Practice Life Magazine Issue 17 September/October 2017 by The Magazine Production Company

September/October 2017

THE MAGAZINE FOR VPMA & SPVS MEMBERS

Flexible working

Development

Its place in practice Employer responsibilities Small animal case study

Learning from outside the vet profession

SLEEP

NEW TO THE PROFESSION?

Are you getting enough?

Vet acronyms untangled!

THE MAGAZINE FOR VPMA & SPVS MEMBERS

Financial planning for life

At PPS we’re specialist financial advisers to the veterinary profession, so not only do we understand financial planning, most importantly we understand it in your professional context. Whether it’s about your own finances, or about your practice, we’re here to support you. Starting your career

Rewarding your team

Developing your finances

Selling your practice

Developing your practice

Planning for retirement

To find out more or to receive a free, no obligation financial review, give us a call on 01527 880345 or visit our website at www.pps-vet.co.uk @ppsvet

www.pps-vet.co.uk

Professional Practice Services is authorised and regulated by the Financial Conduct Authority, entered on the Financial Services Register under reference 218105. Address: 2 The Courtyard, Harris Business Park, Hanbury Road, Stoke Prior, Bromsgrove, Worcestershire, B60 4DJ. Professional Practice Services is a partnership owned by PPS Group Holdings Limited and Dr Paul Jackson.

EDITORS’ LETTERS

Editors’ Letters

he previous issue (June) of this magazine arrived the day before I had to travel to London for a VPMA board meeting and, even though I had proof-read it some weeks earlier, the 7am train to Euston provided the perfect opportunity to read Practice Life cover to cover. Two hours out of the daily life of a practice manager is quite a chunk to sit and concentrate on black and white text (particularly in the modern news and social media snippet delivery). Even though my smartwatch interjected with the invitation to “stand up”, I ignored it and really immersed myself in the efforts of our contributors. We are a member magazine and do not have the budget of the other vet “glossies” and the fact that Practice Life delivers a polished image and quality content in this regard is commendable.

e’ve broken the back of another year and 2017 is whizzing past. Highlight of the summer for SPVS has to have been the 30th anniversary of the Lancaster student conference, attended by 165 students and many veterinary employers. I was especially pleased to meet so many students from my alma mater, Glasgow, and arranged a fair few EMS placements to my practice in Harrogate then and there. As the conference has grown from strength to strength under the guidance of Cat Curtis who is SPVS’ junior vice-president, it has spread its wings and, as well as delegates from the UK and Ireland, this year students joined us from Budapest and Warsaw, who have attended the last few conferences. New for this year was the “Mentoring New Graduates” stream which was known colloquially as Lancaster for Bosses. Led by Robin Hargreaves and with contributions from Nicky Paull, Carolyne Crowe and

There is a wealth of helpful information in our pages and, increasingly, real people in real practices are contributing content with no desire (or opportunity) for remuneration. In an industry where the public perception of vets as money-grabbing b@$%@?~s still exists, that in itself shows a huge degree of dedication. I often look at the pile of journals in the practice – largely still in their plastic-wrapped outers – and ponder just what chance does Practice Life have among this lot? Approaching Euston, I would say that our modest efforts at reporting management issues, is easy on the eye and brain and, if you really – I mean really – take time to soak up the thoughts and ideas, it can help you manage, mentor and coach in the daily grind.

Ian Wolstenholme, VPMA editor

two recent graduates Alison Price and Alex Roberts, we left with many plans to look after our graduates, and also ourselves, in an ethical and sustainable way. This course should run again so look out for it if you are recruiting new members of the profession. I was especially pleased to have brought my own recent graduate along for the student weekend and we would both recommend employers consider this for any new grads they’ve employed who didn’t make it to Lancaster. Our gala dinner on the Saturday night was a particular triumph, welcoming venerable members of the SPVS family, celebrating our excellent society and the work we have long been doing, and allowing students and potential employers to mingle informally. As ever I was left feeling that the future of the profession is in safe hands with the next generation coming through. Here’s to the next 30 years!

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

September/October 2017 z Practice Life

Contents g

UPDATE: NEWS & VIEWS 5

Leigh-Anne Brown, MRCVS

SPVS NEWS

VPMA

SPVS’ CPD for employers

Ian Wolstenholme, Practice Manager

Returnships – a perspective

Editors SPVS

Editorial Team Emma Dahm 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

New diagnostic imaging for ChesterGates VPMA’s professional qualifications g

NURSE TALK

BVNA’s governance review g

COLLEGE CORNER

Putting vets and VNs at the heart of innovation g

HOT TOPIC

Flexible working – how it can work in your practice g

WELL-BEING

Are you getting enough sleep? g

MANAGING PEOPLE

Bringing in skills from outside the veterinary profession g

CLIENT CARE AND MARKETING

Importance of selling in practice g

BUSINESS HEALTH AND FINANCE

Practice Finances: getting to grips with the basics g

PRACTICE DEVELOPMENT

Your guide to veterinary acronyms! g

CPD SHARED

SPVS-VPMA Events: © 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.

Focus on Finance day reviewed g

CPD DIARY

Joint congress preview – 2018 Focus on practice team day

39 28

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

Practice Life z September/October 2017

News & Views

Celebrating 80 years

with 80 prizes… in 80 days! STAFF at White Cross Vets are being given the chance to win big in celebration of the company’s 80th birthday. Independent vet group White Cross Vets, established in 1937, is running a series of prize draws where its 190-strong team can win 80 prizes over 80 days. Prizes include a weekend for two in New York, European holidays, festival tickets, a smart TV, an extra week’s holiday, and a chance to be the MD for the day. Managing director Tim Harrison explains: “Every day at 1pm we broadcast a draw from somewhere in the country via Facebook Live, where a lucky winner is picked and announced – it’s creating a real buzz around the group. “The final draw for the top prize of a trip to New York will take place on September 30, during our annual Congress. Every team member has been entered and anybody new to our practice is added as soon as they join so nobody misses out!” Rebecca Bredbury, a veterinary nurse from Walkden, said: “I watched the live draw on Facebook while on my hen do in

Peter Coelho, Assistant Finance Manager, with Moses, during one of the prize draws.

Tenerife and I couldn’t believe my eyes when I won a holiday for two to Barcelona. I am so excited about going. I will be taking my fiancé Ryan who will be my husband by then.”

Innovation and inspiration join RCVS awards The Royal College of Veterinary Surgeons (RCVS) has launched two new awards for veterinary surgeons or veterinary nurses who are making a tangible positive impact on the profession and who are inspiring others by their example. The RCVS Inspiration Award is for a veterinary surgeon or veterinary nurse who has demonstrated the ability to inspire and enthuse others consistently throughout his or her career. It is open to those who have inspired and motivated individuals or groups or who have worked at a professionwide level. The award would recognise those who have gone ‘above and beyond’ what may normally be expected from a professional colleague or tutor. The RCVS Impact Award is for a veterinary surgeon or veterinary nurse who has made a considerable impact that has affected the profession, animal health or welfare, or public health. Such impact could have been made through any field of veterinary endeavour, including clinical practice, research, education or veterinary politics. Chris Tufnell, Senior Vice-President of the RCVS, said: “I am very excited to be introducing these two new awards for those veterinary surgeons and nurses who go above-and-beyond the call of duty for the benefit of their profession, animals and society as a whole. “I am keen to emphasise that these two new awards are relevant for veterinary professionals from all walks of life and any stage of their career – these are not life-time achievement awards but are for those making a tangible difference whether that’s in their practice, their region or across the country as a whole. “If you know someone like this then I would strongly encourage you to find out more on our website and fill out a nomination form.”

September/October 2017 z Practice Life

These two awards join the well-established Queen’s Medal and Golden Jubilee Award, which are for veterinary surgeons and veterinary nurses respectively who have made a significant impact on their respective professions over the course of a career, and Honorary Associateship for laypeople who have made a significant impact in the veterinary field. Furthermore, at RCVS Day 2017, the College also introduced its inaugural International Award for individuals who have worked internationally from either within or outside the UK, to safeguard and improve animal health and welfare. The International Award this year went to Christophe Buhot, former President of the Federation of Veterinarians of Europe. Nominations for all six honours are now open and the nomination forms and guidance notes can be downloaded from www.rcvs.org.uk/honours.

The deadline for making nominations is Friday 22 September 2017. All nominations will be considered by the Operational Board for approval by RCVS Council at its March 2018 meeting. Awards will be made at RCVS Day in July 2018. Those with questions about making a nomination can contact Peris Dean, Executive Secretary, on p.dean@rcvs.org.uk

SPVS News President’s Welcome

Brian Faulkner

I trust you have had a good summer. Alongside various contributions and communications as SPVS President, three events have dominated my attention since my last report in April. These are 1) the SPVS Leadership Academy; 2) the arrival of our new SPVS Executive Director, Nichola Watson; and 3) the Lancaster student conference. The SPVS Leadership Academy took place in March and again in May at Walton Manor Hotel, Warwickshire. The course, which was kindly sponsored by Vetshare, took the form of 2 x 2 days. The aim of the course was to help practices review and improve their practice management systems, with a particular focus on improving profitability. On the first day I covered my Colourful Culture philosophy, which is about the proactive pursuit of four outcomes: clinical resolution, client satisfaction, financial resolution and colleague satisfaction. As a group we discussed the KPIs available to track these objectives as well as looking at dashboard systems in order to report these. The following day we looked at driving financial productivity inside the consultation room and the common causes of turnover “haemorrhage”. In the afternoon Nick Stuart looked at improving profitability by measuring and paying attention to cost of sales, cost of staffing and manging overheads. The third day was devoted to marketing. Andrew Rastall of Connected Vet presented his analysis of each of the participating practice’s positions with respect to their digital marketing strategy and opportunities. Andrew demonstrated to the group how it is possible to achieve an unassailable advantage in terms of a digital presence by using various tactics to optimise search engine results as well as how social media can be used to augment this online presence. The final session focused on HR. Jack Boiling and Sarah Verzijl from CVS’ HR department facilitated a very interesting discussion on recruitment and retention as well as change management and grievance and disciplinary considerations. Mark Johnston from Vetstream also showcased Pathway and Practis management software that enables managers to easily customise and track their colleagues’ training requirements and schedules. Nichola Watson joined SPVS as Executive Director at the start of April. She joined us with extensive experience running and managing membership organisations. Nichola’s first week was a “baptism of fire” as it happened to be our quarterly Officers and Council meetings, followed by a whirlwind tour aimed at getting to know the profession during BSAVA Congress. As well as attending numerous events to get to grips with the “whos” and the “hows”, not to mention the “whys”, Nichola is already working our secretariat and council to evaluate our member benefits, our web presence and digital footprint, as well as ensuring that our surveys can now be delivered electronically. So remember to look out for the survey emails when they come through and please complete them. I was also privileged to open our annual Lancaster student seminar. As is the case for many SPVS members, the Lancaster student seminar was the first introduction to what SPVS is and what it does. I fondly remember the seminar I attended as a student in 1994 and how valuable many of the principles I learnt during that seminar have been, not just as a new graduate, but throughout my career. This year marked the 30th anniversary of this seminar. As such, the seminar leader for the last six years, Cat Curtis, decided to run a parallel stream alongside the undergraduates for the bosses who will employ them. We had around 165 student attendees as well as the employers. On the Saturday evening there was a networking dinner where the students and their potential employers got to meet and mingle. I look forward to catching up with you later in the year.

SPVS SALARY SURVEY

re you paying your team the going rate? Are your salaries in line with other practices? Whether you are recruiting, doing an internal pay review, looking for a new job yourself or trying to negotiate a pay rise, it helps to understand what the typical salaries are and the trends. SPVS Salary Survey is the accepted benchmark for salaries within the veterinary profession and now is the time to take part. All SPVS members who complete the survey online will be sent personalised survey results allowing you to benchmark your practice against the industry averages. VPMA and BVNA members may also complete the survey and the results will be published on their websites. To take part, visit www.spvs.org.uk and help ensure the survey is as accurate and up to date as possible.

