that you’re just like us – except you get to express anal glands. YOLO :-)

Alison Lambert, BVSc MMRS, Managing Director, Onswitch After qualifying in 1989, Alison worked in practice for several years before pursuing a business career with Hills Pet Nutrition and MARS. In 2001 she established Onswitch – providing research, marketing, CPD and business consultancy for vets. Alison lectures at The University of Nottingham Vet School in Customer Understanding. www.onswitch.co.uk March/April 2017 z Practice Life

CLIENT CARE & MARKETING

MARKETING EXTRA: VET ON THE RADIO Ian Wolstenholme, Practice Life editor and practice manager at County’s End Veterinary Practice, reveals how his practice got involved with the local community by taking up a weekly radio slot hat on) I was conscious of the potential pitfalls of live radio I’ve had a few different jobs before so we all agreed some basic ground rules such as no phone-in settling into veterinary practice just over a decade ago, and it’s strange how and, if there were any listener questions, we should see them in advance to prepare accurate answers. Better still, we could plan those earlier skills that appeared to bear no relation to the role have led to specific themes and build much of the practice marketing and social media strategy around this monthly landmark. something that benefited the practice Six months down the line we have built an excellent over the past year. For around 25 years relationship with Oldham Today presenter Dave McGealy and I was actively involved in what could be described as “the popular keyboard latest figures indicate that the slot has around 22,000 listeners! Oldham Community Radio 99.7 FM was a gold award winner world” via radio broadcasting, print Katie Ford at the National Radio Awards in 2016. journalism and concert performance. The station’s output is archived online so we even get I decided to cut back the interest due to the all-engrossing repeated regularly. It really is a win-win situation and I would nature of practice management. encourage practices to explore this ideal source of PR at zero After a successful client evening on the subject of pet cost, apart from, in our case, an hour of vet and manager poisonings last April, I contacted our local community radio time. That said, what is difficult to quantify is just how much station to see if they would like a review. I suggested that our vet, Katie Ford, might like to explain how it had gone, since she alternative revenue comes through the practice door from had done much of the presentation to an enthusiastic audience. these broadcasts! Oh yes and guess what? Now I’ve been asked to produce and Reluctantly she agreed and a very simple telephone resume present a new series of keyboard music shows for the station. during the station’s morning magazine programme ensued. Like I said, funny how all these jobs and interests come full A week or so later the radio station manager rang to ask if circle. If you would like to have a listen to some of Katie’s vet Katie would like to do a regular monthly “ask the vet” slot and slots here is a link: much to my surprise, Katie jumped at the chance, with the Medivet_Practice_Life_15_Mar:Apr17.pdf 1 05/01/2017 13:00 proviso that I go along for moral support! Of course (with PM https://soundcloud.com/user-791592706/katie_ford_vet_slot_january_2017

Over

practices form the Medivet family

… ating celebr SUC OUR

thank you...

C E SS

Do you want to be part of something amazing?

Contact Daniel Preter today on 01923 470 046 – he’d be delighted to hear from you. vetrecruitment@medivet.co.uk www.medivet.co.uk

Practice Life z March/April 2017

BUSINESS HEALTH & FINANCE

DISPUTE RESOLUTION:

WHAT ARE THE ALTERNATIVES TO COURT? It is likely most managers will experience disputes in the practice and resolving them is not always straightforward. Rachel Crean, dispute resolution solicitor, offers insight into alternatives to going down the court route.

Before you lock horns consider an alternative way to resolve your dispute

ost of you reading this article will be veterinary practice managers or those involved in management in one form or another. Your roles and, at times, your clients, are demanding. I suspect you spend much of your energy ensuring that your many spinning plates keep doing just that. So when the prospect of litigation looms, whether it be the need to escalate action against someone else – for example, someone who owes you money or has provided a poor service, or in the form of a claim against you, it will be the last thing you need. This article considers some of the settlement options available to you and addresses the following questions: • What is settlement?  • What are the potential routes to achieving settlement?  • What are the non-court alternatives to settlement? • Is settlement always appropriate?

What is settlement? The alternative to pursuing a legal case all the way to trial is to seek to reach a settlement. Settlement involves you agreeing to accept less than you initially wanted to achieve, ideally in exchange for concluding the dispute swiftly and without incurring significant costs. For example, someone may owe March/April 2017 z Practice Life

you £10,000 but you agree to accept a discounted sum of £7,000 in full settlement of the debt. You would have lost out on £3,000 but you would have gained certainty and a prompt payment, while avoiding the costs, stress and time commitment associated with litigation. Generally, both parties will need to be willing to move from their original position for this to be achieved. Settlement is particularly important where you have an ongoing working or other relationship with the other party. For example, the other party may be a supplier you wish to continue working with, a client whose business you wish to retain, a landlord from whom you will be renting premises for years to come, or simply someone you expect to encounter on a regular basis due to the proximity of your homes or workplaces. A further advantage of settlement is that you can resolve the dispute in ways that a court would never order. For example, you may agree to waive payment for a historic invoice in exchange for a commitment that 10 new orders will be placed.

