December 2017/January 2018
THE MAGAZINE FOR VPMA & SPVS MEMBERS
Practice Wellbeing Question Time Yoga at work & home Practice Pilates Embracing individuality
What will happen after Brexit Restrictive covenants in contracts Notice of termination
STOCK CONTROL
WHAT CLIENTS WANT
What’s the point?
Time to take action!
THE MAGAZINE FOR VPMA & SPVS MEMBERS
Financial planning for life
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EDITORS’ LETTERS
Editors’ Letters
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he end of the year is looming as I write and I’m fresh from attending London Vet Show. It was a superb conference as usual. I presented this year on flexible working – something of a hot topic at the moment. It was terrifying presenting to so many people, but the experience was massively rewarding and my presentation was well received. My talk echoed the article I wrote recently in this magazine (Sept/Oct 17). Despite how much we want to fight it, the world has changed and the working world in particular. Portfolio careers and the gig economy are replacing the idea of a ‘job for life’. People demand their job fits around their lives and our duty as employers/managers is to help make this happen. We owe it to
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et another year has flown by! Talking to company reps and other such visitors to the practice, there’s a positivity within the industry and things feel definitely “on the up”. Very soon, and after much discussion and consultation, the VPMA is set to have a makeover to reflect the changing face of practice management in our world – more of that later. Increasingly, experience is proving desirable from other managerial sectors and practices are capitalising on new skills within their team to fully exploit diversity and create the best client experience. Suddenly the emphasis is on that most neglected of clinic staff – the reception team – to be armed with new training tools. Health plan providers, buying groups and the like are offering specific (often free) courses on dealing with confrontation, empathy training, soft selling techniques and so on, rather than simply how to answer the phone. Long overdue is a body to represent people like Judy and Ryan in my own practice, who face the public each day and all the fulfilment and challenge that brings. The BVRA (British Veterinary Receptionists Association) is a relatively
our workforce – our practices depend on them as much as our clients. Flexible working is here to stay, but for it to work, and in vet practice particularly, it has to be based on goodwill. It is give and take – accommodating requests for swops in rotas, early finishes, occasional days off for family matters will pay dividends in terms of staff loyalty. The topic will be discussed at our upcoming congress I’m sure. I’m really looking forward to seeing everyone at Celtic Manor, and in particular to the Wellbeing Awards. In meantime, I wish you all a very Happy Christmas!
Leigh-Anne Brown, SPVS editor
new champion for the role, which offers an accreditation, forum and its own congress and I really hope it will raise the bar and inject even more prestige into the job. I was recently talking with a supplier colleague about this and mentioned that I often think of the reception role as a sort of concierge service. My colleague (basing it on the dictionary definition) thought the word was belittling. That same evening I read a story on Forbes online about how, in the US, so-called “concierge medicine” is set to boom – a truly bespoke medical service that may yet find inroads into veterinary medicine. Is it therefore so belittling to think of our front desk team as the concierge of the clinic? Talking of congresses – our own VPMA/SPVS Congress will be here before we know it and promises to be better than ever. Hope to see you there and if you want to share some stories from your own practice that would be great – just ask the desk team – oops, concierge – to contact me and we can meet for a chat.
Ian Wolstenholme, VPMA editor
Practice Life is the magazine of SPVS and VPMA. If you are interested in joining either or both associations, visit www.spvs.org.uk and www.vpma.co.uk
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Contents Editors
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UPDATE: NEWS & VIEWS 5
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VPMA NEWS
SPVS Leigh-Anne Brown, MRCVS VPMA Ian Wolstenholme, Practice Manager Editorial Team Emma Dahm Publisher Libby Sheridan 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
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New era for VPMA Secretariat g
SPVS NEWS
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Vet recruitment issues highlighted g
NURSE TALK
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BVNA appoints strategic director g
COLLEGE CORNER
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RCVS Innovation Project now live!
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.
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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.
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Taking care of Team Wellbeing g
VDS NEWS
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Visit from a Princess g
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MANAGING PEOPLE
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Top three hot employment questions g
CLIENT CARE AND MARKETING
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What clients want: ask then act! g
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BUSINESS HEALTH AND FINANCE
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What’s the point of stock control..? g
PRACTICE DEVELOPMENT
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Making the most of your CPD budget g
Š 2017 Practice Life All rights reserved.
WELL-BEING
CPD SHARED
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Managing, motivating and engaging your team g
CPD DIARY
Events for the whole team in 2018
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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
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News & Views
A first for pets in the north-west Pets and owners in the north-west now have access to CT scanning services, as well as MRI, through services offered from Northwest MRI&CT in Wigan. Northwest MRI was set up in 2010 to offer owners MRI scanning for their pets in the local area and, then in 2013 the service was made available nationwide. The practice has now added CT scanning to its services. James Weston, managing director, said: “Accessible advanced imaging is something that we have worked very hard to perfect to ensure that the process between pet owners and referring vets is seamless, and communication is paramount. “Most pets can be seen within 24 hours of first contact and we can even pick them up in our dedicated MRI and CT ambulance to ensure a hassle-free experience for vets and owners,� he added. The referring vet will receive the images five minutes after the CT scan has finished, providing near real-time images. As an additional service, the centre will send the scans for assessment by European imaging specialists so the referring vet will receive a full diagnostic report.
Cat Friendly Clinic website launched A web resource to support the Cat Friendly Clinic programme has been launched. International Cat Care developed the website to provide both a hub for owners wanting to find a Cat Friendly Clinic and for veterinary professionals wanting to learn more about becoming part of its Cat Friendly Clinic initiative. Veterinary practices looking to become accredited under the scheme can discover case studies and photographs from practices already underway with the scheme, as well as access advice on cat handling, communication and appropriate feline hospitalisation facilities. The Cat Friendly Clinic scheme has international reach, with 966 clinics accredited in 32 different countries, and practices may choose to accredit as bronze, silver or gold level. Visit catfriendlyclinic.org to find out more.
Putting EBVM into your CPD! January 8, 2018 The University of Nottingham is running a modular threemonth course to help those in practice efficiently read papers and run journal clubs, as well as techniques to carry out clinical audit. The course has a practical focus around the principles of evidence-based veterinary medicine and how they can be applied in the practice setting. The course is taught mainly online, with two on-site training days. Visit the website for details: http://www.nottingham.ac.uk/cevm/trainingopportunities/training-opportunities.aspx
December 2017/January 2018 z Practice Life
Paragon Referrals goes large! A new multi-disciplinary referral centre in Yorkshire is set to be one of the largest purpose-built small animal referral centres in the UK. Paragon Veterinary Referrals in Wakefield is due to open in the new year and will have 24-hour intensive care facilities, eight consulting rooms and five operating theatres, as well as a full digital imaging facility. The disciplines offered at the centre will include cardiology, neurology, oncology and ophthalmology.