M SPVS AG 5th

ursday 2 Date: Th ry 2018 Janua .00 Time: 17 Venue: sort, anor Re Celtic M port New

Brian Faulkner, SPVS President

Practice Life z September/October 2017

SPVS NEWS

WELLBEING AWARDS 2017 NOW OPEN! This autumn sees the return of the 2017 Vet Wellbeing Awards, run by SPVS and RCVS Mind Matters Initiative.

he Awards, now in their second year, are open to UK veterinary practices of all sizes and were created by SPVS to turn a spotlight on practices where wellbeing is valued, inviting them to share what they are doing well with other owners and managers. The Awards recognise those practices with management systems and initiatives that motivate and engage their staff and who can demonstrate their commitment to being a better place to work. The Awards were the idea

of Nick Stuart, Past SPVS President who says: “We were delighted with the quality of entries we received last year and were encouraged with both the activities and incentives that practices are undertaking to ensure that their team members’ wellbeing is encouraged and maintained through what we all know can be very busy and stressful jobs.” For more information about last year’s winners and how to enter this year’s awards, visit www.vetwellbeingawards.org.uk

WIN!

Fre e t ick e ts t o SP VS/VPM A C o ngre s s & Banque t

THIRTY YEARS OF SPVS LANCASTER

he finalyear student weekend at Lancaster is always a highlight of the SPVS calendar and this year we pushed the boat out to celebrate its 30th anniversary. Fancy dress themes Cat Curtis, Lancaster organiser and SPVS JVP, were embraced by with her fiancé Freddie Mercury. many who remembered 30 years ago, and also many who weren’t even born! The gala dinner was a great success and truly a gathering of the best of our profession.

September/October 2017 z Practice Life

The dinner was a great success.

SPVS NEWS

EMPLOYING NEW GRADS:

SPVS’ CPD FOR EMPLOYERS This innovative CPD session from SPVS was held alongside the final-year seminar at Lancaster on July 8. Facilitated by Keystone and chaired by Robin Hargreaves, it was a lively and interesting day in the company of two recent graduates, Alison (2015) and Alex (2014), who shared their experience of the veterinary workplace frankly and openly in a panel discussion. Leigh-Anne Brown reports.

etween the two graduates they have experienced fulltime employment in four very different practices, and Alison has recently decided to become a locum. The “bosses” were able to ask what was good and bad about their experiences since joining the profession and to reflect on how the support we offer our own teams compares. It was clear that those of us in the room cared deeply about supporting newly qualified vets and a rich seam of anecdotes about negative experiences in early employment was shared. While some attendees were quite protective of grads, the grads themselves were keen to stress they don’t want to be mollycoddled; rather they want to be trusted, encouraged and pushed to extend their skills, while feeling their employers “have their backs”. One recurring theme was how much support their peers had lent them and that things like year group Facebook groups and Whatsapp message groups with friends at a similar stages of their careers, and that having recent grads alongside them in practice was immensely helpful too. In some instances these colleagues were better, more approachable mentors than the senior vets. Nicky Paull delivered a session on the RCVS PDP. I admit to ignorance of this beyond knowing grads should complete it in around the first year of qualifying; I hadn’t even realised the RCVS made it compulsory. Going through it in detail with Nicky was illuminating. The PDP provides a benchmarking ability to grads so they can track their own development and see their skills develop from day one to year one competency,

and they have the benefit of a PDP dean, who is not associated with practice, as a mentor. Average time to complete the PDP is 18 months and the limit is three years; Nicky stressed the process of logging activities is not onerous and should take only a few minutes a week. There is a section for reflection when things have been learned or not gone to plan, and this belongs to the candidate and is private from their boss. The group talked about the differences between being supportive and trusting, and overprotective and worried. Carolyne Crowe then helped delegates learn about being mentors by learning about learning, and the differences between coaching and mentoring. We learnt a great deal about how the language we choose to give feedback is heard, and how we can foster a culture of resilience. She helped us discuss stress versus pressure, assessed our own, and coached us in the arts of asking for, receiving and giving feedback. Huddles and debriefs are useful tools for feedback and can be incorporated into practice life relatively easily and informally. The final panel session with Robin and the recent grads opened up discussion, with contributions from the whole room, and drew a very productive session to a close. Keystone and SPVS will be running this course again and for anyone who wants to be a good employer of new grads – and have a chance of keeping them as a valuable member of your team – I would highly recommend it.

Practice Life z September/October 2017

SPVS NEWS

RETURNSHIPS: a perspective The profession is facing an unprecedented skills shortage, and we are aware there is a high rate of loss of first opinion practitioners in the first years after qualification. One practitioner who has been quietly offering a route back to practice in the form of returnships is Austin Kirwan, practice principal at Barn Lodge Veterinary Hospital – in conversation here with SPVS’ Hazel Bentall.

ustin explains: “A returnship is for someone who has done the job before. They will have some experience and skills, and will have taken time out for a variety of reasons. We offer a boost of confidence in a secure environment to reskill and address any issues that were there before.” H: “Could any practice offer this? A: Probably not... you need a reasonable amount of kit and, ideally, accommodation for the candidate so they can really commit to and focus on the training. You need time and space but also a mix of routine and exciting cases. You need a mentor with some training experience who is patient and empathetic. Practices geared up for quality EMS – especially if they have helped coach students with difficulties like dyslexia, dyscalculia, and anxiety have good building blocks for this type of placement and could take it to the next level. The rewards for the practice can be huge in terms of the intrinsic reward in helping contribute to improve someone’s professional life and, by extension, improved animal welfare by helping practitioners develop. H: How important is it to take a “returnee” away from their own life? A: It is important and it demonstrates a level of professionalism and adaptability as well as a degree of interpersonal skill. The perspective offered is healthy and clear, and it’s more impressive than popping in for a few hours here and there to a local practice. H: Have you undergone specialist training on mentoring? A: I have a diploma in counselling. Some formal training is useful, but you also need a lot of common sense. Having a reflective and questioning nature is useful; my interest was sparked during my Masters qualification in ethics – it included a psychology module which started a fascination with the mind, which tied in to issues seen in professional conduct. Working within your boundaries is important; you can’t make a diagnosis about people’s mental health status, for example. Part of the process is assessing a candidate’s support networks, checking they are registered with a GP, whether they are working with the RCVS, and so on. H: Conflict between RCVS Code of Conduct and the demands of clients can be stressful A: If you know that you are working against your values on a regular basis, if you are doing something that is fundamentally incorrect, this will lead to stress. When externally applied the stress is exponential because, when you lose free will, you lose yourself as September/October 2017 z Practice Life

a person and this is one of the main reasons why people end up in returnships. Emotional intelligence is very important. H: Are there any patterns with the candidates? You don’t advertise? A: No, it’s word of mouth and reputation. I get referrals from Vetlife, RCVS and clients have sent us vet students in the past. There are other practices doing this in a kindly and supportive manner, in a quiet way and doing a sterling job. My dream would be the creation of a UK network where those who are doing the mentoring can share ideas. I know there are other practices doing this and we need to be working together – I would be happy to be a contact point to help facilitate this. H: So, what are the outcomes? A: Some drop off the radar. Some have the most wonderful experience and get back to basics and realise that they could find practice delightful after all. H: Maybe they were in the wrong practice before? A: There are always other ways of doing things. Add to it that university training leads you to expect university standards, which, out of necessity, are very different from first opinion practice, and people can feel overwhelmed at the difference. Our slight detachment can identify areas a candidate isn’t aware of; for example, in one case we were able to realise that a person had a short-term memory problem that could have meant undertaking surgical procedures was very risky; we were able to identify that in a very safe and controlled way. H: Do successful candidates go on to become mentors themselves? A: It does become a case of ripples that spread. Some people will need support for their whole career, and others have just lost confidence, but they can absolutely fly. H: In a future issue of Practice Life we will be speaking to a candidate who has completed a returnship to discuss their perspective. Biography Since qualifying as a veterinary surgeon Austin has spent most of his time in first opinion small animal practice, where he still works full time. He is a past member of RCVS Council and served on the DC and PIC. On leaving council he became a director trustee of VBF and chaired the VetHelpline for six years, as well as increasing his role with St George’s University in Grenada. Austin has an interest in medical ethics and how it is taught to undergraduates and transposed to practice.

VPMA News President’s Welcome September will see me move into my last few months as president of VPMA and they will be among the busiest of my two years. Between now and Congress in January there are several veterinary congresses along with some new events, like the RCVS Innovation symposium that take place during this time. We will also be having the last few VPMA board meetings that I will chair – along with some joint officers meetings and congress planning. It is also the time to reflect on the past couple of years and see how far VPMA has come in that time. Our membership is steadily growing, which is fantastic given that the way veterinary businesses have changed in the way that they are managed over the past few years, and maybe there are fewer traditional practice managers in the industry. I think this shows that VPMA is able to evolve and serve its members well – regardless of the type of business or ownership/management structure they come from. Our new to management CPD – whether in the form of our congress lectures or the webinar series – is constantly developing and has been a great success. We have spent a lot of time talking and listening to people moving into management within the industry to provide them with the training, support and resources they need – ensuring that VPMA is the first place they look to for all things management. The VPMA board has been strengthened over the past two years also, helping to ensure the sustainability of the association with the right people to drive it forward in the future. I am excited for the things that are on the horizon for VPMA and I know we have the right people in place . Our regions are more active than ever – we have some fabulous and committed regional organisers who are providing the meetings and opportunities for our members to support, share and learn from each other. I am also a little bit proud of the number of VNs we have joining VPMA as they move into managerial roles. One of my main objectives this year was to get the message across that VPMA is not just for practice managers but for ANYONE who is involved in the management of a veterinary business – and this still remains one of our main strategies for the future. I am sure that I will be seeing a fair few of you over the coming months as it all gets a bit hectic! Take care,

T HAS been a busy year for the Veterinary Practice Management Association and we have supported many events in 2017, from the Head Nurse Congress in May to VetFest in June, as well as offering our members the fabulous annual joint Congress in January, which is always a joy to be involved with. A new departure for the Association this year was through our joint initiative with the Royal College of Veterinary Surgeons for the Mental Health for Managers roadshow – designed to help those in management roles in a veterinary practice or other veterinary workplace support colleagues with mental health issues. The one-day courses covered basic mental health awareness; HR employment regulations and the legal position; the role of the line manager in supporting someone with poor mental health; making reasonable adjustments; planning ‘return to work’; and designing and putting in place wellbeing action plans. Moving on to the end of the year, we are looking forward to catching up with some of you at that bright and shiny congress that is London Vet Show, in November, where we will be chatting to delegates about the benefits of membership, topics for a further series of New To Management webinars, as well as offering information about our specific practice management qualifications, the Veterinary Practice Administration Certificate and the Certificate in Veterinary Practice Management. And of course we’re always looking onwards and upwards so as soon as Christmas is over we have the 2018 Congress to look forward to – there’s always so much to learn and so many acquaintances old and new to catch up with.

Registration for the Congress is now open – see page 39 for details!

tice c a r P y r Veterina gement Mana n AGM tio Associa y

rsda u h T : e t Da 2018 y r a u n a 25 J .00 Time: 17 anor M c i t l e C Venue: , Newport Resort

Renay Rickard RVN CVPM VPMA President

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VPMA NEWS

NEW DIAGNOSTIC IMAGING SUITE FOR CHESTERGATES VETERINARY SPECIALISTS

hesterGates Veterinary Specialists’ advanced imaging facility was opened by TV presenter Louise Minchin and her Labrador Waffle, and Ian Wolstenholme went along to the event. I was invited to the opening of Chestergates’ new diagnostic imaging centre and went along to see breakfast TV presenter Louise Minchin and her dog Waffles check out the facilities. Louise and family moved to the Chester area when the BBC Breakfast programme moved to the new Salford Media City a couple of years ago. Professor John Innes, UK referral director, explained from a clinician’s point of view, how things have changed for the centre. “When I first arrived at Chestergates, there was a fantastic team of vets and nurses, but the facilities

weren’t what we’d describe as leading edge. Since CVS took over, it has invested £2m in facilities, so we can now practise our science and art and deliver first class veterinary services to clients,” he said. Chestergates’ client Fiona Graham and her poodle Brandy also attended the event, and she was full of praise for the new facilities. “It’s very reassuring to know there’s a facility of this quality available and to give this level of service. I know there are many good vet practices in Chester, but to have somewhere so close that has an MRI scanner, and a CT scanner, and other high tech equipment, to quickly diagnose a deep-rooted issue and be able deal with it themselves, is a tremendous asset to the area,” she said.