Routes to settlement There are a number of routes to achieving settlement, including the three described below. The most appropriate route will depend on factors such as the sums at stake and the relationship between the parties.

BUSINESS HEALTH & FINANCE

“If legal issues arise, bear in mind that free advice may be available to you – for example, from your membership organisations or Citizens Advice – or that it may be appropriate to seek specialist advice at an early stage” Going to court is not the only way

Negotiation

Non-court alternatives to settlement

There are no rules around the process to be followed when seeking to negotiate a settlement. It can be carried out face to face, via telephone and/or correspondence. You may negotiate directly with the other side or involve lawyers.

If settlement discussions are unsuccessful, you may wish to consider referring the dispute to a third party. Some example options are listed below. Expert determination

Facilitated discussion

Broadly speaking, facilitated discussion means involving an independent third party to assist your communications with the other party. The facilitator’s role may be to pass messages between you, or to attend a meeting with both of you to help facilitate constructive discussion. Ideally, the facilitator should be someone whom you both respect – for example, a mutual colleague/fellow professional or someone from a representative organisation.

In summary, the parties agree to appoint an expert third party to settle the dispute. For example, if you were in a dispute with a former partner about your partnership accounts, you may wish to jointly appoint an accountant with experience of assisting veterinary partnerships to determine the dispute. An agreed set of papers would be sent to the expert, and both parties would usually have the opportunity to make additional written representations.   Arbitration

Mediation

Mediation is a more formal version of facilitated discussion as it again involves a neutral third party assisting the parties to communicate with a view to reaching a settlement. Mediator costs would generally be split between the parties to the dispute. There is complete flexibility as to the process, and the mediator can guide you through your options as the mediation progresses. There will often be a combination of joint and separate meetings between the parties and the mediator, followed by the mediator working between the two parties to relay messages, offers and counter offers. Tips for settlement negotiations include the following: • explicitly state that any settlement discussions are confidential and “without prejudice” to the legal dispute; • document any settlement reached, obtaining the signed agreement of both parties; and • if settlement discussions are initially unsuccessful, this does not mean that court proceedings are inevitable – you can settle at any point prior to judgment being given by the court. For example, if settlement is not achieved during mediation, it is relatively common for disputes to settle in the following days or weeks.

Arbitration is a less formal version of court proceedings, which takes place in private. The arbitrator determines the process to be followed, which may involve witnesses giving live evidence. The arbitrator is often a practising or retired judge or senior barrister. Given the similarities with court proceedings, costs can be similarly high.

Is settlement always appropriate? The short answer is no. Settlement may not be feasible if there is no middle ground. Further, you may wish to pursue the dispute all the way to trial in order to set a precedent for other potential claims. If legal issues arise, bear in mind that free advice may be available to you – for example, from your membership organisations or Citizens Advice – or that it may be appropriate to seek specialist advice at an early stage.   Biography Rachel is a partner in Veale Wasbrough Vizards’ commercial litigation team, based in London. Prior to joining Veale Wasbrough Vizards in January 2017, Rachel led the dispute resolution department at Lockharts Solicitors. Rachel trained at a niche healthcare law firm and, since qualification, has specialised in healthcare-related litigation and dispute resolution, with a focus on primary care. rcrean@vwv.co.uk / 020 7665 0950.

Practice Life z March/April 2017

PRACTICE DEVELOPMENT

New to the

Practice Standards Scheme Applying for awards through the RCVS’ Practice Standards Scheme is enough to sharpen any team’s wits, but the benefits go beyond accreditation, explains Helen Boyd, an RVN at Macqueen Veterinary Centre.

The practice team

acqueen Veterinary Centre is a purpose-built independent practice based in Devizes, Wiltshire. We have recently attained our hospital status. It’s a small animal practice of first opinion and orthopaedic referrals run by a husband and wife team, Ian Macqueen being the orthopaedic surgeon and Jacky Macqueen being practice manager and surgical vet. The practice has a total of 40 full and part-time staff, consisting of 10 vets, 17 nurses, eight receptionists and five people working ‘behind the scenes’. Day-to-day operations are split out between five nurses on the surgical team, three nurses on in-patient care, two clinic nurses and a full-time laboratory technician. We also have a referral ophthalmologist who visits the practice weekly, a mobile MRI unit and ultrasonographer, both of whom visit fortnightly. My role at the practice is split between surgical nursing and in-patient care/emergencies on night duties. I’ve recently passed my Vets Now certificate in emergency and critical care, which is often put to the test in the middle of the night! My role in preparation for the awards assessment, alongside my colleague senior ward nurse Sarah, was to cover the category of in-patient service, including pain management. This involved writing new protocols – for example, for blood transfusions, catheter placement and management, and physiotherapy. In January 2016 the practice decided to apply for five awards from the RCVS’ Practice Standards Scheme. We felt that with March/April 2017 z Practice Life