VPMA News President’s Welcome So this will be my last column as my two years as VPMA President comes to an end and I pass the reins to incoming president Julie Beacham. It’s been a fantastic two years and I am grateful to the VPMA membership for giving me the opportunity. I hope that you think I have represented you well. I would like to thank the VPMA board who have been a massive support and a brilliant team to work with. I would also like to thank the VPMA Secretariat who work tirelessly in the background supporting the VPMA board and running the administration of the association. We said goodbye to Linda in October who worked as part of the VPMA team for well over a decade. I wish her all the best in her future career and want to personally thank her for her support over the past two years. I would not have managed to juggle everything and keep up with my responsibilities without her. So, looking forward, our Congress is just a few weeks away and I look forward to seeing many of you there. The programme looks fantastic and the social events as always are the hot tickets – dust off those dancing shoes and get your feather boas out in readiness for our Moulin Rouge themed banquet. I have attended many congresses over the past few years and ours is definitely the best… and I am not the only person who thinks so! We will be announcing some important and exciting news at Congress having spent a lot of time looking at the strategy of the VPMA and its sustainability in this ever-evolving industry. Over the past year we have been working hard on the rebranding of VPMA as we make it sustainable and relevant to the whole industry. We are really looking forward to sharing this with you all as we launch our rebrand at Congress in January. On a personal note, after 32 years working within the same practice I was offered an opportunity to make an investment and join the board of directors, which considering I joined them as a 16-year-old YTS trainee, has been a long and interesting journey. So as my time as VPMA president comes to an end. My new challenge starts! Take care, Renay Renay Rickard RVN CVPM VPMA President
NEW ERA FOR THE VPMA SECRETARIAT Julie Beacham writes....
Linda, right, with Maria at the 2017 VPMA-SPVS Congress.
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hen I joined the VPMA back in 2006 I felt a bit overawed. For one thing, I wasn’t actually a practice manager at that point and also contacting VPMA meant getting in touch with “The Secretariat”. It all sounded a bit Orwellian. Who were these mysterious people? It didn’t take long to realise that the VPMA Secretariat consisted of two very efficient and friendly ladies named Maria Barratt and Linda Marshall, who carried out the office functions and administration. They were not scary or mysterious at all and they have been a constant feature of VPMA life since they took on the role in 1998. Maria and Linda have always worked in a job-share capacity, looking after our members and supporting the VPMA Board, all busy people in the veterinary industry, to fulfill our duties and abide by the Articles which set out how the Association must conduct its business. Sadly, good things do sometimes have to end and Linda has decided on a career change as of November 2017. Maria is staying on and we have been amazingly lucky that Linda’s departure has coincided with Cath Grimsey MBA, the VPMA’s Finance Director, relocating and looking for a new part-time challenge. Following a handover period, Cath is now joining Maria and a new chapter begins for the Secretariat. We can never replace Linda’s knowledge of the workings and history of the VPMA, but we feel sure that Cath will be an excellent successor. We would like to say a big thank you to Linda for all her hard work and her contribution to the success of VPMA over the past 20 years. Good luck Linda and do keep in touch!
Julie Beacham BSc(Hons), CVPM, VPMA Junior Vice-President
Veterinary Practice Management Association AGM Thursday 25 January 2018, 17.00 Venue: Celtic Manor Resort, Newport Practice Life z December 2017/January 2018
VPMA NEWS
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FROM YTS TO DIRECTOR
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he journey to the top of a career can be very challenging, with hurdles and obstacles to overcome. Renay Rickard, VPMA president, is practice manager at Kernow Veterinary Group in Cornwall. She was recently made director and shares her inspirational journey of scaling the veterinary career ladder. Renay is coming up to the end of her two-year stint as VPMA president and she has overseen many changes in that time. She is on the RCVS Schedule 3 consultation steering group, is chair of VN Futures career development working party, and has brought about the VPMA’s successful New to Management webinar series. She is also a CVPM holder. Kernow Veterinary Group, a large mixed practice and member of the XLVets group, was formed following the merger of three practices and now comprises five small animal clinics and a large animal unit. The group provides 24-hour emergency cover, has a wealth of veterinary expertise with many long-standing employees, and is a VN training centre. In Renay’s Practice Manager role she oversees more than 100 people.
changed, as did the structure of the practice. Renay had been responsible for taking care of everything from the business aspects through to the team and their needs, and now, a dedicated administration team and a growing middle management team keep the practice functioning efficiently as it evolves. Renay’s appointment as a director was something she worked hard to secure. When she was promoted to practice manager, she already had 32 years’ service. This stood her in good stead and has helped her, along with natural management talent, to maintain the momentum required to push her career skywards. The traditional route to partnership would have involved a hefty investment and a long wait for a director to retire. Renay was offered a different route, involving her taking a lower level of investment and ownership share, with the opportunity to increase this later. This has both benefitted Renay and opened a new structure for succession that will help others and the practice in the future.
Hurdles Renay’s biggest challenge during her career has been people management. With directorship, however, there is a certain Where it all began pressure attached to knowing that people are your responsibility Renay joined Pelyn Veterinary Group, as it was then, under a Youth Training Scheme (YTS) in 1985, as an animal care trainee. and that you are no longer an employee, she explains. Being a good listener and a clear decision-maker has helped her greatly. She went on to qualify as a veterinary nurse in 1989. Renay’s Renay is a mother of two and learning to juggle motherhood hard work and determination were quickly recognised by Partner alongside her career has been a challenge. Flexible working and Nicky Paull and she was made head nurse in 1993. Renay was part-time hours are more common in the veterinary industry determined to reach even further in her career and, in 2004, she nowadays, but previously it was a struggle to keep the balls in became Pelyn Veterinary Group’s practice manager. The group then merged with Harleigh Vets and Churchend Vets in 2014, the air at times, she says. and subsequently, Ellis Vets in 2017, and Renay’s responsibilities Renay’s career path has been rewarding and she would grew once again. recommend it to others looking to follow in her footsteps. As practice manager for the whole group, Renay is now Her advice to others is simple: ‘to be a good practice manager, responsible for overall health and safety, managing clients you have to treat it as your own business.’ Having ‘been there (including bad debts) and supporting HR. The practice continues and done that’ she knows exactly what is required of each role. to grow and Renay has overseen three building projects this Working in veterinary practice is something she really enjoys year alone. The practice’s expansion meant her day-to-day role and has never considered anything else.