Poodle Brandy, who is a Pets As Therapy dog.

Waffles having her paw laser-imaged for a titanium paw print.

A group shot from the event.

September/October 2017 z Practice Life

The £1m MRI scanner.

VPMA NEWS

Regional News

ver the summer, our Regional Organisers have been extremely busy hosting the VPMA/MMI Mental Health for Managers courses. Following the trial course in Swindon in February, we held a further 11 courses around the country. We hope you managed to attend one as the feedback has been extremely positive. Both Rebekka Fiorani and Jerry Crick held regional meetings over the summer, in Bromsgrove and Chiltern Hills, respectively. Attendees who fed back said they found the days useful. As autumn approaches, we have a number of meetings planned: Rebekka’s September meeting will focus on time management, while Jerry’s will focus on knowledge acquisition, management and dissemination. Suzanne Headington and myself, the Regional Organisers for the south-west, are holding a meeting in October, which will be a discussion group following the Mental Health for Managers course. Linda Mogford, our Regional Organiser for Wales, is also hosting a meeting in October, and with this she is holding the popular CVPM workshop.

To find out more about any of our meetings, contact the VPMA Secretariat or visit www. vpma.co.uk. We hope to see you at one of our meetings soon. Finally, I would like to remind all members that you can bring a non-member friend FREE OF CHARGE to any regional meeting (only one free meeting per person per year).

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 CHESHIRE/DERBYSHIRE Kate Mincher Tel: 01663 745294 ro2@vpma.co.uk CHILTERN HILLS Jerry Crick Tel: 07771 573762 ro24@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 NORTH EAST/CO. DURHAM Claire Bake Tel: 01388 602707 ro16@vpma.co.uk NORTH WEST REGION Janet Hughes & Janie Clare Tel: 07964 505226 ro17@vpma.co.uk

SCOTLAND NORTH EAST Michelle Murphy & Stephanie Simpson Tel: 07841 417610 or 07900 923398 ro25@vpma.co.uk SCOTLAND SOUTH Michelle Southern Tel: 07972 918189 ro18@vpma.co.uk SOUTH WEST Suzanne Headington & Renay Rickard Tel: 01242 680000 or 01208 872254 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 Practice Life z September/October 2017

VPMA NEWS

VPMA’s professional practice management qualifications

t is easy to get lost among the baffling array of courses, online learning, and CPD events covering the general topic of “management,” but if you’re looking for something that is relevant to the practice environment and developed by practice managers, look no further. VPMA offers two such courses, the Veterinary Practice Administration Certificate (VPAC) and Certificate in Veterinary Practice Management (CVPM). The VPAC has proved a popular qualification with both veterinary administrators and those wishing to gain an introductory qualification before moving into practice management. The CVPM is awarded by the VPMA to individuals who have demonstrated their ability to effectively manage a veterinary practice, hospital or unit. The ILM Level 3 Certificate in Leadership and Management is also suggested by VPMA as a learning tool appropriate for the practice manager role.

About the VPAC The VPAC course consists of units including Office Procedures, Finance, Information Technology and Customer Care, along with units focusing on topics specific to veterinary practice such as Ethics and Statutory Requirements and Basic Veterinary Support. A full list of the units and what they entail is available in printable format from the website. Lynwood School of Veterinary Nursing runs a distance learning VPAC course, with intakes in September and April. The VPAC is designed to cover the skills required to carry out administrative tasks efficiently with the minimum of supervision and to be able to present the finished task to the supervisor, manager or employer. A reasonable understanding of the tools being used and the way they work (accounts software, and so on) is necessary to complete such tasks, but it is not necessary to have an in-depth knowledge or understanding of the impact of that work on the overall business strategy. If your role is to take overall strategic responsibility for the business or a substantial section of it, you may wish to take a look at the CVPM.

September/October 2017 z Practice Life

Visit the website for details: http://www.vpma.co.uk/ education/vpac.html

About the CVPM The CVPM is aimed at both experienced managers who are new to the veterinary industry and members of the veterinary team who are currently working in a management role. The qualification also provides a benchmark for veterinary employers seeking to employ a new practice manager. Individuals must demonstrate their ability by providing evidence of their managerial skills over six core areas: • General management • Personnel • Communication • Financial management • Marketing • Strategic management For more information on the CVPM visit the website: http://www.vpma.co.uk/education/cvpm.html

ILM Level 3 Leadership and Management The College of Animal Welfare also offers the ILM Level 3 Certificate in Leadership and Management. which is a more general management qualification, awarded by the Institute of Leadership and Management. This professional qualification will develop skills across various areas to give students the confidence to lead teams through the spectrum of management challenges likely to arise in any management situation. The blended learning course offers a combination of online learning and study days allowing for home study with regular tutorial support and college-based lectures on key topics. Visit the website for more information: http://www.caw.ac.uk/course/ilm-level-3-certificate-inleadership-and-management/

Nurse Talk BVNA’S GOVERNANCE REVIEW

In association with

By Samantha Morgan

You may have heard that BVNA is undertaking a governance review this year, but may not appreciate what that means or what the potential impact may be on BVNA members. Business of BVNA This is being made stronger by ensuring vital support staff are in place to run our CPD, journal, congress and membership. We have updated our Articles of Association, bringing them up to date with legislative changes, and the restructure of council. These new articles will be dropping through members’ doors soon!

Electing a new president Governance is not about what we are doing, it is about how we are doing it. Over the past 18 months, BVNA officers have been reflecting on how BVNA operates as a business. BVNA celebrated its 50th year in 2015 and during that year we saw some big changes within the veterinary nursing profession, with the introduction of the Royal Charter. The timing seemed right to take a step back and really look at how BVNA is running. Being the only representative body for veterinary nurses in the UK, BVNA needs to ensure it is strong enough to survive any risks there may be to its existence, and that its foundations are strong enough to withstand another 50 years at the very least. The governance task takes on three main streams of activity and, although the main details will be discussed at the AGM in October, below is a preview.

The process was reviewed and now each prospective president must go through an interview process with our advisory board. This ensures we select the best candidates to lead the association and any future leaders are given development plans to help them in their role.

Voice of the members It is important to us that we are speaking on behalf of members at any association meeting, committee or working party where they are represented. Therefore, we set up VN Voice, a quick poll system that allows BVNA to engage with its members and gain views on specific parts of our profession. BVNA wants to develop a louder political voice too. We are working with a few key people and associations to lobby on key issues, such as animal welfare and breed-specific legislation.

It has been a busy time, and one that will steer the path for the future – stronger – BVNA. We hope you all agree.

VN VOICE SURVEY SHOWS SUPPORT FOR PUPPY CONTRACT THE LATEST VN Voice survey results gave us calculable information about the use of the puppy contract from the BVA’s Animal Welfare Foundation (AWF). Few respondents had heard about the contract; however, once it was described in the survey, 100% of respondents said they would use it. The puppy contract has been developed to empower puppy buyers and help them to avoid problems that may arise from buying a puppy from an irresponsible breeder. Puppy buyers can use the information provided by the breeder or seller to make a decision on whether they want to buy the puppy they have seen. The VN Voice survey also showed that nurses are not really being asked about puppies prior to purchase – something we were disappointed to hear. VNs need to be promoting that our valuable advice can be useful to pet owners, even if their pet is not sick. Many nurses have exceptional knowledge about behaviour, puppy health, nutrition and preventive healthcare products, and this knowledge should be shared to improve overall animal welfare.

BVA has been increasing its coverage of the genetic conditions certain dog breeds suffer from, and, as advocates of animal welfare, we have a duty to be educating owners about the situation and promoting responsible breeding. We will use the results from this survey in our discussions with the Animal Welfare Coalition to aid any further projects.

The puppy contract can be accessed from the BVNA website or visit https://puppycontract.rspca.org.uk/home If you would like to take part in the next VN voice survey and have your say you can sign up through the BVNA website https://www.bvna.org.uk/ Practice Life z September/October 2017

NURSE TALK

NATIONAL PET MONTH 2017 During National Pet Month in April, the Veterinary Animal Welfare Coalition launched its second public-facing campaign to improve pet owners’ understanding of their animals’ welfare. Each day a member of the coalition posted a piece of advice on Twitter that vets and vet nurses wished owners knew about their pet, using the hashtag #wewishyouknew. The Coalition is made up of seven veterinary organisations: BVA, BVNA, Blue Cross, BSAVA, BVZS, PDSA and RSPCA. In the run-up to National Pet Month, BVA, BVNA and Blue Cross polled over 500 veterinary professionals about the one thing they wished their clients knew about their pets. The answers covered a wide range of issues, from care around arthritis and encouraging breed research before purchase, to problems such as the dangers of anthropomorphism and the importance of preventive health care. Issues around feeding and obesity were the most common concern, with more than one in five vets or VNs mentioning something related to incorrect diet. BVA compiled the answers to launch the campaign, with a mention during a BSAVA Congress press conference; a press release of the key findings issued to national, regional and trade press; and the creation of 30 key messages, which each organisation agreed to promote on Twitter every day throughout April. The #wewishyouknew posts gained a large amount of interaction from both veterinary professionals and pet owners, with some practices joining in the campaign by sharing the ’s advice or tweeting their own tips. The Veterinary Animal Welfare Coalition gave careful consideration to ensure the messages were not seen as vets complaining about owners, so used direct quotes or factual language to reflect the veterinary voice while keeping animal welfare at the heart of the message. Each post also contained a link to one of the organisations’ websites so owners could find out more. The tweets are still available for members to share, just search #wewishyouknew on Twitter to find out more.

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College Corner

PUTTING VETS & NURSES AT THE HEART OF INNOVATION At a symposium to be held on September 20, the RCVS will launch a programme to put vets at the heart of innovation in animal health and welfare. Anthony Roberts, RCVS Director of Leadership and Innovation, writes about how the College will be putting its ambitions into practice.

here is a huge amount of interest in relation to innovation and how it can enhance and improve animal health and welfare. Technology is developing at an exponential rate, new businesses are emerging and investment is coming into the sector at an unprecedented level. Indeed, former hedge fund manager and well-known US investment commentator, Jim Cramer describes the ‘humanisation of pets as the greatest investing theme in the market’. Where does this interest leave veterinary professionals and what impact could innovation have on veterinary businesses? Technologies such as telemedicine, wearable or implantable devices and fast and low-cost genomic sequencing (to give just a few examples) present veterinary practices with huge opportunities to improve animal health and welfare, and facilitate access to veterinary care. On the other hand, these new technologies could provide a foundation for new business Deborahwith Croylethe andpotential team models to disrupt more traditional ways of running veterinary practices or even sidelining the profession. The RCVS wants to ensure that veterinary practitioners are at the centre of innovation in the animal health sector, and to benefit from the opportunities that innovation can bring to the sector. For this reason on Wednesday 20 September 2017 we will be holding an Innovation Symposium at the Warwick Business School campus in the Shard near London Bridge. Although the event is invite-only we will be holding a social media competition so that 10 members of the veterinary professions – five veterinary surgeons and five veterinary nurses – can attend. Details of this competition will soon be announced on our website www.rcvs.org.uk. Inspired by the ambitions that came out of our joint Vet Futures research initiative with the BVA, this event will bring

together thought leaders from the veterinary and veterinary nursing professions and those involved in developing innovative veterinary technologies or business models. It will provide a forum to discuss the opportunities and threats presented by innovation in the sector, and the impact it may have on the profession and how it is regulated. The event will also provide a launch pad for an ambitious programme to showcase new technologies, encourage veterinary professionals to engage with innovators, and provide practical advice on launching new products and services.