“Our method for success was to break down each award and its modules into bitesize pieces. They were shared out among key members of the team, all under Jacky’s management” a bit of hard work and determination that this was achievable and would be an excellent way of showing our clients and other practices that we are as good as we say. Since 2005, when the scheme was launched, more than half of all veterinary practice premises in the UK have become accredited. Members of the public can search for practices that are accredited through the scheme. The five awards that we applied for were: • Team and professional responsibility; • Client service; • Patient consultation service; • Diagnostic service; and • In-patient service.

PRACTICE DEVELOPMENT

From left, RCVS President Chris Tufnell, Jacky Macqueen, Helen Boyd and Ian Macqueen.

In July 2016 we attained an outstanding accreditation on all five awards and were the first practice in the UK to achieve this. Our method for success was to break down each award and its modules into bitesize pieces. They were shared out among key members of the team, all under Jacky’s management.

Roles and responsibilities As you can see from the diagram, each unit was split among sixteen members, except for two modules where the entire vet and nursing team had an input. Having a large team is a double-edged sword in this situation. On the one hand, work can be delegated across a higher number of people, which balances the workload, ensuring that nobody is swamped and that day-to-day tasks are carried out with little effect on an individual’s ability to perform their duties. However, it brings with it the challenge of communication, training and implementing new protocols. The collation of information and cross-team collaboration required to embed the new protocols is not to be underestimated and a disciplined and well organised project lead is required to ensure that the transitions take place smoothly and effectively within certain time constraints. We found the PSS awards programme well structured, clearly defined and easy to follow. Expert guidance and assistance is on hand to guide practices and ward off any issues before they become a problem. The requirements for each award are laid out in a series of numbered points, making it easy to plan and complete each discrete objective in turn. We discovered at the early stage of investigation that our own practice standards were, in many cases, applicable and from there it was a matter of adapting them to the structure required by the RCVS. This exercise allowed us to benchmark where we had come from against where we wanted to be and highlighted areas for change and improvement, while reassuring us that, in actual fact, we weren’t too far off “best practice” standards.

Inspection day On the day of the assessment the inspector made us feel at ease throughout the whole process. He had a relaxed manner and was able to ask questions through conversation (which is a very clever technique!). He was very personable and

Diagram of how the work was split between the team

“We found the PSS awards programme well structured, clearly defined and easy to follow” understood the practicalities of a working practice, providing us with feedback as we went along so we knew our progress on a stage-by-stage basis. It is important to point out that three weeks prior to the inspection, we scanned and sent through all our documentation so that the assessor had plenty of time of examine and assess these.

Benefits to the practice The whole process has been very useful to our practice as it has provided an audit record on the majority of all our procedures carried out within the practice and allowed us to update and improve our working systems. For example, new surgical checklists, new general anaesthetic monitoring forms, physiotherapy techniques and so on. It also highlighted areas where extra training was required, which may not have been obvious beforehand, such as when completing pain scoring sheets, maintaining and setting up the endoscope, and using the dental x-ray machine. It is important to note that change is difficult to implement. People tend to be inherently resistant to change and therefore it is important to communicate goals very clearly, highlight the benefits to everyone, and ensure that the entire cohort of staff buy in to the programme. I would recommend this assessment for anyone considering applying for PSS awards as we have found it has improved our standards in all areas, including better patient care, improved client experience and a more organised working environment. It has enabled the induction of new staff members to be much more efficient and consistent. It has been an educational process that has led to extra training being put in place where necessary, such as in pharmacy management, and new analgesia techniques instigated. It has helped to unify the team and improve morale as everyone has worked to the common goal of achieving the awards and we all continue to strive for improvement so that we maintain the status we worked so hard for. Practice Life z March/April 2017

CPD SHARED

SPVS/VPMA Congress 2017

review

All the fun of a BIG CPD and social programme rolled into a packed few pages... This year’s combined VPMA-SPVS Congress was another huge success. For the fifth year running, members of both associations came together for the management congress, which has quickly become a firm favourite in the veterinary calendar. Andy McCann, performance coach to high profile business leaders, Olympians and world champions opened congress in a suitably upbeat way. He was joined by Wales and Lions rugby legend, Ryan Jones, who also addressed delegates. Ryan talked about how people often do things that have always been done purely because they’ve always been done that way. He talked about the benefits of asking why a job needs to be done in a certain way and looking at other ways in which it might be done that could lead to a better outcome. Rugby legend Ryan went on to talk about the time the Welsh team questioned why they had to walk away after facing the New Zealand team doing the haka before their rugby match. He explained that the evening before the game they discussed what they would do and the team replied “we would do what we’d always done” and that was to “watch them do their dance and then get on with the game”! The Wales team was then asked if they realised the haka was only over when the opposition walked away, which was the All Blacks’ cue to leave? Ryan showed the video of what happened Referee Jonathan Kaplan asking Ryan Jones if he wouldn’t mind moving on