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 EAST & WEST SUSSEX Liz Panter Tel: 07877 672351 ro7@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 Tamsin Swain ro6@vpma.co.uk
ESSEX REGION Liz La-Page Tel: 07772 382465 ro22@vpma.co.uk THE MIDLANDS Julia Barham Tel: 07974 794687 ro3@vpma.co.uk KENT REGION Siobhan Park Tel: 07849 773 152 ro23@vpma.co.uk
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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
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
SPVS News President’s Welcome
Brian Faulkner
Season’s greetings as we approach that time of year again! I trust you have had a good year. My year as President has flown by and seems to have gathered momentum as the months have passed. Various events have required my attendance and attention since my last report in September. Nichola Watson, our Executive Director, who was appointed in April, has flourished in her role and got her head around the people and the various organisations within the veterinary profession with impressive speed and understanding. Nichola has been helping myself and my council colleagues with various projects, including modernisation of our SPVS forum, a review of our affiliations with HR and health and safety compliance providers. In the autumn we conducted a survey on recruitment to contribute to the Government’s Migration Advisory Committee (MAC), which advises on the economic and social impacts of Brexit and what immigration policy should look like following the UK’s departure from the EU. Members can access the results via our website, www.spvs.org.uk I was privileged to attend various events and meetings in my capacity as president, which included the BVA Members’ Day, held in the Titanic Quarter in Belfast. A couple of weeks later I was once again back on the “mainland” when I attended Vet NI/AVSPNI’s conference in the Slieve Donald hotel in Northern Ireland. I presented two lectures, one of which explored why practices struggle to retain vets and the second looked at how SPVS surveys and services (salary, fees, profitability and Vet Viewer Benching marketing service) can be used in practice. I attended Westminster twice in the autumn. The first time was in support of a Parliamentary Briefing on Brexit and its impact on animal health and welfare, as well as establishing the BVA (and its associated societies) as the place to go for expert advice, information and opinion on animal health and welfare. The event, hosted by BVA honorary member, Neil Parish MP, provided an opportunity to engage with MPs and members of the House of Lords on the profession’s key concerns regarding Brexit, including workforce concerns as well as standards of animal welfare. My second trip to Westminster was to attend NOAH’s conference, which also focused heavily on the impact of Brexit on the future of animal health. The meeting, which was chaired by NOAH Chief Executive Dawn Howard, heard talks regarding where animal health sits within the political context, as well as regulatory issues plus opportunities for collaboration and innovation with respect to animal health. Finally, I attended a series of conferences as SPVS President including BEVA, BCVA and BVA. I was sorry not to be able to attend BVNA as it clashed with the Vet NI/AVSPNI’s conference. Stephanie Writer-Davies attended in my place as she was also unable to attend BVNA last year due to the same clash. I hope you have a peaceful Christmas and I look forward to seeing you at our annual congress at Celtic Manor at the end of January. Brian Faulkner, SPVS President
SPVS Dates For Your Diary 2018 January 25-27, 2018 SPVS-VPMA Congress, Celtic Manor Resort, Newport A wealth of speakers new to the UK veterinary conference circuit from different sectors, professions or countries who bring expertise in leadership, marketing, customer care and staff wellbeing. Visit www.vpma-spvs-events.co.uk for further details and to book.
March 10-17, 2018 Snowscene, Hotel Eder, Maria Alm, Austria First-rate skiing, CPD and networking! CPD includes: On a slippery slope – approach to some common emergencies – Yvonne McGrotty Human behaviour – how it affects our practice, client and team relationships – Libby Kemkaran-Thompson Visit https://spvs.org.uk/ for details
AGM 2018
Society of Practising Veterinary Surgeons The SPVS AGM will be held at 5.00pm on Thursday January 25, at the Celtic Manor Resort, Newport The election of Officers and Councillors will take place and all SPVS members are invited to take part in these elections. Nominations for Councillors and Officers need to be received in writing, duly proposed and seconded, 15 days before the AGM (January 10, 2018). Nominations should contain the signature of the nominees and their proposers and seconders. All proposers and seconders must be members of the Society.
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SPVS NEWS
Nichola Watson, SPVS Executive Director SPVS has been serving its members for more than 80 years, striving to be the voice of the practising profession and promoting high working standards and quality of life for employees. I am honoured and excited to be appointed its first Executive Director. Firstly, thank you all for making my first six months a wonderful roller-coaster ride. Although I am new to this exciting industry, I have been met with warmth, positivity and support from peers, members and stakeholders alike. There have been many highlights over the past six months, including being instrumental in the delivery of SPVS’ first electronic surveys, visiting UEVP in Brussels, developing a new member forum and, most importantly, getting to understand how my role can support SPVS in further benefiting its members. Supporting member benefit development is my main priority; this ranges from participating in political working groups, to establishing a new membership survey. Either way, SPVS is your organisation and if you’d like to contact me – please don’t hesitate! I’m delighted to announce the launch of a new SPVS online forum, which will provide members with a place to network, problem-solve and help and support one another in an easily accessible and safe environment. It is intended as a complement to the existing email discussion list and will enable members to easily search for topics, access useful SPVS information and up or download documents. In addition, the site is hosted by www.vetpol. co.uk meaning that SPVS members will also be able to access helpful management and practice advice available on the wider Vetpol site, as well as place job vacancies – all for free! SPVS members may upload posts, comment on other members’ posts, ‘like’ posts, upload documents and download them. You may ask questions, volunteer advice, and share documents. In fact, you may do anything you like as long as it is done in the community spirit of support and sharing. Have a great Christmas and New Year and I look forward to meeting many more of you at my first Congress in January. In the meantime, please be sure to visit the SPVS website www.spvs.org.uk for our survey results and details of our new membership forum hosted by www.vetpol.co.uk. Stay smiling. Nichola
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SPVS SURVEY HIGHLIGHTS
VET RECRUITMENT ISSUES A crisis in the recruitment of vets has deepened, according to the results of the latest SPVS survey of practice owners and managers.
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he survey, carried out in September, showed more than half of the businesses that took part did not have a full complement of vets, with 28% reporting a severe impact on their ability to cover out of hours work. Most practices had attempted to recruit in the past 12 months and 31% had failed to find a suitable candidate at the time of participation. Of those who had received applications, only 38% had come from the UK, it was reported. An unwillingness to do out of hours work and dissatisfaction with working hours was cited as the most common reason for candidates not accepting a position. This, combined with the fact that most respondents said they planned to reduce their working hours, indicated the crisis may deepen in years to come. Brian Faulkner, SPVS President, suggested that to succeed in recruitment, employers will need to consider a more flexible approach to work patterns and hours. “This survey provides valuable evidence to support the profession as we work with Government and universities to try to counter this crisis in recruitment, which threatens to get worse with Brexit. “Left unchecked, it will become increasingly difficult for vets to provide a satisfactory 24-hour health service for the UK’s pets, horses and farm animals,” he added. Only 22% of practices reported finding a new recruit within three months in the 2017 survey, compared with more than 30% two years ago. The survey also showed that twice as many respondents in 2017 were advertising for new or recent graduates compared to the 2015 survey. Peter Brown, SPVS Vice President Elect, who oversaw the survey, said: “Our message to employers is that those practices offering good training and support, together with internships for new or recent graduates, appeared less likely to be facing recruitment issues.”
The full survey results are available on the SPVS website at www.spvs.org.uk
Nurse Talk
In association with
VETERINARY SURGEONS ACT: SCHEDULE 3 CONSULTATION UPDATE
BVNA was not surprised at the outcome of the consultation, although being such an emotive and important issue we would have liked to have seen a higher percentage of registered veterinary nurses and student veterinary nurses responding. What was highlighted in the report was a lack of confidence veterinary nurses had in their own abilities; in fact, veterinary surgeons had more confidence in us as a profession than we had in ourselves. As for a lack of understanding about Schedule 3, BVNA feels it is more a lack of confidence than truly not understanding. Certainly, veterinary nurses have the Code of Conduct built into their pre-registration syllabus, so it is taught from quite early on the in programme; in theory, there should be good knowledge surrounding Schedule 3. BVNA is not able to comment on each university’s veterinary science programme, but it certainly helps if student veterinary surgeons work alongside veterinary nurses during their practice placements and see effective delegation of tasks from early on in their career. BVNA did find that during the VN Futures roadshows, delegates found there was a lack of clarity on some of the
terminology used in Schedule 3. This contributed to a lack of understanding and therefore the low desire of some veterinary surgeons to delegate tasks. The most important thing that BVNA would like to see now is some action taken after this consultation. BVNA sits on both the Schedule 3 working party and the VN legislative group and we will be voicing members’ views. BVNA would like to see more education produced postregistration about the delegation of tasks for veterinary nurses by the RCVS in various forms. We would like to see practices and RVNs, vets, and even student veterinary nurses, thinking about how best to use the role we fill within practice. BVNA would also like to see the Veterinary Surgeons Act updated to be more in line with the current skills of RVNs with recognition of those who have additional advanced skills that can be well used within practice.