Modern technology, modern guidance While we want UK veterinary professionals to be at the forefront of innovation in order to treat their patients more effectively, we also recognise the issues that new technologies can present from a professional and regulatory perspective. The majority of our guidance, for example, assumes that interactions between veterinary surgeons and veterinary nurses will be face-to-face and not via an app, or video or even the telephone. Issues such as remote diagnosis and prescribing of medication, jurisdiction if a vet is providing telemedicine services from another country and data gathering via apps and wearable devices all have to be carefully considered. So, while we seek to promote innovation, we are also looking at how we regulate technology in an appropriate and proportionate way. This is why, in February this year, we launched simultaneous consultations aimed at the veterinary professions and the public on the use of telemedicine in veterinary practice. The aim of the consultation was to help us identify potential risks associated with telemedicine, areas where it may be useful to address the needs of both the profession and the public and to support the development of new professional conduct guidance to help vets and vet nurses navigate the complexities of telemedicine. The consultation received 1,230 responses from members of the profession (both vets and vet nurses), 229 responses from animal owners and 15 responses from veterinary organisations and other stakeholders. We are currently in the process of analysing the results with a view to putting a paper to our Standards Committee before the end of the year on how we could change our guidance so that it is more relevant to the use of technology in practice.

Biography Anthony Roberts: Director of Leadership and Innovation, RCVS Anthony is responsible for the delivery of the strategic ambition to become a Royal College with leadership and innovation at its heart. He has worked at the RCVS for seven years and has been responsible for delivering key projects such as the First Rate Regulator Initiative and the launch of the new Practice Standards Scheme. Prior to joining the RCVS Anthony worked in public affairs and media relations at the British Plastics Federation. He holds an MBA, an MA (Hons) in Philosophy and Politics and the CIPR Diploma in Public Relations. Practice Life z September/October 2017

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HOT TOPIC

FLEXIBLE WORKING: how to make it work in practice

Clients and staff are demanding more flexible working arrangements and it is up to the veterinary profession to work out how. Owner and JVP, Leigh-Anne Brown, BVMS, MRCVS, shares how being flexible has benefitted her practice.

he veterinary profession has never offered a 9-to-5 career, but with increasing compliance with the Working Time Directive and outsourcing of oncall, we have had to change from the traditional rigid full-time and part-time roles that were generally the norm. In my practice we have a standard contract of 40 hours a week for vets and RVNs, but anyone can work pro rata if it works for the business. Experienced full-time vets usually choose to work a four-day, 40-hour week and we have a one-in-five weekend rota for vets, which is moving to one in four next year, with two full days off in lieu during the week. We have extended consulting hours so they are now 8am to 8pm with extra late appointments until 10pm two days a week, and weekend hours and bank holiday hours are now 9 to 6. These developments have come about as a result of client demand and from the need to differentiate us from other local providers. Demand is particularly high for our Sunday and bank holiday clinics, with these making some of the most productive hours we trade. We are a standalone practice so had the choice whether to trade seven days or not; the business case for doing so was compelling. Everyone’s lives have different demands whether through child care, parent care, studying, outside interests, portfolio careers, and so on. Our lowest hours contract at the moment is an RVN on 16 hours over two days a week, but, as her son moves to school in September, she will move to shorter days and more of them to cover the period we need for theatre and nurse procedures. Our SVNs are all on paid placements. They will all be a year further on and able to progress with their Schedule 3 tasks under supervision, and as one comes to the end of teaching and NPL she can cover more shifts and get more practical work in the run-up to her OSCEs. One of our full-time vets who was returning from maternity leave negotiated three days a week and the weekend, which covered the rest of our week day off. Cat, our pioneer flexible vet, works two extremely long shifts a week as well as her weekend making sure her need for childcare is minimal. In the past we have reduced hours when parents have been ill, when a dog has suffered from separation anxiety and needed some behavioural therapy at home, when health has been suffering temporarily (including me, close to burnout last year), for compassionate leave, for study…

Flexibility We jiggle the rota and the consults and ops slots available to suit our people as long as the business can function. We try to be fair and sometimes have to ask people to work alternative shifts. Inevitably, as the owner and the most local clinician (seven minutes away from the practice), the odd emergency shortfall falls to me, but it’s right that it should. I have gone in on my day off only twice this year, which interestingly, is much less than in previous years when we had more rigid working rotas. I work fewer hours now than I have for a long time, but am achieving more productive clinical work with the team I have around me. I’m very lucky that my vets and nurses are very passionate and care about handing over their cases, writing good notes and plans. We have developed excellent hospital sheets and care plans (by we I of course mean the nurses!) with help from the Vets4Pets Clinical Advisory Board, which I sit on and have gained a passion for checklists and protocols through. We all try to see our “own” cases as much as we can, which clients always prefer, but nominate a vet to handover to if we are going to be absent. A real recent flexible working success case was a small dog who had lymphoma. His family had first and second named vets and nurses on his care team and they were always able to see a familiar case through the rollercoaster of his chemotherapy and, ultimately, euthanasia. Our business has always run with an out-of-hours provider, but we are increasingly able to cover more of the day ourselves. We use amazing OOH providers and this relationship is facilitated by excellent communication and handovers. Even our practice managers work flexibly with one on maternity leave considering what will work for her return. They and I have the advantage of being able to do some work remotely. Rota writing, for example, is easier to do from home than in the office with the phone ringing. Insurance claims can be done at weekends as we are open anyway, if it suits the people doing them to swap their hours around. Flexible working for the whole team has worked for us and I believe it can work across the profession. It undoubtedly brings new challenges regularly, but through offering it we have attracted some excellent people and a really lovely team. For example, vet Cat MacPherson whose case study is detailed here. I can only see flexible working becoming more and more normal with the evolution of the profession. Practice Life z September/October 2017

HOT TOPIC

Flexible working: your responsibility as an employer

Quite simply, flexible working is a pattern of work that differs from the one under which an employee is currently working; Citation’s Sheena Stacey talks through an employer’s obligations.

Flexible working arrangements come in many forms, here are a few examples: • Working from home all or part of the time; • scaling down from full-time to part-time hours; • compressing work hours, ie, working five days’ worth of hours in four days; • changing work hours to fit around the school run, for example; • staggered hours; • job share; and • annualised hours.

Making a statutory flexible working request By law, all employees who’ve been with their current employer for at least 26 weeks have the statutory right to request flexible working. When putting in a request for flexible working, it must be in writing, be dated and include the following information: • A statement to the effect it is a formal request under the Employment Rights Act 1996, for a variation of the contract of employment; • If and when they’ve made a previous request; • the variation being sought and the proposed commencement date; and • an explanation of the effect the employee thinks the change would have on the employer and how it might be dealt with. Employees are limited to one flexible working request in any 12-month period. Are there any exceptions? Regardless of an employee’s length of service, they’re not entitled to make a statutory request for flexible working if they: • are part of the armed forces; • are an agency worker (unless they’re returning from parental leave); • have already made a request within the last 12 months; or • are an employee shareholder (unless they returned from parental leave within the last 14 days).

During this meeting, you should allow the employee to bring a work colleague along – this applies to appeal discussions too (should it come to this). Any discussions should be held in a private place. If you receive multiple flexible working requests, you should deal with them in the order you receive them. Remember, the outcome of the first request may impact your business’s structure, so be sure to factor this change into any subsequent requests. In some cases, if several employees submit a request, it might be worth having a discussion with everyone involved to see if compromises can be made.

Handling requests fairly As an employer, you’re responsible for dealing with the request in a “reasonable manner”. To ensure you deal with the request reasonably, we’d recommend holding a meeting with the employee to discuss the request. This’ll give you the opportunity to delve into the reasons behind the request, find out how the change will benefit the employee and come to any compromises – if necessary.

Your decision You’re legally required to respond to a flexible working request within three months of receiving it – this includes hearing any appeal. When coming to a decision, you should weigh up the benefits to the employee, with the potential impact on your business. Under no circumstances should you unlawfully discriminate against the employee.

September/October 2017 z Practice Life

HOT TOPIC

Once you’ve reached a decision, you should inform the employee – in writing – in a timely manner. By formally documenting everything in writing, you’ll avoid any potential confusion down the line. Whether you accept the flexible working request as it is, accept it with modifications or reject it, be sure to sit down with the employee and run through how and when the changes will take place.

Contracts of employment The flexible working request will result in a permanent change to the employee’s work pattern, so you’ll need to update their contract of employment to reflect this. This can be done by issuing a new contract or by attaching a written and signed document to the employee’s current contract. This document should include details like: the employee’s name and address; the change in work pattern; the date the change will take effect; and the employee’s signature. Working flexibly doesn’t affect an employee’s statutory rights – so things like an itemised pay statement, a right to not be unfairly dismissed, redundancy and holiday pay, for example, would still apply. Turning down a request You can only turn down a flexible working request if you’ve a genuine business case for doing so. There are eight “fair” reasons for rejecting a request, and these are: • the burden of additional costs; • the detrimental effect on the employer’s ability to meet customer demand; • an inability to reorganise work among existing staff; • an inability to recruit additional staff; • a detrimental impact on quality; • a detrimental impact on performance; • an insufficiency of work during the periods the employee

proposes to work; and • planned structural changes.

Appeal process If you reject an employee’s request, you must allow them the right to appeal. Before escalating it to a formal appeal process, it might be worth having an informal chat with the employee in question to see if it can be resolved off the record first. It’s always better to resolve the situation in the workplace, to avoid potentially being taken to an employment tribunal. As we previously touched on, appeals must be dealt with within three months of the flexible working request initially being lodged – unless you and the employee both agree to extend this timeframe. If you arrange a meeting to discuss an employee’s request – including any appeals raised – and they fail to turn up to the meeting, you should rearrange it. If they fail to turn up to the rearranged meeting too (without good reason), you’re within your rights to consider the employee’s request as withdrawn. If you go down this road, you should let the employee know of your decision in writing. Non-statutory requests Employees who aren’t entitled to make statutory requests – for example, because they’ve already made one within the previous 12 months, and employees who just want a temporary change to their working pattern, can make a non-statutory request. Because this type of request doesn’t fall under the law on flexible working, there aren’t any set procedures or rules for making such a request.

Got a question? If you have a question about flexible working, or any other HR and employment law matter, give Citation’s experts a call on 0345 844 1111.

Biography Sheena is National HR Services Manager at Citation. She is responsible for a national team of 30 field-based HR consultants and a HR support team, delivering employment law and HR consultancy services to mainly SMEs across a broad spectrum of industries and sectors.

CASE STUDY: CAT MACPHERSON, VETS4PETS, HARROGATE Catherine (Cat) graduated from Edinburgh in 2007. A passionate, evidence-based clinician studying for a Cert AVP in internal medicine, Cat had to think creatively how to combine enough clinical practice to keep her up to date and seeing enough cases while managing family life after her second maternity leave. Her husband Ian is an equine surgeon, also doing postgraduate studies, and they have two children. Cat has found a position with clinical standards that suit her in a practice that trades until 10pm. She works Wednesdays and Thursdays 10.30am until 10pm, and one in five weekends 9am to 6pm both days. This averages 28 hours a week, and Cat still manages the school

run on Wednesdays and Thursdays. When Ian is on call, Cat’s mum is able to look after the children for them. Cat has a particular interest in ultrasonography and her appointment made an investment in a very high quality machine feasible for the practice, and she tutors the other clinicians in its use. Because of her studies, Cat is active in journal clubs and always has a learned opinion on new developments and standards of care in the profession. She is particularly admired by the nursing students who can rely on her knowledge on many issues. In addition to this she brings a great deal of care and compassion to the team and is a great mentor. Working enough hours to keep up to date, cover the costs of living, and still have five full family days most weeks makes the long shifts and late finishes work for Cat, and clients are very grateful for the extended consulting hours she can provide. Practice Life z September/October 2017

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WELL-BEING

VETLIFE’S GUIDE TO

GETTING A GOOD NIGHT’S SLEEP Sleep is as crucial as eating well and exercising when it comes to good health, but 39 per cent of people in the UK are suffering from disrupted sleep or insomnia symptoms at any one time, according to the most recent data from the British National Psychiatric Morbidity Survey. This figure has been steadily increasing over the past 15 years.

n general, our lives are more hectic than ever; we work longer hours and our exposure to blue light, which interrupts our circadian rhythms, has increased hugely with the introduction of mobile phones and laptops. Loughborough University’s Clinical Sleep Research Unit has discovered that the other main things which keep people up at night are: • a partner snoring; • getting up to go to the bathroom; • an old uncomfortable bed; and • a partner using an electronic device in the bedroom. In addition, most people in the veterinary community will have had nights where sleep eludes them as they worry about whether they are going to have to cope with an emergency call in the middle of the night, endlessly re-run clinical cases in their mind, or worry about colleagues, bosses or employees. Trying to get some sleep above the practice or in the on-call room when there’s a noisy in-patient in the dog ward, while resisting the urge to get up and give him some extra sedation, can be a real challenge. Our physical health is deteriorating as a result of our reduced sleep patterns, with an increased risk of cancer, heart disease, type-II diabetes and obesity – but so is our mental health. So, here are Vetlife’s tips for establishing good “sleep hygiene” for you to snuggle up and read. Don’t forget that anyone who gets less than six hours a night raises their

“The message is that to stay mentally sharp in later life – something we all care passionately about – you need to take care of your sleep.” Prof James Goodwin, chief scientist at Age UK

risk of an early death by 13 per cent compared to someone who sleeps between seven and nine hours, so it really is worth taking care of yourself.