March/April 2017 z Practice Life

during the 2008 rugby game when the team decided not to do what had always been done. This will be a lasting memory for me and a great learning point for everyone who wants to question why we do things in a certain way. Even if you don’t follow rugby it is worth looking it up! Visit the website http://bit.ly/2lMjtnW

CPD SHARED

VPMA New to Management stream For the second year running, VPMA held a stream for management beginners at the joint VPMA-SPVS Congress. The full day of workshops took place on the first day of Congress, January 27, and had nearly 60 delegates in attendance. Libby Sheridan reports representatives from veterinary associations, Mark Beaney from veterinary accountants Hazlewoods, together with Georgina Hills and Helen Sanderson. The final discussion panel, with collective management experience of about 150 years, consisted of VPMA President, Renay Rickard, Georgina and Helen, VPMA Junior Vice-president, Julie Beacham, and experienced practice manager and director, Pauline Graham, from Capontree Vets in Brampton. Discussions included how to give estimates, the best policies for obtaining payment, and, for managers new to the veterinary profession, which learnings should be prioritised. The topics discussed were as follows: • Management and leadership: can I do both? • The people behind the organisation: Delegates at the NTM stream listening to Mark Harwood

The stream was organised by VPMA Board Members Helen Sanderson and Georgina Hills, and sponsored by Centaur Services. Speakers over the day included practice owner and manager, Gillian Page, from Ayrton Vet Hospital,

RCVS, VDS, BVNA & BVA. • Profit and loss: a practical approach. • Introduction to KPIs: why you need them and what to do with them (focusing on the top five practice KPIs and top five client KPIs). • Question Time with a panel of experienced managers.

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Recruitment Performance Management Sickness and Absence HR Management

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Health & Safety

HR & Employment Law

ISO Certification

Training

0845 844 1111 citation.co.uk/vets Practice Life z March/April 2017

CPD SHARED

New to Ownership: A new stream from SPVS This new lecture stream on the Saturday of Congress explored the ownership options for vets and, importantly, others who wish to make the move into veterinary practice ownership. SPVS’ Leigh-Anne Brown reports

As our profession rapidly evolves, the traditional route to ownership of a vet serving his or her time and eventually being invited to buy in to an independent practice is far less common than it used to be. The majority of us can’t take it for granted we’ll have this opportunity. SPVS is the organisation that represents bosses – including practice owners, so it was only fitting to run a New to Ownership stream. First up was Brian Faulkner from The Colourful Consultancy and Saxon Vets. Brian is a vet who has a Masters in psychology, has built up and sold several practices, and advises the profession extensively on many aspects of business management. Brian encouraged us to consider from the start what were our business and non-business, and clinical and non-clinical objectives. He examined both noble and less noble reasons why we might want to step into ownership and shared/confessed his own reasons, and was frank about the downsides and challenges of setting up from scratch. As he said, one presentation slide is not enough to cover the downsides! He was encouraging, though, about the positives,and it was an honest and balanced presentation.

Ownership Brian explained that his business plan is to be a financially attractive “target” to sell the practice seven years after opening. Perhaps the most useful thing he had learned, he said, was a good working knowledge of Microsoft Excel, and he went on to show us how plugging different values into his spreadsheets affected financial progress and could allow you to set a realistic business plan. He discussed marketing tactics and a footfall strategy that worked for him, as well as how to benchmark your practice against competitors. The list of decisions you will have to make when setting up from scratch is long and intimidating and Brian finished by listing some of them and advising careful decision making- when you have a limited pot of cash – you need to be getting a return on your investment as soon as possible.

Alternative options Next, we saw a panel of practice owners who had decided NOT to set up from scratch. Brian chaired and the panel discussed their journeys: Maggie Robinson as a practice manager and non-clinical owner, Martina from Cirencester as a Vets4Pets joint venture partner and Gerry from Hendon as a Medivet branch partner. Each was able March/April 2017 z Practice Life

to openly discuss his or her experience of their ventures and many preconceptions were examined. This was a lively session with plenty of questions from the floor. One thing that was encouraging was that each of the speakers was finding their career choice to be professionally and financially rewarding. They were frank about pitfalls, and the levels of debt they had committed to, as well as the financial rewards they were drawing. Speaking to young vets in the SPVS 5-15 lunch later that day, both sessions had been extremely useful for those who were at a crossroads in their career – they left with a list of questions to consider and a better idea of their ownership/nonownership options. Having decided to become an owner you’re going to need some money. And a business plan. Enter Peter Gripper from Anval Ltd. Anval offers business planning services, in-practice training and advice on getting the best price when selling a practice. Peter reflected on his experiences and advised us to consider the personal, professional and business outcomes we wish to achieve. Do you want to be first or second opinion? Have you got support from your life partner, will you be able to support your family in the early days? What if you want to take time out to start a family? How are you going to manage your team, finances, loans, ROI, and viability? What about succession? What are your exit routes?