BVNA AND BVA SIGN MORANDUM OF UNDERSTANDING On September 21, the BVNA and BVA announced their new strategic alliance by signing a memorandum of understanding. From developing actions jointly for Vet Futures and VN Futures projects, to the launch of the Team Vet campaign following the Brexit vote, BVNA and BVA have worked shoulder to shoulder on a range of priorities. The memorandum recognises the foundations that have been built though collaborative working and is intended to build on the relationship between the two organisations. As part of the memorandum, BVA and BVNA have agreed to identify opportunities to work together to represent the views of veterinary surgeons and veterinary nurses to the media, policymakers and general public and to raise the profile of the veterinary professions and the wider veterinary team. The two associations have also agreed to work together to deliver joint events and support each other’s members. BVNA Senior Vice President Samantha Morgan said: “BVNA is very pleased to sign this agreement to formally recognise the close relationship our professions have and, therefore, both representative bodies have. This is going to be a symbiotic relationship, with both professions and representatives retaining their own unique identity but forming a single, strong voice. This
is a proud milestone for BVNA, something we have worked hard to achieve and we believe this formal understanding between our representative bodies is a positive step forward for the veterinary nurse profession.” BVA Senior Vice President Gudrun Ravetz said: “This memorandum really captures the importance of the veterinary family, my presidential theme, in terms of us all working together to achieve the best possible outcomes for animal health, welfare, public health and our professions. “At community level, we could not achieve a fraction of what we do if vets and vet nurses did not pull together and, at national level, one strong veterinary voice will achieve so much more if we work in unison. I am delighted that BVA and BVNA have had the strategic foresight to formalise our close working relationship, with many more opportunities to come for collaboration that will best represent the voices of our members.” The memorandum between BVA and BVNA is agreed for a period of three years and will be regularly reviewed during that time. Practice Life z December 2017/January 2018
NURSE TALK
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BVNA APPOINTS STRATEGIC DIRECTOR The BVNA has appointed Robin Millar as its new strategic director, effective November 1. This follows recent announcements about a governance review and restructure at BVNA. Wendy Nevins, BVNA president, said: “It is a great pleasure to welcome Robin to the team at BVNA. Council recognised that this position is important to our future plans and positioning for the challenges ahead. I have every confidence Robin’s appointment strengthens the BVNA as a consistently strong representative body for veterinary nurses across the UK, now and for the future.”
Download your free nursing skills ebook! A FreeBook created for the 2017 BVNA Congress is now available to download. The book brings together a selection of chapters from CRC Press and Routledge that cover key topics in veterinary nursing. With chapters including writing nursing care plans, effective communication and continuing professional development, this FreeBook is essential reading for all veterinary nurses. It contains a multitude of tips and easy-to-implement strategies from bestselling nursing books including: Becoming a Nurse, Professional Values in Nursing and Introduction to Nursing Research. It also includes exclusive content from Veterinary Nursing Care Plans: Theory and Practice, which you can read before it publishes! If you have any problems downloading this FreeBook from the BVNA website or have any questions about using this for a course or distribution, contact medicine@crcpress.com.
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08/11/2017 15:19
College Corner
RCVS INNOVATION PROJECT NOW LIVE! Ever since Gordon Moore predicted in 1965 that the number of components in an integrated circuit would double every year (also known as Moore’s Law), the exponential development of technology has been well recognised. Here, Anthony Roberts, Director of Leadership and Innovation at the RCVS, describes how the College’s new project will help put vets at the forefront of innovation.
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ust 15 years ago it would have appeared implausible that we would be carrying a powerful handheld computer in our pockets or bags which is capable of a multitude of things – from watching the latest films and listening to music; measuring the amount of exercise we do; and even turning our central heating on and off remotely, but it has become part of everyday life for the majority of us. And while innovation has had high-profile disruptive effects in areas such as the way we consume music, film and television, as well as how we travel and where we stay (think Amazon, Netflix, Uber and Airbnb), in the less visible world of health and healthcare, exponential innovation is having a profound impact. In human healthcare, for example, apps such as Babylon Health put a healthcare professional in your pocket through an advanced AI symptoms checker and telemedicine appointments with GPs and specialists. Author, speaker and advisor to business and government on the impact of technology, Professor Richard Susskind, OBE, has identified that the professions – typically guardians of expertise in a particular field of knowledge – are increasingly at risk of being disrupted or even bypassed by the exponential growth in technology – and vets are no exception. This is why, following the publication of the Vet Futures Action Plan in July 2016, which identified innovation as a key issue, the College has decided to launch its innovation project ViVet (Latin for “it will thrive”) to help the veterinary professions embrace innovation and be at the forefront of developments. The basic premise of ViVet is that innovation in the animal health sphere is going to happen anyway and, this being the case, it is essential that veterinary surgeons and
veterinary nurses talk to innovators or, better yet, are the innovators so that animal health and welfare is always a prime consideration. This was the overwhelming message that came across when we held our inaugural Innovation Symposium at the Warwick Business School in the Shard in September where we invited a number of speakers working in the space where innovation and animal health and welfare meet to talk about current and future developments. Among them were, for example, Greg Dickens and Guen Bradbury, vets who work for innovation consultancy Innovia, who described a number of scenarios of how, in the very near future, the work of veterinary surgeons could drastically change. For example, they described how a cat’s genomic data could be gathered and used before surgery to help inform its risk of interaction with anaesthetic agents, its risk of coagulation problems and the use of premedication before anaesthesia or how a remote consultation, conducted by telephone and video, for a dog that had gone lame after chasing a squirrel might be informed by data gathered from the dog’s activity tracker. We heard from Dr Adam Little, the Director of Veterinary Entrepreneurship and Innovation at Texas A&M University, who explained that the increasing “humanising” of pets means people are looking for more and more convenient services for their pets, for example, through trackers and remote monitoring systems. And with consumers increasingly turning to technology to resolve their problems, vets had a challenge to get their clients into the practice. Adam’s contention was that the only solution is for vets to become the innovators in areas such as mobile veterinary medicine, using big data, biometrics and gene sequencing – this is the only way to ensure the profession isn’t overly disrupted and that animal health and welfare is a primary concern. The importance of regulators seeking to foster and support innovation was also highlighted in an excellent talk from
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Christopher Woolard of the Financial Conduct Authority who told delegates about its “regulatory sandbox” that offered a safe space for innovators to develop financial products with regulatory oversight to ensure that they were compliant and protected and enhanced the consumer experience. As just this short digest demonstrates – there are lots of complicated issues at play and the solutions may not seem easily forthcoming. However, the aim of the ViVet programme is to support veterinary professionals in engaging with innovation and to encourage innovators to engage with the veterinary professions when launching new products or s ervices. In doing so, it seeks to put veterinary professionals at the centre of innovation in the animal health sector. The programme will also be showcasing – through case studies, blogs, e-newsletters and other online resources – new technologies and business models and will provide practical advice on how vets can launch new products and services. It will also involve an ongoing review of the College’s regulatory framework for the professions so that it does not overly hinder innovation, but instead encourages it to be fair, ethical and responsible. With this in mind we will also be giving regulatory advice and guidance to those from within or without the profession on how to bring new products or services to market. If you are a veterinary innovator – or simply have a few ideas on how innovation could improve the profession – I1am19/10/2017 very Medivet_PracticeLifeMagazine_#18_DEC2017.pdf
Use of drones in agriculture and for animal disease surveillance is advancing fast.