Build your own bedtime routine • Have a cut-off time of 9pm for looking at your phone or other devices and try not to have them in the bedroom (unless you are on duty and it’s the on-call phone!). • Start to wind down an hour before sleeping with relaxing activities like reading or a bath, and a hot milky drink or camomile tea. • Keep your bedroom dark, cool and free of clutter. • Invest in a good quality mattress and pillows. • Avoid coffee, tea or alcohol before bed and don’t eat for a few hours before you try to sleep. • Get up at the same time every day, give or take 20 minutes, whether you still feel tired or not. Practice Life z September/October 2017

WELL-BEING

Is 10pm the perfect bedtime? • Going to sleep at 10pm means you can get eight hours’ sleep and still wake up at 6am... • which means you can fit in a 30-minute workout and still be at work by 8/9am... • so you’ll be energised to tackle your most important jobs before lunch... • and in the evening, there will still be time to do whatever you want for a few hours before you go to bed.

Vetlife Helpline is available 24/7 if you would like to talk through a problem with a trained volunteer who has experience of the veterinary profession on 0303 040 2551 or by anonymous email via the website www.vetlife.org.uk

Deal with worrying thoughts • Worrying whether you will sleep, and trying too hard to drop off, will wake you up. • Try writing down anything that is worrying you or that you have to remember to do the next day. • Remind yourself that you do your problem-solving during the day when your mind is at peak performance, not in bed at night. • Exercise during the day to relieve stress.

Tips for insomniacs • Try simple mindfulness exercises – focus on feel of the duvet on your feet, for example; • try the 4-7-8 breath technique – inhale for 4, hold for 7 and exhale for 8 seconds; • talk to someone about problems currently on your mind or write a journal; Medivet_PracticeLifeMagazine2017_Sep_Oct2017.pdf

• don’t go to bed too early, because you get most of your deep sleep in the first part of the night and you are more likely to wake up after that; • if you are agitated, get up after about 15 minutes and do something relaxing in another room in dimmed light for 15 minutes; • give yourself permission to just rest rather than sleep; and • seek treatment if you experience sleep problems for a long time – Cognitive Behavioral Therapy is the recommended treatment for insomnia and www.sleepio.com is a useful online therapy programme and website. There is more information on other aspects of self-care on the Vetlife website at www.vetlife.org.uk

06/07/2017

11:06

30 YEARS

CHEERS TO 30 YEARS!

let the good times roll... Have you heard? The champagne corks are popping! This year we’re turning 30, and we’re celebrating in style!

We began in 1987 with one man’s dream to offer the highest standard of veterinary care – 24 hours a day, 365 days a year. We’ve never stopped growing: from our first practice in Hendon to over 160 practices around the UK today. Together, we’re one big family sharing our values of being caring, trustworthy, exceptional and progressive. Here’s to the next 30 years! Do you want to join our growing family? We’ve got everything you need to turn your dream into a reality. Contact our Head of Recruitment, Daniel, today. He’d be delighted to hear from you.

vetrecruitment@medivet.co.uk www.medivet.co.uk

September/October 2017 z Practice Life

ing… t a r b c e le SUC R U O

C E SS

MANAGING PEOPLE

BRINGING SKILLS AND EXPERIENCE

FROM OUTSIDE THE PROFESSION Moving into a new industry can feel like a daunting experience, but in reality, it shouldn’t be – Penelope Fox from Blacks Vets shares her experiences

s individuals, we are often unaware of the value of our skills as they have developed gradually over time, making it difficult to assess where our true strengths lie. One of the best ways to recalibrate our learning and ensure continued professional growth, is to make a move outside of our comfort zone and apply all that we have learnt to a new setting. This was pretty much my rationale in 2006 when I moved into education and then again in January 2016 when I accepted the post as Head of Client Experience and Technology at Blacks Vets. Blacks is a five-branch network of practices, with an accredited veterinary hospital, based in the West Midlands. Ready for a change and a new challenge, I was keen to see if my theory worked in practice. A veterinary one! Fortunately, Blacks has long recognised the value of individuals from outside the veterinary world and champions the lateral thinking and fresh perspective an industry outsider can bring. The MD here has experience in both corporate and SME businesses so understood my background and the value I could add, and many of the team have experience in other industries too, including healthcare, travel, hospitality and teaching. Collectively, we complement our team of highly qualified veterinary professionals to deliver excellent pet healthcare and client experience, ensuring that as a business, we continue to grow and push forward. So how exactly has my background in business and teaching helped positively impact on our network of practices? Here are some of the key areas I have contributed to by sharing my skills from a non-veterinary context.

People power Retaining talent within your practice is fundamental to its success and is something that the corporate world does well. Developing your team by working with each individual’s goals, strengths and objectives means that morale and motivation levels stay high. Wherever possible, we promote from within ensuring our environment is always one of progression and potential. The benefit of doing this within an independent veterinary environment is that we can manoeuvre very quickly – no committees, no waiting for meetings, a quick call to get the go ahead on a good idea to recognise and reward our people and it is done. Using my teaching skills, I have devised and delivered a number of development sessions covering data management, interpretation and presentation, which has improved efficiency

in reporting. We encourage interaction between teams and share best practice, adapting and implementing within our own remit where we can.

Structure and process Sometimes, things are the way they are for a very good reason. But sometimes, things are the way they are because, well, they just are! One of the main advantages of having someone from outside the industry join your team is that they view a business through fresh eyes. We may be able to identify where a process has become unnecessarily lengthy or a team structure is vulnerable. Importantly, we may also have the correct skills to implement change for the better in an inclusive way, valuing individual and team views, retaining the heart in the practice, as well as efficiency and pride in running a good practice. Change with the very best intention can become a hindrance if it isn’t properly managed in an inclusive, transparent way.

Thinking like a client While a veterinary practice’s principle focus is, without doubt, the provision of excellent pet health care, it is also a business that competes for market share just like any other company. When presented with choice, consumers vote with their feet and give their custom to the providers that go above and beyond standard levels of service. Being one step removed from the clinical aspect of the practice enables a good, objective perspective when it comes to how a client perceives care. Anyone who comes from a sales or customer service background will straight away be in tune with what consumers are looking for and how their experience can be augmented. From booking an appointment through to after-care following a pet’s operation, the customer journey is integral to ensuring your practice can give the very best care, by promoting a smooth and inclusive experience. Some of the areas where my skill set has proved particularly useful include team structuring to ensure optimal productivity, telephony management to improve first impressions, and overall efficiency and process strategy to crystallise thinking and standardise working protocols across all branches. Keeping up with technology Taking a good, hard look at the infrastructure of your own practice can seem like an overwhelming prospect and one which might be better filed under the tab “if it ain’t broke, don’t fix it”! However, investing in the right IT support infrastructure can improve the lives of everyone connected to the practice: staff, patients and clients alike. With the right skill-set, this need not be the painful and costly transition you might anticipate. Practice Life z September/October 2017

MANAGING PEOPLE

Industry outsiders can offer a fresh perspective and complement the team of highly qualified veterinary professionals.

One of my first assignments for Blacks was to review and assess IT provision with a view to developing and expanding our systems at a strategic level. Fifteen years of working in a corporate environment provided the necessary planning skills to tackle the project on a number of levels, from determining fundamental requirements and distinguishing those from the “nice-to-haves” to managing the roll-out across busy, live practices and overseeing new system training for staff. Inevitably, there were minor hiccups (learning opportunities as we call them!) along the way, but my training ensured that we kept on track and within budget, skills gained from my time in both the business and teaching sectors. Good leadership must of course empower individuals to go forward and put into practice what they have learnt, so part of my remit has been to ensure the successful transfer of knowledge so that teams can themselves confidently use new techniques. For

example, we have seen a significant decrease in IT issues as our teams now have the methodology to solve the vast majority of day-to-day queries, meaning that only the more difficult issues are put forward for resolution. The past 20 months have truly been an adventure, opening up a new and exciting world which I’m thrilled to be part of. For me, the best part is that I’m still learning and I hope that I continue to do so, as the benefits on both a personal and professional level have been immeasurable. I wouldn’t change anything about my career path as the skills I have built up over the years are put to good use every single day. If you’re thinking about employing from outside the veterinary field, I would urge you to take the plunge as every business, irrespective of nature, needs to keep evolving. As theories go, this one certainly turned out to be well proven!

Biography Penelope Fox, BA Hons, CCMI Penny joined Blacks Vets in January 2016 as Head of Client Experience and Technology, after 15 years working in management positions. Her experience spanned sales, customer service, business development and project management. This was followed by a career change into the world of secondary education, teaching business studies and IT, while also coordinating support for students with special educational needs. Penny has relished the challenge of adapting her skills for a new environment.

CASE STUDY: NEIL SYMONDS CHURCHVIEW VETS, WIRRAL Having recently switched from a career in general practice to the veterinary sector, I’ve found there to be a number of parallels, with many of the skills being transferable. Both roles are ultimately about managing people and delivering successful outcomes for clients and patients. Many people are unaware that their GP surgeries are frequently independent businesses and need to be run as such. As a result, I’ve found the skills I’ve learnt with regard to strategic planning, and making a business case, to be really useful. A frequent area of focus within both sectors is the ability to source alternate income streams to increase overall profitability. One area where the NHS excels in in terms of its clinical governance: all GP practices are stringently inspected by the care quality commission while the level of regulation required in veterinary care is also on the rise. Being able to bring this experience and implement a similar framework to achieve compliance has been a real advantage in my new role. September/October 2017 z Practice Life

Implementing more structure generally within my new practice, by using some of the techniques and communication strategies learnt in my previous life has not only increased our sales, but also raised levels of morale within the practice. In addition to performing more efficiently, a recent staff survey highlighted they are also clearer in terms of what is required of them and feel more supported. Ultimately, this results in the staff feeling more empowered and valued by the organisation. So be flexible! Previous experience has taught me that while being organised is always a benefit, no amount of planning will ever eliminate there being situations where you have to adapt and reprioritise your workload. Ultimately, working in either type of practice means you will need to be adaptable to overcome the challenges that any given day may present. Whether that’s an unhappy customer or leaky plumbing, both fields require a manager who can work flexibly to overcome challenges, in what is frequently a fast-paced, ever-changing but rewarding work environment.

MANAGING PEOPLE

CASE STUDY: LIBBY KEMKARAN-THOMPSON VETERINARY BUSINESS CONSULTANT I had a successful career in London consulting and recruiting with the big banks and law firms. After setting up my own consultancy I was away on a business course in Hawaii when 9/11 happened. The island went into lockdown and I was trapped there for a few days – I did some hard thinking and realised that life was too short, and could, out of the blue, be made shorter. I realised I had to follow my dreams and take the leap into the unknown. So I immediately quit the city and decided to retrain to be a vet, despite having precisely none of the relevant qualifications. I volunteered every weekend at the family vets and at cat sanctuaries while I began the long hard slog of getting through two years of A levels. I gained a place at Cambridge University, but was surprised to discover how little focus was put on the commercial side of veterinary practice. It’s as if the course designer expects vets to spend 100% of their time staring down a microscope at pathology – there is little focus on the actual day-to-day role of a vet in practice, which, in reality, requires a high level of people interaction and more than a little business awareness.