Business plans Peter took us through what a business plan is and what a bank wants to see. This was expanded on in the next session, given by Nick Lawrence from Moore Scarrott. Nick knows the system inside out, with an impressive banking background. Although there are a lot of fairly dry figures in a business plan, it was interesting to see that character traits, such as personality, are still a factor in lending proposals. Banks can be wary of vet practices because the prospective partners can often have relatively little business or commercial experience and there is not the certainty of predictable cash flow from day one, and applicants often do not have tangible security. A major part of the appeal for the Medivet and V4P partners was that their model offered a business partner that could provide this. Nick was able to discuss exactly what banks expect us to bring to the table, and the “what if” scenarios they may want to ask you about. He reviewed the types of funding available, whether or not to incorporate, and how to run financial projections for the first three years of trading. His talk was there to prepare us for the interrogation we might endure when lenders try to assess our business acumen, and to help us secure the best possible terms and make wise decisions about what we invest the money in. I felt this stream was a very valuable addition to Congress and really filled a gap for those who may be considering ‘buying in’. The speakers were very open to discussing challenges, there was no sugar coating, and it will be invaluable to run year after. The world has changed for vet practice owners and SPVS is there to guide us on the roads ahead.

CPD SHARED

VPMA-SPVS Congress January 27-28, 2017 The veterinary event that creates a buzzz!

CPD SHARED

In a nutshell… take-home points from Congress VPMA’s Cath Grimsey chaired several sessions at congress as well as attended many others from a learning perspective. Here she shares her top take-home messages

LEARNINGS FROM EACH LECTURE I CHAIRED

OTHER SESSIONS

Tracy Israel

• Lone working. Sky guard is GPS app on phone that can be activated to notify re lone working. Run by Redcare. • Identify hazardous materials (warning signs). New red triangle signs in place since 2013. Train staff how to deal with them. New risk assessment! Identifying hazardous materials. • Manual handling. Maintenance of lifting tables. Review repetitive tasks and record equipment and procedures. • Risk assessments are a legal requirement. Two means of control is gold standard, training is one. • Practice vehicles – remember use of handheld mobile phones and that this needs to be in lone working too. Prison sentences. • Fire – Electricity and Radiation are legal requirements. HSE website. Opinion of panel was that a “no fire-fighting approach” is not a pragmatic or acceptable policy, omitting duty of care to employees and public to take care of themselves. All advice was to get NEBOSH qualified person in to do FRA and training, and implement any improvements, or send an employee on the IOSH course to get qualified to have the skills in house. • Fire Marshall laminated cards by the FDA give everyone specific tasks to do in the event of a fire alarm. Tick list. Fire Marshall jacket on first person who arrives at the FDA. • Risk assessments need to be stored for three years three months minimum. Insurance carts go back 40 years.

• Five-star attitude in an employee leads to five-star service from that employee; • Attitude is influenced by a wide range of factors, including family background, financial status and mental/physical health; and • Giving every client a Magic Moment is the way to client retention and repeat business – keeping clients is far cheaper than finding new ones!

Steve Holman • Incentivising employees to get clients signed up to PHPs helps make them a success; • Incentives like verbal praise are as highly valued as financial incentives; and • Price point is important in gaining staff buy-in. If employees think it’s a rip off they won’t promote it to clients.

John Sheridan (SPVS Profitability Survey lecture) • The health of veterinary practice is intrinsically linked to the health of the profession and industry at large; • A practice may measure success in many ways, but financial success is crucial; • Average salary of a GP is £101k and a vet is £44k – JS thought this mainly due to vets undervaluing themselves; • SPVS Profitability Survey revealed potentially 2,800 vets working in 458 loss-making practices (when scaling up responses given so far); and • 18% profit, accounting for owners’ salaries, is considered excellent. I personally question this and wonder how corporates would view this? 18% not particularly good EBITDA.