happy to have a chat about how ViVet could support you and your business – you can contact me on a.roberts@rcvs.org.uk. In the meantime please do have a look at the programme’s dedicated website www.vivet.org.uk where you will find details about the programme, our online resources and videos and recordings of the speakers at the Innovation Symposium. 12:25
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everyone achieves more Long hours, high stress and increasing client expectations. Is it possible to achieve a fulfilling work-life balance? At Medivet, we believe it is! We know that success comes from great teamwork where there’s respect, trust and people can care for one another whilst also focusing on what they do best. We’re moving away from trying to do it all ourselves and are starting to enjoy the benefits of great teamwork – including a better work-life balance. Teamwork is where the magic happens. To join the Medivet family, contact our Head of Recruitment, Daniel Preter, today on 01923 920 890. He’d be delighted to hear from you!
vetrecruitment@medivet.co.uk www.medivet.co.uk
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TAKING CARE OF TEAM WELLBEING Wellbeing has been in the news a lot recently and the XLVets group is no exception – here Jacqui Dodds shares her experience of Thriving in Practice along with case studies from other practices
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aragon Veterinary Group is a mixed practice based in the heart of Cumbria. We cater for equine, exotic, farm and small animal clients and perform specialist procedures, such as embryo transfer. The practice has three branches and 55 staff. The practice was set up more than 70 years ago, and, in 2005, was a founder member of the community of independent practices called XLVets.
Thriving in Practice With buzz words like “wellbeing” being used increasingly in the world of veterinary practice, I knew it was time for us to join in and embrace this new thinking. The days of James Herriot are long gone, when, popping over to visit an elderly client’s cat, you would also have time to fix her flat tyre and have a quick chat over a homemade fruit cake and a pot of tea! Practice life has evolved while the expectations of our clients have blossomed. The reality is that ours is now an incredibly pressurised environment to work in – something we are very aware of, and we are pushing hard to redress the balance. To be able to survive in this challenging and stressful environment, efforts need to be made to ensure we take care of all our staff. This includes looking after our team’s physical and mental wellbeing. Earlier this year, XLVets developed a framework for doing just this, the “Thriving in Practice” project, and we’ve been using this to help drive our wellbeing initiative. The project focuses on five key areas, which are drawn from the New Economics Foundation’s evidence-based Five Ways to Wellbeing actions¹, which include: 1. giving – doing something for a friend or neighbour, such as holding a group activity; 2. being active – this can help combat depression and increase health; 3. connecting – increase your social network; 4. taking notice – pay attention to your surroundings, disengage with any devices; and 5. keep learning – learn a new skill, take up a new hobby or sign up for a course.
Why focus on wellbeing? Stress and mental health problems are commonplace in the veterinary industry, with suicide rates four times higher than the national average and twice that of doctors and dentists². Last year, mental health problems affected one in four in the UK, with one in six in England reportedly experiencing mental health issues, such as, depression or anxiety on a weekly basis (Mind.org.uk, 2017). Sadly, this issue has particular significance for those in the veterinary profession, with many of us having experienced mental health problems ourselves or been aware of colleagues battling issues. This is no surprise when you consider the long hours, relatively poor pay compared to allied professions, and high stress levels that we experience. As a topic, mental health has gone under the radar for too long, but it is now starting to be addressed through projects such as the Mind Matters Initiative (https://www.vetmindmatters.org) and the SPVS Wellbeing Awards (https://spvs.org.uk/wellbeing). Poor mental health correlates with increased absenteeism and higher staff turnover – 17 million working days were lost to sick leave for mental health issues in the UK in 20154. This can be explained when you consider the negative impact that it can have on the overall health of those affected, as it is believed be a contributory factor for conditions such as heart disease, hypertension and diabetes5. Those experiencing mental health problems are also more vulnerable to suffering from ‘burn-out’. So, making sure you are taking care of your team’s wellbeing can also help to improve your margins too. The good news is that there is something you can do to help, and the best antidote is to boost your team’s physical and mental wellbeing. This will not only help to keep your team mentally healthy, but also make your practice somewhere that people want to work together and feel inspired to excel as a team. How can you improve your team’s wellbeing? Through making changes at my own practice, I have learnt a lot about ways to improve wellbeing and the positive impact this can have. These are my recommendations for anyone wanting to do something similar: Practice Life z December 2017/January 2018
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Top-tips for team wellbeing • Be considerate and respectful of each other
• Have regular team meetings • Encourage communication • Support each other • Have fun and socialise outside work • Share decision making and problem solving • Get the team involved in plans for the practice • Encourage feedback • Small gestures can have a big impact – so, put the kettle on! 1. Encourage team support We face stress and pressure every day in practice. Encouraging and educating team members to recognise signs of stress can help to support colleagues by spotting things early and helping them. A small gesture can mean a lot to someone who is struggling – just getting them a cup of tea can be a welcome stress-reliever, and the act of doing it shows that someone is thinking about them. Recognising that a team member needs a break or has missed their lunch is a small but significant gesture. Encouraging them to stop and sit down for a minute shows caring, and highlights that self-care is taken seriously in the practice. It’s too easy to get caught up in the whirlwind of constant activity. 2. Acknowledge team diversity The first step is to acknowledge that your team will be made up of individuals who are diverse, with different personalities and ways of working. This can sometimes lead to conflict within the team if these differences aren’t acknowledged. Therefore, encouraging your team to recognise and use each other’s skills will drive a team culture of respect and good communication. One of our practice values at Paragon is teamwork. We strongly believe and encourage everyone to be considerate of each other while providing consistent support, feedback and appreciation at all times. By promoting wellbeing and offering support, the practice is a happier place to work. 3. It’s good to talk Communication is king in the workplace and especially within a team. Frustration and stress can often be avoided just through effective communication, whether this is team members talking to each other one-to-one or making time for regular team meetings. Regular communication is invaluable and gives the team a chance to vent about any issues, and dispel any tensions. Channels of communication need to be kept open at all times. This extends to management too. At Paragon, we also try to encourage the team to talk us about issues they have; we want them to be open with us. We want to look after our staff and bring this caring ethos to the forefront of the practice. December 2017/January 2018 z Practice Life