New graduates come out fairly green and in some cases unaware of what it takes to make a success of their first few years while they learn the ropes clinically. So I wrote some training for the vet students while in my final year at Cambridge, which the vet school implemented, and did my final year project on “Preparedness for Practice” for which she won the Pfizer Animal Health prize in 2011. In 2015, I was hit by a car and sustained damage to my neck and shoulder. I absolutely loved working as a vet, and I’d worked for so long to get there. I kept trying for a further year to work as a vet on and off, but it was just too painful to do surgery and move animals around – I ended up going home after each day in so much pain that I couldn’t then care for my children. I came off the register and became a consultant again. I now use my business background to teach vets how to build their business and help grow their team – I have a unique perspective because of my weird path in life – I just hope my misfortune can now benefit other people!

CASE STUDY: EMMA MCEWAN PRACTICE MANAGER, WOOD VETERINARY GROUP LIMITED, GLOUCESTERSHIRE I started with Wood Veterinary Group in October 2011 as practice administrator. In March this year, I was offered the opportunity to take on the new role of Practice Manager as recognition of the work I was already doing and to enable the practice to move forwards. Wood Veterinary Group is a large practice based in Gloucestershire, which has been running for over 50 years. I work from the busy RCVSaccredited small animal hospital and we have a smaller branch practice and a farm animal department. We currently employ 75 staff and offer a 24/7 service. Previous to working at Woods, I worked as an accounts administrator and assistant to the company administrator for a group of private care homes for adults with disabilities and challenging behaviour, in the north-east of England.

The role was one that stood me in good stead for working in the veterinary profession and I am forever thankful to my previous employer for giving me the skill set that has been essential in “hitting the ground running” here at Woods. I was used to juggling recruitment, payroll, invoicing, credit control, reception duties, cash handling, discrepancies, as well as the ongoing compliance to ensure standards were met. Working within the care industry was challenging yet rewarding and that is exactly how I describe my role here at Woods. I think coming into the veterinary profession from outside has given me a fresh perspective on how I see my role. The challenges faced within the practice are not dissimilar to those faced in the private care industry, from offering the very best level of care, value for money, staffing requirements, empathy, meeting compliance and with the necessary requirements set by a governing body. As much as I loved my previous role, I don’t see my future being anywhere other than Woods!

Practice Life z September/October 2017

CLIENT CARE & MARKETING

The importance of selling in practice Selling pet products in your practice serves many functions, as ROYAL CANIN’s John O’Connor explains

rofit is, of course, one of the main reasons that we devote time to selling products, but the more important reason is footfall. We rely on our clients to come to us when their pet is in need of veterinary attention, but most of the time their pet is healthy. By developing an effective over-the-counter sales business we can ensure clients visit the practice many more times during the year and thus increase their awareness of all the products and services available. An average pet owner may visit the practice once or twice a year, for vaccinations or if their pet has hurt itself in an accident, for example. If a pet owner is coming to the practice to buy products, however, he or she will visit between eight and 10 times a year. Surely, then, it’s worth investing 15 minutes to ensure the first impression is of a place “I want to bring my pet” and not a place “I have to bring my pet.”

Size matters It’s important to consider the size of your practice when it comes to selling. Space comes at a premium and practices have a finite amount to use when it comes to the waiting room. However, by following a few simple rules, a huge amount can be achieved with even the smallest of waiting rooms.

After the Royal Canin treatment.

September/October 2017 z Practice Life

Understanding the importance of the space is key. The typical pet owner will spend far more on products for their dog or cat than they ever will on services like veterinary consultations, pet insurance, and so on. They probably aren’t buying those products from their local veterinary practice, but why should we allow this to continue? Our friends in the grocery sector would be ecstatic if they had the opportunity to sit a consumer in a room for five or 10 minutes before letting them into their stores. This opportunity to influence the consumer and raise their awareness of the products and services on offer is invaluable and should be maximised to ensure the pet owner is fully aware of what they could and should be doing for their pet. This isn’t about selling products or services that aren’t required; it is about ensuring the pet owner is fully aware of what constitutes responsible pet ownership and giving them the information that allows them to make an informed choice following a recommendation. The key to developing this awareness and subsequent sales is presentation and merchandising in the waiting room. If a product looks like it is good quality and is displayed in a quality fashion, more clients will want to purchase it and are far less likely to question the cost. This is reinforced further when displays are well stocked, clean, clearly labelled and priced. Most purchasing decisions are made in-store, so if the presentation is right, sales will improve. The same can be said for posters

CLIENT CARE & MARKETING

or notice boards advertising practice services like neutering or blood testing. Framed, professional posters or clear and tidy noticeboard displays will entice pet owners to these services and make them far more likely to follow your recommendation when they are in the consultation room.

Simple rules to follow Some other straight forward rules can be followed in the practice waiting area which can really help to influence people in their purchasing behaviour. For instance, all businesses should merchandise from left to right and from the bottom up. We read from left to right and research shows that products placed in the bottom left corner will sell most, so you might wish to place your best-selling item there, or position a product that is not selling well here to increase visibility. Keeping your shelves well stocked at all times is also essential. Consumers are typically reluctant to buy the last of anything that is on the shelf and gaps on the shelves may in our mind look like a busy, profitable day but in the consumer’s mind it actually has a negative influence. The layout of the front-of-house area will also influence many aspects of the practice and can either drive or restrict over-thecounter sales. As part of this layout design, time should be spent reviewing the seating options for clients. We tend to put seats

against the wall and have lots of empty space in the middle of the floor. It might be possible to put the seating in the middle of the floor and free up that valuable wall space for displaying products and services. Having back to back seating can also give a natural division of the waiting room into a dog waiting area and a cat waiting area. Cat owners, like their pets, have higher expectations and are disappointed if their cat is treated like a small dog. A separate cat waiting area with cat-specific products and a place for their cat carriers to be kept off the ground will see your cat business increase with very little effort or expense. It is an interesting exercise to walk into the waiting room and look for anything that is related to cats; in many cases over 95% of the products, posters, treats and so on that are visible are related to dogs. Lastly, pricing is always a contentious issue with differing opinions on best practice. However, as a rule of thumb, every product and service should be priced and displayed in the waiting area. The fear of it being seen as too expensive is unfounded and in most cases if a product isn’t priced then a consumer will not ask. The general assumption is if it isn’t priced it must be too expensive. Similarly with services, if you display your prices on the reception wall then it makes all of your staff far more confident when it comes to charging for a recheck consultation, prescription fee or making up a large bill.

Biography John O’Connor is Veterinary Marketing Manager for UK & Ireland at ROYAL CANIN’s head office in Castle Cary. John has worked at ROYAL CANIN® for more than ten years and has spent the last six years as Regional Sales Manager in Ireland. Prior to this he built a wealth of experience in clinical practice after graduating from University College Dublin with a degree in Veterinary Medicine in 2000, working initially in mixed practice before spending four years in an orthopaedic referral hospital in Dublin. He has served on the Veterinary Ireland Companion Animal Society national committee for the past five years and recently assumed the position of President of Veterinary Ireland.

Practice Life z September/October 2017

CLIENT CARE & MARKETING

CASE STUDY: SELLING CLINICAL DIET FOODS IN PRACTICE STEPHANIE WRITER-DAVIES, VET AND PRACTICE OWNER, MIMRAM VETERINARY CENTRE In January 2017, as a result of an idea driven by our head nurse, Mimram Veterinary Centre began the process of becoming a Royal Canin Approved Weight Management Centre. The nurse had an interest in diet and nutrition in animals, which had led to her developing a successful Weight Watchers type service for our patients, so this was a natural progression. Part of the approval process required us to recruit a number of new slimmers to our weight control clinics, with each overweight pet being moved on to the Royal Canin Satiety Support or Obesity food, and the owners making a purchase of at least their initial supply from the practice. This meant that everyone – vets, nurses and receptionists – had to be prepared to actively promote and sell the food with the “pressure” of measured targets. Of course, “selling” is a bit of a dirty word where veterinary practice staff are concerned. It’s something we do every day, but we’re often reluctant to admit to it. With minimum sales targets having been set at the end of our Royal Canin training day, I found myself wondering how the team would react and I confess I was a little worried it wouldn’t go well. However, my fears were unfounded and four months later, in May, the practice achieved its status as an Approved Weight Management Centre – and we didn’t just scrape through, we exceeded our targets and the process hadn’t felt in the least stressful or negative. I think our experience with this programme proves how easy selling can be, as long as you have buy-in from all members of staff and, most importantly in my opinion, there is a genuine belief that what they are being asked to promote is in the best interests of the animals. In our case, there was no question on either front; every member of our team gave up a Sunday to attend the initial training day. We learned about the adverse health impacts of obesity and the nutritional principles behind a diet that is safe and effective, and everyone felt confident they could both recognise when an animal was overweight as well as give advice to clients about the importance of weight control for their pets. Additionally, the protocols for recruiting new slimmers and giving recommendations about food were created collaboratively with input from everyone so that no group in the practice would feel their job role would be adversely affected by pressure to convert the sale. The atmosphere in the practice was really enthusiastic as we went through the process; the names of the new slimmers were added to a list on a board so we were all aware of how we were doing and we had regular update meetings to discuss how things were going and iron out any issues. There was never a sense of anxiety about achieving our targets or grumbles about having to sell food; just a sense of positivity about how well we were doing. The result is that numerous cats and dogs are healthier having lost weight, their owners are happy and seeing the benefits to their pets, and the practice sales of the Weight Control range of September/October 2017 z Practice Life

food have increased by nearly 65% compared with the same period in 2016. Interestingly, there was also an increase in sales of all the Royal Canin food ranges; perhaps a side effect of everyone feeling more knowledgeable about food and nutrition generally. We’ve also had to completely rethink the way we use the consulting rooms and manage the practice day to make time for the increased number of nurse consultations, which has had other positive effects... but that’s a different case study!

BUSINESS HEALTH & FINANCE

PRACTICE FINANCES: GETTING TO GRIPS WITH THE BASICS Steve Headon of Moore Scarrott takes a look at the financial elements that make up a practice’s basic financial position

t is always a challenge to address the financial issues in what, ultimately, is a clinical environment, where clinical best practice must take priority. However, to allow practices and their owners to survive, thrive and develop, it is essential to generate an appropriate level of profit. Clinical best practice and financial performance are not mutually exclusive, but sometimes it can be a struggle to establish how to bring the two together within a practice. We need to start with clinical protocols and the clinical standards of the practice. These must be determined by the veterinary professionals and practice owners. Every independent practice will vary to some degree and each practice will produce different financial results. Nonetheless, through benchmarking approximately 500 practices, we have been able to establish realistic ranges of practice KPIs, which, in turn, allows practices to adapt behaviours or working practices to fine tune their performance. Before a practice can consider such fine tuning, it is first necessary to establish the financial basics of practice finances.

A & M Veterinary Practice Profit and Loss Account As At 30.04.2017

30.04.17 30.04.16 £ £

Turnover Fees 500,000 63% 665,000 61% Drugs 300,000 38% 540,000 39% 800,000 700,000 Health Plan 100,000 50,000 900,000 750,000 Cost of Sales Drugs purchased 180,000 20% 175,000 23% (net of stock movement) Lab Costs 40,000 4% 25,000 3% Other direct costs 15,000 2% 10,000 1% 235,000 26% 210,000 28% Gross Profit

665,000 74%

540,000 72%

Profit Before Overheads

323,000 36%

225,000 30%

Overheads Establishment 45,000 5% Administrative 90,000 10% Financial 10,000 1% Depreciation 15,000 2% 160,000 18% Profit

163,000 18%

40,000 80,000 15,000 20,000 155,000

5% 11% 2% 3% 21%

70,000 9%

Figure 1 summarises a straightforward profit and loss account for a practice, showing the key parts in summary.