March/April 2017 z Practice Life

CPD SHARED

Congress marketing stream ‘on the nail’ Reviewed by Ian Wolstenholme The 2017 VPMA-SPVS Congress was simply excellent. Stream C, which ran across Friday and Saturday, looked at two areas of practice that have to be “on the nail” – front of house and marketing. Once again, expert speakers were on hand to provide hints and tips, notably Brenda Tassava from Halow Tassava in the US, who provided a step-by-step guide on how to re-evaluate the job postings that attract the right candidate for one of the most critical roles in the practice. Soft skills are now essential, explained Brenda, as is the ability to adapt attitudes for the many different scenarios encountered in daily practice. You can hear Brenda’s take-home messages in my short conversation with her here: https://1drv.ms/u/s!AoZdFmzs8IShgP8qcmasSqyxcUkNmQ.

Living up to expectations The Celtic Manor Resort once again provided an all-inclusive amenity and proved that it is more than up to the job of hosting world-class conferences. The reception area of a five-star hotel and that of a veterinary clinic waiting room may not appear to have that much in common, but both can learn from one another. Tracey Israel, Head of Learning and Development at Celtic Manor, was on hand to lead a highly interactive session entitled ‘Training for five-star customer service’ where she focused on the creation of ‘moments of magic’ – looking at what is normal, better and best service. Later in the afternoon I was delighted to be a participant in the case study discussion presented by Denplan in which my colleague Matt and I were quizzed by an enthusiastic audience about the merits of implementing a pet health scheme in practice, including the initial engagement, maintaining motivation and looking at the pros and cons of offering rewards and incentives.

Marketing the practice Following a full-on presidential banquet, entertainment and partying, I had to keep a clear head to chair the marketing lectures. First up was Andrew Rastall, the Connected Vet, who spoke about how personalised content and outbound communications can raise interaction rates. Listen to my comments here: https://1drv.ms/u/s!AoZdFmzs8ISh9CbU-QYJnAY-VdT4. Susie Samuel from Vet Help Direct offered advice on how digital marketing is changing and where to put your spending money. Obviously(?) every practice should have a Facebook page but it’s now worth looking at possibly dipping into alternative social networks, such as Instagram – hear more at https://1drv.ms/u/s!AoZdFmzs8ISh9Cd6y11DgTPWi_nX.

Client ‘nudging’ You may believe that your behaviour is always rational, but the evidence suggests that humans are easily influenced. When a waiter asks you if you would like a large glass of wine you are being nudged into behaviour that is disadvantageous to your health. A double session presentation from Claire McDonald and Ed Gardiner was illuminating and helpful on how practices can take advantage of nudging clients into desirable behaviours to help pet healthcare as well as the business. I chatted to both Claire and Ed, listen here: https://1drv.ms/u/s!AoZdFmzs8IShgP8p6C4qYkpGECQUIg. www.practicelife.biz z February/March 2017 z Practice Life

Dentistry as a marketing opportunity was another dynamic presentation from returning speaker Bash Halow. He went into detail about team engagement and how preventive dental care in pets can help prevent many other illnesses. With case studies from US practices that Bash has worked with, the facts and figures were up to date and showed that with the right pricing (without the need to discount and use of sensible payment plans) there is a wealth of opportunity in small animal clinics. My VPMA colleague Julie Beacham chaired some of the ‘Front of house’ presentations and her three ‘take back to practice’ messages were as follows: 1. The client is the only person who can reduce the level of care that a practice intends to provide. 2. Never assume what your client can afford or is willing to spend. 3. Focus on client care for those in a reception role and employ those with people skills and empathy, rather than choosing those whose primary concern is working with animals. Practice Life z March/April 2017

CPD SHARED

Breakfast Meetings

Citation Breakfast Meeting Friday 27th

With a full room and full bellies from a Celtic Manor breakfast, Citation employment law specialist, Catherine Smith kicked off the session on a mix of topics. Updates included the advice to carefully check contract status for locums after the successful appeal by Uber drivers for employment rights, and a similar challenge by Deliveroo in the pipeline. Meanwhile Scotland has pledged to abolish tribunal fees. Claims have dropped significantly recently, but this doesn’t mean disputes have gone away; rather, pre-tribunal negotiations are solving quite a few of them, eliminating the need for a more formal process. Settlement agreements have been under scrutiny by the HMRC, with a draft finance bill in motion to abolish the loophole of giving a £30,000 tax free lump sum. This is likely to become taxable. Brexit is still a bit of an unknown and already the UK is feeling the effect of a slowdown of people with needed skills deciding to come to the UK to work. Other tips followed: Disciplinary Hearings: • Minutes from a disciplinary hearing need to be signed off and dated by the employee. These minutes should be an accurate reflection of what was discussed in the meeting. Before issuing to the employee, check you are happy with the content. If not truly reflective, they can be tweaked. Notes from a meeting don’t have to be typed- handwritten notes are acceptable. If the employee disagrees with the content of the notes, you have the option to change them if you agree with their comments. Where, however, the employee claims significant changes needed that you don’t agree with, you have the right to say that you are confident that your notes are correct and you will keep their comments on file.