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4. Make decisions together as a team Discuss changes to the practice or plans for the future as a team. This will give everyone the chance to voice their opinion and give feedback. It helps to generate a feeling of ownership and a sense of working together. It will also make your team feel valued and respected and avoid confusion later when changes are made, which can be unsettling for the team. 5. Share the burden A big part of working in practice involves making decisions big and small, which is a source of both pressure and stress. I always encourage the team to talk it through with each other, especially with difficult cases. I think this gives the team a chance to demonstrate their respect and trust for each other and reinforces a sense of care. 6. Have fun together! So much of our time in practice is spent moving at 100 miles per hour with little down time away from the practice. Encouraging the team to socialise is a vital part of practice life. It gives team members a chance to see a different side to their colleagues and to chat in an informal environment, which can make it easier to discuss any worries. We often have social “get togethers” with individual teams as well as the whole practice. It’s good to see colleagues outside of the work environment, as it gives the team a chance to get to know individuals from our other surgeries, whom they wouldn’t usually work alongside. In the summer, we host a barbecue and hold practice rounders matches. Also, on a Thursday night, we often gather down the local pub for a drink after work to unwind. 7. Small gestures make a big difference Sometimes it’s the small things that make the difference. For example, I enjoy making bacon butties for the team, which always goes down a treat. We try to make sure that we always have some sweet treats in for the practice and take it in turns to bake birthday cakes for everyone to share. 8. Do something together Doing an activity together to raise money for charity can help the team to bond and increases a sense of wellbeing. We recently took part in the Gelt Gladiator mud run as a practice and entered two teams of eight from all sectors of the practice. It was a great success with everyone completing the course and I loved seeing the team pulling together to support each other. The highlight was when the whole team decided to cross the finishing line together! www.paragonvet.com www.xlvets.co.uk References: 1. New Economics Foundation (2008). Five ways to wellbeing: the postcards. Accessed October 30, 2017. http://neweconomics.org/2008/10/five-ways-to-wellbeingthe-postcards/?_sft_project=five-ways-to-wellbeing 2. Vet suicides outstrip UK average (2005). BBC news story http://news.bbc.co.uk/1/hi/ health/4310596.stm. Accessed October 30, 2017. 4. Businessrevieweurope.eu, 2016 5. Rajopal, 2010
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CASE STUDY: PAULINE GRAHAM’S PRACTICE PILATES
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auline Graham is practice manager for Capontree Vets, which is a mixed practice with three surgeries that cover Northumberland, Cumbria and southern Scotland. She has worked for Capontree Vets for many years and, in 2006, was appointed as a director. She also serves on XLVets and BVA Boards. “In 2015, to help the team to relax and unwind after the stresses and strains of everyday practice life, I decided to experiment and introduce “practice Pilates” sessions. Two of the vets who helped to get the sessions up and running had been affected by back problems and recognised the physical health benefits that Pilates could offer, such as helping to protect against back injuries and improve core strength. Life in practice can be physically demanding as well as stressful. Lifting and carrying patients is routine, and contorting the body beyond its capacity when restraining a wriggly patient and raising a vein at the same time is not unheard of! Consequently, it is not uncommon for those working in practice to suffer from back problems. After finding a private tutor, the practice Pilates sessions were set to go and every Thursday at 7pm our waiting room was transformed into a Pilates studio! All members of the Capontree veterinary team were invited to join in the sessions, which were an instant success. Prior to starting the Pilates sessions, I was apprehensive about how beneficial they would really be.
However, any doubts quickly evaporated, as I noticed how much it helped me to de-stress after a hectic day at work. The Pilates sessions created a stress-free environment that was also conducive to communication and I noticed staff from all areas of the practice were interacting with each other. I received a lot of positive feedback from the team, including from head receptionist, Joanne Brown. “I joined Capontree Veterinary centre Pilates group a year ago,” she said. “Not having done Pilates before, I wasn’t quite sure what to expect, especially as the class was taking part in the waiting room at the practice! I have found Pilates a great way to de-stress and unwind with my work colleagues at the end of a busy working day.” Katie Hayton, one of the veterinary surgeons, added how beneficial it had been to her health. “Having suffered niggling back injuries throughout university and since starting work, I have been advised to do Pilates by physiotherapists. Unfortunately, finding a class to fit in with the working hours of a vet has proved tricky. “I was delighted when classes were organised by the practice two years ago. I’m a complete convert. I sleep better and can cope with long periods of standing and operating far better than I ever have before. Now I’m pregnant, I’ve kept going to classes and my midwife assures me it will help with labour and returning to full fitness after giving birth.” It’s easy to see how even just making a small change can have a huge impact on both the health and wellbeing of colleagues and I hope other practices will follow.” www.capontreevets.co.uk
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CASE STUDY: MAXINE EVANS, CEDAR VETERINARY GROUP Cedar Veterinary Group is a busy veterinary practice catering for small animal and equine clients, based in Hampshire. In 2015, Maxine Evans joined the Cedar Veterinary Group as head nurse.
F
ollowing Maxine’s attendance at a ‘Thriving in Practice’ business seminar, held at XLVets, Maxine was inspired to put the theory into practice and to start making changes at Cedar Vets.
It’s good to talk and to listen! Maxine feels that the veterinary profession has been set in its ways for too long and still harbours a lot of old-fashioned views that need to change. For example, the attitude of ’keeping your head down’ and ‘pushing on’, is no longer a healthy strategy for coping in this stressful and intense environment. She considers it important to encourage open communications within the practice teams to help give them the support they need to do things or make changes. Communication is key to recognising when a colleague is struggling, however, creating the time to sit down and chat to someone in the hectic practice environment is difficult. To help overcome this, Maxine has started sending small personal text messages out to the team in the evening just asking how they are. She says the team has responded positively to this and believes that this can be an effective way to reach out to team members that may need to talk away from the practice. Going forwards, Maxine would like to have the time to sit down and have regular one-to-ones with each of the team members. Listening is a skill that Maxine fully appreciates, she has been actively making sure that she pauses just to listen to what the other person wants to say before speaking. “Too often, and especially when we are rushing around in practice, we don’t make time to do this and it’s important. Part of listening is ensuring that the other person has time to express themselves and ‘open up’. “Working in practice often involves enduring long hours and with the rise in the expectation of clients, the veterinary team is under more pressure than ever before. Times have changed and this needs to be recognised in the industry. People are still not used to talking openly in practice about mental health and as a result are suffering in silence, which is contributing to the attrition that we are seeing in the veterinary industry.” The power of positive feedback and a coffee machine! The practice also holds regular clinical meetings every five weeks over breakfast. This is a chance for the team to feedback any concerns or discuss any difficult cases. It is also an opportunity to learn. Guest speakers are invited to give talks on topics such as mental health, followed by a discussion with the team. It’s not always the big things that make a difference and a small change that has a had a big impact on the team has been the addition of a Nespresso coffee machine! Maxine explained that it not only makes the team feel appreciated and cared for, but is a great pick-me-up when it’s been a bad day.