Practice Life z September/October 2017

BUSINESS HEALTH & FINANCE

A brief resume of the key elements:

A & M Veterinary Practice Balance Sheet As At 30.04.2017

Turnover Practices undertake work for clients, issue invoices to those clients and the clients pay those invoices. Fixed Assets The invoices issued will be for services provided and for Tangible assets 650,000 665,000 Intangible Assets 480,000 540,000 medicines supplied or administered. There might also be 1,130,000 1,205,000 some food sales and other ancillary income. Current Assets Increasingly, practices will also generate income from Stock 30,000 35,000 health plans. This income will comprise some fee income Debtors 20,000 18,000 and some medicine sales. Cash at Bank 122,000 77,000 Out of a total turnover figure, a certain element will be in 172,000 130,000 respect of fees and a certain element drugs. It is possible to Current Liabilities Creditors 35,000 30,000 consider turnover and the underlying fee:drug ratio. Taxes 35,000 30,000 This fee:drug ratio can be compared practice to practice 70,000 60,000 and it can give an indication as to how vets handle cases, how the practice’s pricing might be set, how much is “given Net Current Assets 102,000 70,000 away” either through (literally) forgetting to book things or Long Term Liabilities through discounting (more on this below) and a multitude Loan 380,000 440,000 of other issues. HP Liabilities 28,000 33,000

30.04.17 30.04.16 £ £

408,000

473,000

Costs of sales Practices will incur direct costs in connection with Capital and Reserves generating the turnover (before considering labour costs). Called up Share Capital 300 300 Net Assets

824,000

802,000

Profit & Loss Account Shareholders funds

823,700 824,000

801,700 802,000

Figure 2 shows a straightforward balance sheet for a practice, in summary. September/October 2017 z Practice Life

Gross profit After deducting the costs of sales, the gross profit remains. This KPI can be compared within the individual practice, period-on-period, or practice-to-practice.

BUSINESS HEALTH & FINANCE

It is a very useful indicator linking in to several areas; practice pricing, veterinary case management, ability of practice staff to charge for all work undertaken, to name but three. The benchmark KPI is significantly different by species type and between first opinion and referral work. It is therefore fundamentally important to ensure correct comparisons are being made, before any conclusions are drawn.

Labour costs These costs represent the actual cost to the practice of all staff employed in and working for the practice. It also includes in the management figures (which we are concerned with here) a notional salary for any proprietorial input to the practice. This allows comparisons to be drawn practice-to-practice, regardless of how they are staffed. Profit before overheads This is another fundamental KPI. It shows what is left from each £1 of turnover to pay for everything else; premises, running the practice, equipment, loan repayments, proprietorial “drawings”, tax payments and reinvestment in the practice. Overheads These are all the other costs of running the practice. Most will be self-explanatory to many readers. Special mention should be made of equipment purchases and depreciation as it always causes confusion. If a practice buys x-ray equipment costing, say, £20,000 net of VAT, this cost is initially shown as an asset on the balance sheet – no cost is shown in the P&L. Each year (or period) following the purchase, an amount of this cost is written off to the P&L account, termed depreciation. This effectively recognises the “wearing out” of the x-ray against the income generated from the use of this equipment. Net profit After deducting the overhead costs, the remainder is the net profit. For benchmarking and management reporting, this figure tends to be an adjusted figure, after allowing for proprietors’ notional salaries and a notional rental cost for any owned buildings (after removing any costs of finance on loans relating to the buildings)… and one other point to note: All figures in the accounts are recorded on an “accruals” basis. This means that for expenses they show what has been used or consumed in the period rather than a “cash” basis, which records what has been paid in the period. For income, it shows the value of work done in the period rather than what has been paid to the practice. Fixed assets This shows the cost of the assets purchased by the practice, less the depreciation charged against those assets since they were

purchased. It is not a valuation, simply a calculated figure. The distinction between tangible and intangible assets tends to be whether one can see and kick them (tangible) and whether you cannot (intangible). The most common intangible asset in the veterinary world is goodwill (the premium of the practice value over and above the other assets).

Current assets These are items that are either liquid or can be converted to cash relatively quickly; stocks on the shelves, debtors (money owed to the practice by clients for work done but not yet paid for) and cash in the bank. Current liabilities The practice will owe suppliers for goods and services supplied, but not yet paid for (creditors) and HMRC for taxes (VAT, corporation tax, PAYE and so on). Long-term liabilities Any liability due in more than 12 months are shown here. It tends to be the capital outstanding on any loans or HP liabilities. Capital and reserves The net assets of a business trading as a company equate to shareholders funds. These are split between the underlying share capital (typically a nominal sum) and the P&L account. For a limited company, this shows the accumulated aftertax profits, not paid out by way of dividends. An increase here indicates an increase in the value of the practice but it does not give a market value for the practice as the fixed assets (tangible and intangible) are shown at a depreciated historic cost. However, an increase shows that profits have been retained within the business. Bankers and suppliers take comfort when this figure increases! What does it all mean and what do we do about it? Everyone has a different view on figures and, more importantly, what can be done to change or improve the results. It is beyond the scope of this article to consider the interpretation of the figures, the KPIs and the actions that can be taken to improve the results. However, the first step to take is familiarisation with the figures, what the KPIs are at present and what they have been in the past. If they are not currently available for the practice then this is your first action point. With this information to hand, it is a case of monitoring the figures and KPIs on a monthly or quarterly basis. Once that process is in place and functioning, the next steps can be considered. With the pressures that are inevitable in everyday practice life, it is crucially important to ensure the practice is performing so as to generate adequate profits (and cash) for future investment in the practice to keep it viable, thriving and developing.

Biography Steve is a Partner at Moore Scarrott and works exclusively within the veterinary team, Scarrott, dealing with a wide portfolio of clients. He joined the practice in 2008 and became an Associate Partner in 2010 and a Partner in 2012. Steve has lectured for BSAVA, VPMA/SPVS, BVA, BCVA and BEVA as well as holding special lecturer status with the University of Nottingham where he lecturers vet students on practice finances. Steve is married to Rachael, who is a small animal vet working in north Devon, and he is the son of Devon dairy farmers. This background provides additional insight into the veterinary profession and the challenges faced by farmers, which is invaluable in providing advice to clients. Practice Life z September/October 2017

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PRACTICE DEVELOPMENT

New to the profession? Your guide to veterinary acronyms! Acronyms associated with the veterinary profession are many and often so similar it can be a challenge for those new to the vet world to get to grips with them. BVA, BVNA, BVCA... the list is almost endless so Practice Life has put together a guide to these and other need-to-knows for those who are from outside the profession or are new to it. If it sounds like a foreign language to you now, keep this glossary to hand and you’ll soon be speaking the lingo like a “local”! GENERAL AND REGULATORY RCVS Royal College of Veterinary Surgeons

Statutory regulator. Sets the standards for and monitors the quality of veterinary education; holds registers of those vets and veterinary nurses who are qualified to practise; sets professional standards for vets and veterinary nurses; and helps practices raise their standards through the Practice Standards Scheme. https://www.rcvs.org.uk/home/

VSA Veterinary Surgeons Act

The RCVS regulates the profession in the UK in accordance with the Veterinary Surgeons Act 1966.

Veterinary surgeon VS Vet Veterinarian (US)

The title “veterinary surgeon” is protected in law: only those who are registered with the RCVS can use the title.

MRCVS

Veterinary surgeons must be registered with the RCVS to practise in the UK and have the initials MRCVS (for Member of the Royal College of Veterinary Surgeons) or FRCVS (for Fellow) after their names.

RVN Veterinary nurse Registered veterinary nurse

To use the title veterinary nurse, a person must have trained and qualified using an RCVS-approved route and be entered on the Register of Veterinary Nurses. The title is not protected in law, although efforts have been made to do so. http://www.rcvs.org.uk/education/i-want-to-be-a-veterinary-nurse/

DEFRA Department for Environment, Food and Rural Affairs

The UK government department responsible for safeguarding our natural environment, supporting our food and farming industry and sustaining a thriving rural economy. From pet passports to avian flu, the profession liaises a lot with DEFRA. https://www.gov.uk/government/organisations/department-for-environmentfood-rural-affairs

APHA Animal and Plant Health Agency

An Executive Agency of DEFRA that works to safeguard animal and plant health for the benefit of people, the environment and the economy. https://www.gov.uk/government/organisations/animal-and-plant-health-agency

MEMBERSHIP ORGANISATIONS BVA British Veterinary Association BSAVA British Small Animal Veterinary Association

BEVA British Equine Veterinary Association

National representative body for the veterinary profession in the UK. Looks after the interests of all vets in all disciplines. https://www.bva.co.uk/ Founded in 1957 as a professional body to serve vets who treat companion animals, it was a spin-off from BVA. Holds annual congress each year in April in Birmingham as well as regional meetings. https://www.bsava.com/ Membership organisation for those working in equine veterinary medicine. Annual congress held in September. https://www.beva.org.uk/

Practice Life z September/October 2017

PRACTICE DEVELOPMENT

BCVA British Cattle Veterinary Association

Membership organisation for those working in large animal practice. Annual congress in October. https://www.bcva.eu/

BVNA British Veterinary Nursing Association

Representative organisation for veterinary nurses and other veterinary support staff in the UK. Annual congress in October. https://bvna.org.uk

BVZS British Veterinary Zoological Society

BVZS has an international membership and is involved in almost every aspect of the care and welfare of exotic pets, zoo animals and wildlife. https://www.bvzs.org/

ICC International Cat Care

To engage, educate and empower people throughout the world to improve the health and welfare of cats by sharing advice, training and passion. www.icatcare.org

ISFM International Society of Feline Medicine

ISFM is the International Society of Feline Medicine â&#x20AC;&#x201C; the veterinary division of ICC.

VPMA Veterinary Practice Management Association

Membership organisation for those with management responsibilities within veterinary practices. Awards the Certificate in Veterinary Practice Management (CVPM) and the Veterinary Practice Administration Certificate (VPAC). http://www.vpma.co.uk/

SPVS Society of Practising Veterinary Surgeons

A professional association with a primary focus on matters concerning vets in practice and the practices where they work. Produces various surveys of the profession, including a salary survey and fees survey, used as benchmarking tools by the vet sector. https://spvs.org.uk/

SVS Sheep Veterinary Society

Promotes the prevention of disease and the welfare of sheep. http://www.sheepvetsoc.org.uk/

VDS Veterinary Defence Society

A mutual insurance company founded in 1865 and run by veterinary surgeons on behalf of the veterinary profession. Look out for its fabulous quarterly newsletter! www.thevds.co.uk

VETERINARY MEDICINES VMD Veterinary Medicines Directorate

An Executive Agency of DEFRA. Conducts risk-based inspections of veterinary practices that are not part of the RCVS Practice Standards Scheme to ensure they comply with the Veterinary Medicines Regulations (VMR). https://www.gov.uk/government/organisations/veterinary-medicines-directorate

VMR Veterinary Medicines Regulations

The veterinary medicinal products directive sets out the controls on the manufacture, authorisation, marketing, distribution and post-authorisation surveillance of veterinary medicines in all EU states. The directive provides the basis for the UK controls of veterinary medicines. The VMR are revoked and replaced on a regular basis to ensure they are fit for purpose. https://www.gov.uk/guidance/veterinary-medicines-regulations

NOAH National Office of Animal Health SQP Suitably Qualified Person

AMTRA Animal Medicines Training and Regulatory Authority CASCADE

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Represents companies that research, develop, manufacture and market licenced animal medicines in the UK. Provides a compendium of data sheets. https://www.noah.co.uk/ An animal medicines advisor; a legal category of professionally qualified persons who are entitled to prescribe and/or supply certain veterinary medicines (POM-VPS; NFA-VPS) under the Veterinary Medicines Regulations. Under the Veterinary Medicines Regulations, AMTRA is appointed by the Secretary of State to keep a register of Suitably Qualified Persons. https://www.amtra.org.uk/

Procedure vets are required to follow when there is no authorised veterinary medicine for the species to treat a condition allowing other drugs to be obtained and used. RCVS states that the ownerâ&#x20AC;&#x2122;s permission must be given.