March/April 2017 z Practice Life

• You are within your rights to record the meeting on audio or video. However, Catherine pointed out that this often has the effect of heightening emotions, and the tone of the meeting can change, with a tendency to ‘play up to the camera’. Note-taking is preferable. Some employees will record meetings covertly. An employer is within your rights to ask at the outset of the hearing if the employee is recording it. Be aware that a recent court case allowed the admission of a covert recording by the employee, where the content of the meeting was disputed. • Minutes should reflect the timing of the start and end of the meeting, and persons present. If the employee has not brought in a witness, this fact should be iterated at the start of the meeting and it made clear this was their own choice. • Keep in mind the allegation at all times and do not let the conversation go off on tangents. Whilst the evidence submitted by the investigating officer should be considered, keep in mind your own opinion and ensure that you are confident with the decision made. Ask open questions around the allegation. Do not pre-judge guilt/innocence. Try to get to the bottom of the issue and make your own judgment. The hearing should be open, fair and reasonable. • If the employee indicates that they had already/previously raised a grievance that related to the subject of the disciplinary, and this has not been addressed, then the hearing should be stopped until the facts around the grievance are considered. Probation periods: • These are very helpful to employers and a 6-month period is recommended. This gives you a good chance to assess if a new employee is a right fit for you. • A contract of employment should be issued within 8 weeks of the commencement of employment, which should include the probation period, as well as a date for its ending and review. This review is important. • Should the contract of employment be terminated within the probation period, then one week’s notice is applicable. Outside of probation, 1 month is needed. • An employee cannot claim for unfair dismissal within the first 2 years of employment, UNLESS it is regarding a statutory right that has been broken or a Health and Safety issue. An employee may also claim discrimination as grounds of unfair dismissal right from the start of their employment. Evidence trails should always be kept in place for any dispute.

NexGard Spectra Breakfast Meeting Saturday 28th

For the breakfast meeting following the previous night’s banquet, it was noteworthy that again there was a full house in attendance.

CPD SHARED

MD of Inglis vets in Dunfermline, Adam Tjolle, led the session with ‘10 Strategies to Make Your Healthplans Sing’. Following an early introduction of a healthplan some years ago, uptake is now at 50% of clients at one of one of their 7 clinics and a minimum of high twenties at the smallest. Adam himself was somewhat surprised by the initial uptake, and gave his top 10 tips for this high uptake: 1. Engage the team: listen, adapt, talk. a. For Inglis, this involved a trip outside of the practice to brainstorm the idea of healthplans and ensure buy-in from everyone. The meeting had a fun element throughout and led to lots of excitement around the initiative. Adam’s recommendation with team buy-in (and clients) is to ensure that the messaging is built around healthcare and wellness, rather than about the products. b. Their plan includes vaccination, worming, flea treatment, some consultations, discounts, nail clipping and access to a health wellness centre. 2. Engage clients: think about what they need. We always think the clients are going to say ‘discounted services’ but responses to the Inglis client survey highlighted that what they wanted was convenience, the plan to be useful and to be easy. 3. Think about wellness: Inglis vets built a healthy pets centre, focused on wellness that all clients on the plan have access to. The clinic is laid out a bit like a nursery, with a rubber floor (now in all branches), so very dog friendly, a puppy play area and very much a fun environment. The cat consult room, where wellness assessments take place has a set of steps to help with the assessment of mobility. The wellness clinics were initially all nurse-led. 4. Market it a. Adam found Facebook very helpful in promoting the healthplan, using lots of warm ‘well pet’ images, with option for clients to post pictures of their pet. Puppies entering the scheme get a puppy bandana which makes for great pictures; cats get branded luggage tags. Clients also get a branded file in which to keep their products and records. b. Inglis uses a client reminder tool- Virtual Recall, and uses it to make extremely regular contact with clients on the scheme. Adam feels that this regular contact is essential to remind people all the time about what they are getting.

It places the focus not just on products but also looking after the client, and making it easy for them. Without this regular contact, there is the tendency for clients to think the scheme is expensive (at £20/mth) so it is important to remind them to drive the perception of value. 5. Bespoke the plan a. Tweak the plan to suit YOUR clients. If you have lungworm in your area, ensure you cover it. Ensure that you cover local risks or needs. b. For older pets, Inglis have recently started a lifetime plan which includes BP measurement and mobility assessment. c. Adam recommends connecting with clients before they come in for their healthplan check via surveys, so they stay engaged and you’re dealing with the most relevant information at the check-up. 6. Make it accessible a. This includes making it affordable. In one of Inglis branches, in a poor area, the prices of the plan are reduced. Discounts are offered on routine ops such as neutering (and must be purchased at least three months ahead). The uptake is good, even in this deprived area. Again, value is key. 7. Benefit to the team a. All Inglis staff pets are on the scheme so they fully understand it and they get the same reminders that the clients would get. This also helps with endorsement of the plan from the client’s point of view. 8. Measure and adapt Be open to adapting the plan based on feedback. Inglis most recent version of the plan includes free consultations. A new lifecare plan recently introduced includes dental treatment. 9. Make it a full team approach. It will not work without this. a. Ask the client on sign-up where they heard about the plan. Adam finds that vet recommendation is one of the most regular responses. b. The plan should be talked about at every client touchpoint. 10. Ask the clients what they like the most about it. This will help with keeping it top of their minds and drive recommendation.