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Yoga mats at the ready! To help the team to unwind and relax after a hectic day at work, Cedar Vets holds a fortnightly yoga workshop, after work at 7.30 pm. The aim is for the team to not only benefit at the sessions but to also take away what they have learnt and use it to relax at home too. This has been a really successful project and looks set to stay in place for the foreseeable future. To ensure that the sessions were affordable for all staff, Charlie ensured that the fee was subsidised by the practice. Maxine observed that “for some members of the team yoga has been a real surprise, having previously underestimated the benefits and perceived it as ‘wishy washy’.” Building a great future together Just like so many practices in the UK, the main small animal branch is situated in a converted bungalow, that has not been purposefully designed to meet the everyday needs of the veterinary team. Maxine expressed “that this can place extra strains on a busy veterinary team and make routine tasks more challenging.” Cedar vets has already embraced the need to make a change and is currently in the process of designing a purpose-built practice that the team will move into. Maxine explained how they have been involving the nursing team in the planning of the new build and asking for their ideas. This not only makes the team feel valued but has also enabled the team to have say in the design of the building, and to make changes and suggestions that will enable them to work more efficiently. Maxine said that it is through this that she has realised how important it is to share ideas to facilitate progress. Giving back to the team Working hard is important but it needs to be balanced with fun team times too. Cedar Vets treats the team to meals out on their birthdays, hosts a summer party and a Christmas dinner. These are all great opportunities for the team to socialise away from the stressful work environment. It also helps to strengthen the team and their relationships with management and encourage good communication. Thriving in the future Maxine, with the help of Managing Director Charlie, are set to embrace the ‘Thriving in Practice’ programme to make changes to improve the wellbeing and mental health of the team. An important change on the horizon will be moving into the new building. This will be a really positive step, as currently there is no staff room or quiet place to go and get away from it all. The new building will have a quiet area for the staff to relax in and chat privately and also a meeting room, which will make a big difference to the wellbeing of the team. www.cedarvet.com
VDS News
A ROYAL FLUSH A
s Kate opened her consulting room door, her acute sense of smell informed her that the Old Awkward Pargetters (OAPs), must be waiting for her with their cherished, beribboned Yorkshire terrier, Princess. One whiff of the little royal’s breath was sufficient to ensure that anyone within a couple of metres would instantly adopt Republicanism, but Mr & Mrs P were completely oblivious of their darling’s extensive sphere of influence. Despite every consultation concluding with a recommendation to arrange dentistry, the owners inevitably departed, unconvinced, while the exasperated vet swiftly reached for the air-freshener. Kate was therefore surprised to learn that on this occasion the OAPs wondered if Princess might have toothache, having turned down her M&S prawns all week. Taking a deep breath, she proceeded to examine the gruesome mouth, revealing a festering collection of choppers, worthy of any production of Les Miserables. Without further ado, Kate agreed wholeheartedly that dentistry would appear to be the perfect way forward. It was not so simple, of course, as the OAPs became agitated by the thought of Princess being left to cope alone in a cold kennel. Fortunately, the head RVN, Sue, was able to reassure them that nothing would be too much trouble for her, in caring for
their beloved, as she gently prised the reluctant patient from Mrs P’s chest. The procedure was routine, a small tap on the back of Princess’ head being more or less sufficient to encourage her teeth to part company with her skull. Kate left Sue to do a splendid hygiene job on the remaining molars and Princess was soon propped up in regal splendour in her kennel, creating a less than majestic noise. Sue, true to her word, had secured every hot water bottle and microwavable bean bag, to ensure Princess did not succumb to the perils of hypothermia. At the discharge appointment, the OAPs were delighted to see Princess so quick to eat the delicacy they had brought along “for the journey” and happily settled their account. They even arrived for the post-op check with a large box of chocolates to thank the Sue for her admirable nursing care, although she considered the lack of abhorrent odour emanating from Princess’s mouth was reward enough. The tide began to turn seven days later when Princess was presented with a skin irritation. Once the vet had removed the monogrammed raincoat and examined the lesions, the OAPs were less than impressed by her suggestion parasites might be to blame. Princess never mixed with hoi polloi. Preferring the alternative differential, an allergic reaction, they departed, happy enough with a tube of cream. Several consultations followed, but the condition deteriorated and once again Princess stank. Bewildered, referral to a dermatologist was recommended, but readers will recall the owners’ lack of olfactory awareness and they insisted on persisting with the cream instead. One evening disaster struck, as a large portion of Princess’s flank sloughed, necessitating an emergency appointment at the practice’s 24-hour clinic and the pointless application of smelling salts to the delicate Mrs P. Learning of the recent dental procedure, the emergency vet put forward a theory of a heat pad burn and biopsies subsequently confirmed the diagnosis. Sue was mortified and after discussing the matter with the practice principal, offered to hospitalise and treat Princess personally and without charge. The OAPs visited daily bringing a selection of deli goodies to tempt Princess, who was already perfectly content with the more regular diet supplied in-house. The lesions eventually healed with Sue’s tender administrations and even the building appeared to breathe a sigh of relief, when the day of discharge finally arrived three months later. The OAPs expressed gratitude to Sue for her nursing heroics “above and beyond the call of duty” and for treating Princess for nothing, so it came as quite a shock when several days later, an RCVS email arrived out of the blue addressed to her. The consultant was heartening, sympathetic and immediately able to reassure a rather anxious Sue that the nature of the complaint was not likely to mean she would ever have to attend a disciplinary hearing. She pointed out that this was typical source material for a College complaint and Sue should not give another thought to the OAPs’ hurtful suggestion that she was the veterinary equivalent of Harold Shipman and should therefore be “struck off”. Practice Life z December 2017/January 2018
VDS NEWS
Sue learnt that thermal burn complaints and claims were common fodder for the VDS and most arose from the use of microwavable products, old equipment long overdue a service or the fact that most commercial heat pads are not
recommended for anaesthetised patients unable to move away from the heat source. Over the next few days Sue compiled, with the assistance of the consultant, an honest, factual response to the complaint. Once the report had been despatched to Belgravia House, the consultant warned Sue that it might be some time before she heard anything more. Four months passed before Sue rang the VDS to say that she had received a letter from the College closing the complaint, with a smidgeon of advice to avoid cooking pets at regulo 7 in future. Although ecstatic with the result, Sue admitted she had suffered weeks of disturbed sleep, but had found the reassurance, moral support and advice provided by the VDS invaluable, because it was obviously underpinned by familiarity with, and an understanding of, the regulatory process. As a RVN new to the process she had found the advice priceless. Sue felt the only good thing to come out of the whole affair was she now understood the value of the VDS’s inimitable support package, practical, financial and psychological, for all RCVS complaints and would endeavour to spread the message far and wide to her colleagues to call VDS if they were unfortunate enough to find themselves in the same position. The Society’s service for RVNs faced with a RCVS or VCI complaint is considered priceless in times of need and, therefore, it is vital you check your practice has insured you personally on the VDS’s practice policy schedule, or, alternatively, if you work as a locum or in a non-VDS insured facility, we recommend you obtain your own cover from the VDS before the dreaded email or letter arrives to be assured of our expert assistance.
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MANAGING PEOPLE
TOP THREE
HOT EMPLOYMENT QUESTIONS As a regular advisor to veterinary practice employers, Stephenie Malone, a specialist employment solicitor at Harrison Clark Rickerbys, regularly sees the same “hot topics” arising. Here, Stephenie sets out the top three employment questions she gets asked by vets in practice.