PRACTICE DEVELOPMENT

SCHEMES AND AWARDS PSS Practice Standards Scheme PSS awards

A voluntary scheme where veterinary practices are inspected by external assessors and given Core Standard, General Practice and Veterinary Hospital status. Equine General Practice (Ambulatory) for those practices without a physical premises. http://www.rcvs.org.uk/practice-standards-scheme/ In addition to the standards, practices can be assessed for optional awards and be designated Good or Outstanding within each award. http://www.rcvs.org.uk/practice-standards-scheme/apply-for-awards/

TRAINING TP Training practice

A practice that is approved by the RCVS to train veterinary nurses. http://www.rcvs.org.uk/education/i-want-to-be-a-veterinary-nurse/approvedtraining-practices/

RCVS Specialist inâ&#x20AC;Ś

Post-graduate qualifications for veterinary surgeons: http://www.rcvs.org.uk/education/lifelong-learning-for-veterinary-surgeons/ specialist-status/

DipAVN

Diploma in Advanced Veterinary Nursing

Look out for the Dec/Jan issue of Practice Life TOPICS INCLUDE: Congress Update Wellbeing in Practice Special Practice Life z September/October 2017

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SPVS/VPMA Events:

Focus on Finance day PROFITABILITY is ever-present in the minds of those running veterinary practices, so, to keep up with the latest thinking, Cath Grimsey attended the Focus on Finance CPD day

n June 22nd, during the exceptional summer heatwave, l headed west to attend the SPVS/VPMA CPD event “Focus on Practice Finance” at the King Power Stadium in Leicester. Being home to the footballing phenomenon that is Leicester City Football Club, l felt buoyed that their success may rub off onto the 100 or so delegates taking their seats to learn how to make their veterinary businesses more profitable! The day consisted of two excellent streams; Introduction to Practice Finance and Practice Finance the Next Level. Delegates ranged from business owners, directors and executives to practice or business managers and admin leads. I was struck, talking to delegates, how modern veterinary businesses are moving further and further away from the traditional “practice” structure and adopting a much more departmental approach. I met people with strategic, operational and financial roles. It is apparent that talented individuals managing their specialist function of business across groups of practices is fast becoming the new norm. Being in two places at once is always a challenge, but l managed to attend excellent lectures in both streams. In the morning, People, Processes and Productivity by Julie Ross of Vets4Pets aimed to guide owners and managers to the holy grail of “making a lot of profit out of doing as little as possible”. As a qualified vet who has diversified into business consultancy and performance management, Julie has returned to the veterinary industry after several years managing performance both in the UK and USA. It is Julie’s opinion that veterinary businesses aiming to be profitable and resilient in the mid to long-term should be aiming to increase top line (ie, turnover or revenue) by increasing sales on veterinary services through an accurately developed pricing structure supported by an engaged team delivering excellent client experiences, and offering the full range of treatment options to every client. She advised that the veterinary industry has high operating leverage owing to the September/October 2017 z Practice Life

fixed nature of many of our indirect costs (overheads), and that doubling revenue, should, in a well-managed business, lead to almost doubling of profits. Julie warned against too much focus on cost cutting and sent a warning shot to those reliant on high drugs mark-ups for profitability. It is her opinion that in the mid to long-term, big players like Amazon will enter the animal drugs market, providing an excellent supply chain and enticing our clients to buy from them with excellent marketing campaigns. Another environmental threat that she identified was the possibility of Government intervention on the ability to mark up antimicrobials. Such a move would add another dent to income from drug sales. The panel discussion at the end of this stream supported many of these views and all of the advisors, Alan Robinson (Vet Dynamics), Julie Ross (Vets4Pets), Nick Lawrence (Moore Scarrott) and Paul Wilson (Pet Partners) were in agreement that recruiting and maintaining engaged and happy employees to deliver excellent customer service will be key to sustainable financial success in this sector.

CPD SHARED

Cx Congress East Midlands Conference Centre, June 17 The Customer Experience – or Cx Congress – has been running a number of years, and this time Ian Wolstenholme was in attendance to report for Practice Life Fred Siriex inspired delegates with stories from the hospitality industry.

x Congress concentrates on customer experience in the veterinary context and is growing year on year as more people within the profession recognise the importance of good client experience. The delegates were predominantly non-clinical, but with some vets and nurses in attendance. Fred Siriex, a well-known maître-de who also features in Channel 4’s First Dates opened the congress. What is not so well known is the work Fred does with underprivileged young people, who he helps to train in hospitality skills to get them in to work. What does a maître-de have in common with the veterinary industry, you may wonder? Fred shared many stories and messages very relevant to our industry. He told the audience how he never set out to gain a Michelin Star for his restaurant, but “set out to do what he enjoyed and the star came from that”. Many successful veterinary practices are those that set out to do good medicine and their business benefits from there.

Professor Elizabeth Stokoe closed the congress

Fred’s team are taught that they should “see, smile and say hello to a customer before they see, smile and say hello to you”. Stories about difficult customers, gazelles on Red Bull (affectionate term for reception teams), sharing his 10 golden rules and more, this opening talk set the theme for the day. Delegates had the choice of three streams: Pet, Leadership and Equine but everyone came back together for the closing session, delivered by Professor Elizabeth Stokoe, “Choose your words carefully – what clients hear may not be what you are trying to say”. To learn more about this, listen to my interview here: https://www.youtube.com/watch?v=DpTnP7pcq-0 It was then time for the exhibition competition prize to be awarded (a case of prosecco) and an email from Fred to be read out inviting all delegates to his restaurant, including a free glass of Champagne – I am not sure if he knows what he has let himself in for as many people could be seen scribbling down the details for booking! And so the 2017 Cx Congress was over. Next year’s date is already booked – June 16, 2018. I will be going and look forward to seeing you all there. Practice Life z September/October 2017

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SPVS/VPMA CONGRESS 2018 January 25-27, 2018

Celtic Manor Resort, Newport, South Wales

Re gist ration no w open!

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CONGRESS 2018 REGISTRATION IS NOW OPEN! Here’s a taster of what to expect... BUSINESS BREAKFASTS Our platinum sponsors, Boehringer and Citation, will offer a full cooked Welsh breakfast while you learn at their popular business breakfasts. Citation’s Catherine Smith will take your questions on all things related to employment law, while Boehringer’s guest will be American vet Jonathan Bloom, who will introduce a fascinating new approach to practice (more below).

OPENING SPEAKER BENJAMIN MEE Growing up, Ben had a turbulent relationship with the education system and was expelled from school. He started his working life as a bricklayer and decorator. Following an encounter with a dolphin, Ben became fascinated with animal intelligence. He studied psychology before completing an MSc in Science Journalism at Imperial College, which led to a long career in journalism. During a period of tragic family events, Benjamin was looking for a family home when he saw Dartmoor Zoo was for sale – dangerous animals, poor reputation and dilapidation all included. Inspirational speaker Ben will tell all in his opening address at congress…

HAVING IT ALL IN PRACTICE: HAPPY PETS & PEOPLE; HEALTHIER PETS & PROFITS The “fear free” approach to veterinary practice has been taking North America by storm, but is still little known in the UK. The evidence-based concept is simple: too many owners avoid coming to the vets for routine appointments and advice because they know their pets hate it. Canadian vet Jonathan Bloom has embraced the concept in his Toronto practice with great results, but he finds other vets can be harder to convince than owners. He said: “The problem with training vets is they will spend a day at college learning the best insulin for the two diabetic pets they see a year. But five of the next 10 patients will be suffering fear and anxiety, and they didn’t cover that. Pet owners, on the other hand, may not be able to identify dental disease or obesity, but they are experts at identifying fear and anxiety in their pets. Owners love this approach.” Jonathan will present the concept in Boehringer’s Business Breakfast on Saturday morning and then go on to demonstrate step-by-step how this looks in practice in a follow-up double session.

IN CONVERSATION… Sally Hopson, CE of The Vet Group (Vets4Pets and Companion Care) will be “In Conversation” at the end of the day on Friday, interviewed by Patricia Colville, Business Development Director of Vets Now. After graduating from the School of Oriental and African Studies at the University of London, with a degree in Middle Eastern History, Sally joined the graduate scheme at Habitat and began a long and enjoyable career in retailing, including 14 years at ASDA, where she held a number of senior roles. Sally has a particular interest in diversity and served as a commissioner on The Women in Work Commission and the Learning and Skills Council, and was awarded an MBE in 2006.

MIND MATTERS STREAM, IN PARTNERSHIP WITH RCVS Psychiatrist, journalist and author, Dr Max Pemberton, will chair the Mind Matters stream. Max is on a mission to overcome stigma around mental health, pointing out that psychiatry is an area of medicine with one of the highest positive outcomes. His focus for situational or work-related mental health problems is recovery, and he believes that those who have had positive and effective treatment not only achieve a complete recovery, but can be stronger and more resilient as a result of the experience. He will talk about recovery and chair a session on the importance of management in team wellbeing and resilience.

MIND MATTERS: THE CHIMP PARADOX We all have an inner chimp who can be our best friend or our worst enemy... this is the Chimp Paradox, a mind management model first devised by Dr Steve Peters and applied to his work with elite athletes. Do you sabotage your own happiness and success? Are you struggling to make sense of yourself? Do your emotions sometimes dictate your life? Dr Mandy Bertram is a GP with a degree in psychology and one of a small team who have worked with the model for a number of years. She understands the stresses of working in a pressured environment and is passionate about using the chimp model to support individuals, teams and organisations to find greater sense of wellbeing and purpose. Practice Life z September/October 2017

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NEW TO OWNERSHIP AND NEW TO MANAGEMENT Veterinary accountants and consultants are reporting an unprecedented number of new practice start-ups. This is great news for the profession and our New to Ownership stream will help them decide if that’s the route for you, with some great tips from those who’ve taken the plunge, and from financial experts who’ve worked with others who have made a success of it. Meanwhile, the New to Management stream will help those moving into a management role in veterinary practice for the first time, regardless of whether they are managers new to veterinary practice or those already in a clinical role moving into management.

EQUINE We will repeat our popular equine stream, with workshops on time management, employing new graduates, harnessing technology to improve productivity and equine ethics.

Large Animal Workshop To compliment our equine workshop, we will have a stream aimed at all practices employing ambulatory vets, with workshops considering the health and safety of lone workers, how to manage vets who are always on the road, and stock control.

Yes You Can Can!

Br a n d Ne w !

Feather boas, sequins and high kicks are on the menu for this year’s presidents’ banquet, where the theme will be a touch of Moulin Rouge. Our high-energy festival and party band, RPJ, is headed by Rick Parfitt jnr, supported by some of the finest session musicians. Dig out your dancing shoes! Congress will kick off on Thursday night with a Comedy Cabaret.

Opening Speaker: BENJAMIN MEE Benjamin is behind the bestselling book and Hollywood film We Bought a Zoo. When Benjamin and his family found out that Dartmoor Zoo would be closed if a buyer couldn’t be found, he fought against all the odds and managed to buy it. He then faced an uphill battle not only in learning how to manage a zoo and preparing it for opening to the public, but while facing the consequences of his wife’s terminal illness and looking after their two children. His is an inspirational story of making a leap of faith, triumphing over devastating personal tragedy, but succeeding no matter what was thrown in his path. Biography Despite a difficult time in his school days, Benjamin went on to study psychology at UCL and completed an MSc in science journalism at Imperial College. He became a contributing editor to Men’s Health and Guardian columnist before moving to France and starting to write a book on evolution of humour in man and animals. He was recently awarded an honorary doctorate in science from Plymouth University and has a lifelong interest in animal intelligence. In his talks, Ben focuses on motivation and inspiration, leadership, overcoming obstacles, teambuilding and achieving goals.

“Ben’s presentation fulfilled our conference objectives, was entertaining and fun. He demonstrated that with persistence we can overcome the toughest of challenges.” – Duke of Edinburgh Awards

Booking is now open! Read more and register online at https://vpma-spvs-events.co.uk/congress-homepage/ September/October 2017 z Practice Life

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Focus on

Bo ok NOW!