What delegates have to say about congress “My only complaint is that it goes too quickly” “Range of lectures was excellent allowing my team to attend sessions relevant to their field” “My first time at Congress and I really enjoyed every aspect. The quality of the speakers and the variation of topics covered meant that every day was full of really useful stuff” “It had a very good balance between social and business” “Diverse range of lecture topics. Great networking throughout the day” “Overall programme was excellent with best food I have ever had at a conference” Practice Life z March/April 2017

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CPD DIARY

Focus on Practice Finance We are constantly asked by our members for more practical and theoretical courses on practice finance, but it is tricky knowing where to pitch these and what to cover. So SPVS-VPMA Events decided to dedicate a whole day to practice finance and profitability, in two streams: at our Focus Day to be held on June 21. Finance topics featured in various sessions in the January Congress, as well as having its own dedicated stream, indicating what an important topic it is. The Finance Focus Day offers a wealth of different speakers and the workshops will cover the essentials of profit and loss/ balance sheets, cash flow, evidence-based pricing, benchmarking, taxefficient purchasing and how to track and evaluate marketing spend. This event will include presentations from Brian Faulkner, John Sheridan, Nick Stuart and Mark Harwood on topics related to the SPVS Profitability Survey and how to maximise your own practice’s bottom line. There will also be information on paying for online advertising, how to decide how much you need to spend and how to measure your return on investment. As always at our Focus Days, it is not only the great lecture programme but also the exhibition that is a big draw. Exhibitors include PMS providers, accountancy firms and finance companies – perfect for doing some research and finding a company that suits your needs.

The Finance Focus Day will start at 10:00am and finish at 4:30pm. Workbooks, CPD certificates, lunch and refreshments are all included. For more information or to register visit the website www.spvs-vpma-events.co.uk

Our CPD diary continues to grow from strength to strength and this year will see SPVS-VPMA Events hold 15 regional focus days across England, Scotland and Northern Ireland. The topics include marketing, people management, finance and health and safety among others. We will again be extending our member rates to BVNA, AVSPNI and VET Trust members for selected courses.

Managing, motivating and encouraging your team is a new topic for 2017. Carolyne Crowe will present the session on October 31 in Scotland. If you are looking to plan your CPD or for that of your team, look no further as the combined VPMA-SPVS events cater for all. Below is a selection of upcoming events. Visit the website for details and booking vpma-spvs-events.co.uk

COMING UP March 15 – First and last impressions The reception area is the public face of your practice and it is where your clients will form their first and last impressions. Too often the day-to-day management and layout is left to untrained or overworked reception staff or nurses. This event, presented by Clare Hemmings from Royal Canin and Emma Mapletoft from Bayer, will ask some hard questions about what the reception area is actually for.

March 29 – How to be a fair, reasonable and legal boss

news. This one-day course is aimed at practices that already have a Facebook page they would like to take to a new level.

April 27 – Meaningful appraisals One-on-one conversations offer opportunities for growth and development, both for individuals and the practice as a whole, but if you raise expectations which you don’t or can’t deliver, they can do more harm than good. In this practical workshop, you’ll be given the tools and tips to have more useful and productive annual development meetings.

In this one-day crash course on employment law, James Cronin from Eight Legal will discuss how to recruit effectively and efficiently, covering contracts and your rights within the first months and years of employment. This will ensure you can mutually agree in the right way and at the right time, if a new employee just isn’t working out.

May 17 – Video-making for social media

April 26 – Facebook focus

May 24 – The consulting nurse

A practice’s Facebook page is becoming almost as important as its website as a tool to attract new clients and bond with existing ones. It is the human face of the practice where photographs and tips can be shared and followers kept up to date with practice

Brian Faulkner shares some of the top tips from his vet consultation courses reworked for nurses and, together with Clare Hemmings RVN, considers the content, design and marketing of nurse consultations.

March/April 2017 z Practice Life

Online is all about video these days. This day-long workshop with practical hands-on exercises will cover script writing, doing voiceovers, editing and mixing soundtracks, filming a live interview and editing – with hands-on one-to one personal tuition as the day progresses.

WHATâ&#x20AC;&#x2122;S COMING UP

Regional CPD