1. What does Brexit mean for our staff from EU countries? It is expected that Brexit will have minimal effect on EU nationals who are already living and working in the UK. At the time of going to press, proposals set out the protection of EU workers who are currently here, with a simplified process for establishing their continuing right to remain in the UK post-Brexit. As a sector reliant on EU veterinary surgeons and nurses, that will be a welcome relief. If you are concerned that your staff may, ultimately, decide to leave the UK it is recommended that you take early action. Understand if they want to stay in the UK permanently so you can obtain visibility to assist planning your staffing structures and highlight recruitment needs. You may decide to offer to assist EU national employees with their plans to formalise their permanent resident status and offer assistance in gathering their documents together at an early stage. This will enable them to apply for the new “settled status” when they are required to do so. After the UK’s exit from the EU, it is expected that there will be more stringent requirements for EU workers to enter the UK. If you wish to recruit into skilled roles, such as vets and clinical practitioners, your practice could be required to sponsor employees. Deciding to act early by identifying any future requirements your practice might have will enable you to recruit while we can still benefit from free movement within the EU. Until we learn more about the Brexit process, it is sensible to focus on the retention of existing staff, as they will be key to the efficient operation of veterinary practices for the foreseeable future.
2. Should we include restrictive covenants in our contracts of employment? Restrictive covenants are a perennial hot topic across all employers. They are provisions in a contract of employment that prohibit certain activities by your employees for a defined period after the termination of employment. The remedy is for the employer to obtain a court injunction to require the employee to honour the covenants and to reimburse the employer for any financial loss as a result of the breach of contract.
While as a legal starting point, a post-termination restriction on a former employee’s activities is void as a restraint of trade, if there is a legitimate business interest to protect (something of value in the business to protect – such as client relationships and associated income) they can be enforceable against former employees. Examples commonly include restrictions on dealing with customers of their former practice for a set timeframe, or poaching employees. Many employers include a blanket “non-compete” restriction preventing an employee from working in the sector in a competing role for a defined period within a defined geographical radius. While a useful deterrent, it is less likely to be enforceable as it prevents an employee from working and earning an income, without evidence that the employer has sustained any loss of business as a result. Giving restrictive covenants careful consideration at the time of drafting your employment contract is time well spent. Unless they are recorded in a contractual document, a court will not imply restrictive covenants into an employment contract where none have been included. It is not a case of being able to introduce protection “after the event” regardless of how badly the employee has acted or how much financial loss the practice has sustained. Many practices are reluctant to include restrictive covenants at an initial stage of the employment relationship as they are concerned about raising what might happen at the end of a period of employment before that person has even started. However, the threats posed to your practice by departing employees – however long they have been employed – should not be underestimated. Your clinical staff are in regularly contact with your customers; your customers may seek to follow if the staff member leaves the practice. While you cannot prevent your customers from taking their business elsewhere, you can seek to prevent your employees from accepting that work for defined periods. Consider the impact on your business if one of your key employees left, potentially at short notice, to join your rivals or set up a competing practice themselves. Without restrictive covenants in place you have no ammunition to stop them or to recover financial loss from their breach of contract. It is often perceived that restrictive covenants are difficult to enforce and that it is difficult to know what to include to ensure maximum protection. As each case turns on its own facts it is impossible to make generalisations over what will and won’t be upheld as enforceable: every set of circumstances is different. Practice Life z December 2017/January 2018
MANAGING PEOPLE
The law in this area outlines general themes: in order for the covenants to be enforceable they should be reasonable – only be in place for as long as it will take the practice to secure customer relationships and/or to reassure other staff that they should remain with the practice.
3. What length of notice of termination of employment we should be expected to give to employees and receive from them in return? This is a common question from employers in the veterinary sector. There seems to be a misconception from employees that notice periods have to be equal for both parties or that it should be linked to how frequently they are paid. That is not a legal requirement. Under legislation, you must give employees at least the statutory minimum period of notice, which depends on how long the employee has worked for the practice. Those continuously employed for between one month and two years must receive one week. For employees continuously employed for two or more years the requirement is one week for each complete year of employment (up to 12 weeks). Employees continuously employed for more than one month are required to give one week’s notice.
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However, for business continuity reasons, employers commonly want longer notice periods. You can achieve this by having longer periods in your contracts of employment. You can require the notice to be equal or not. Receiving notice of resignation of only one week from an employee gives the practice virtually no time to recruit a replacement. That is why employers usually ask for a longer period. This is particularly the case for more senior staff. Notice required from an employee under their contract in veterinary practices is commonly between one and three months, and six months for senior clinical staff. Under those circumstances, it is usual to have the same period of notice to be given by both parties. It is a matter for the practice to decide what is appropriate. If you wish to negotiate this as part of your job offer to a candidate then of course that is possible, as you can with any part of your contract (being aware of statutory minimum requirements). If a new recruit challenges your notice periods as being too lengthy, you can stand firm with confidence that you do not legally have to change this, and explain those provisions are necessary for continuity of practice service levels. Ultimately, if the employee suggests from the start that their notice is too long, it should trigger alarm bells over their commitment and likely longevity as an employee.
Biography Stephenie Malone Stephenie is a specialist employment solicitor and part of the health and social care team. She advises employers across the sector on a whole range of employment and pay issues as well as employment aspects of the acquisition and disposal of businesses within the health and social care market. She has also worked as a HR consultant and is a qualified mediator. smalone@hcrlaw.com December 2017/January 2018 z Practice Life
CLIENT CARE & MARKETING
What clients want: ask then act! It is the age-old question all practices ask, ‘what do clients really want?’, but the answers are out there, and Onswitch’s Alison Lambert guides you through the data
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must admit my heart sank a little when I was asked to write once more about what it is pet owners want. At Onswitch we have been sharing this insight with the veterinary profession for what seems like a long time. The simple truth is that practices need to be open to the idea of changing what they do to ensure their clients get what they want. And believe me, there are practices that are learning from the huge volumes of consumer behaviour data that’s available in the public domain, who are collecting feedback from local owners and existing clients and, crucially, acting on it. These practices are prioritising their messages and services to meet the very real needs of their clients, and they are doing very well as a result. Customer experience underpins every measure of practice success – by choosing not to focus on it you are accepting suboptimal business performance. For example, fewer owners may register with your practice, existing clients will drift away or spend less, there’s no positive word of mouth recommendations and team morale suffers as a result of increased complaints. Perhaps you’re thinking this doesn’t apply to you because you’re already telling local owners what you do and marketing your practice extensively? Except that if you’re promoting the wrong message to the wrong audience, you could essentially be shouting into a void. Kotler defines marketing as “the science and art of exploring, creating and delivering value to satisfy the needs of a target market at a profit.” The key word here is exploring – not guessing, or assuming it is the same as you’re already doing. You are a service provider, and pet owners can choose not to use your services – they certainly will if someone else locally is offering weekend opening, online appointment booking, a friendly and helpful team and a respectful approach. These of course are likely to be some of the things clients want. For this article, I decided I’m not going to tell you what pet owners want as it might easily be dismissed as “just my opinion”, covert messages from an interested party, and so on. Instead, I’ll sharing with you evidence, facts and data; research findings from eminent organisations, Government bodies and academia. Read them and come to your own conclusions. Customers are telling us what they want, loud and clear. Now it’s for practices to listen. Consumer behaviour is already very well understood. A rolling national programme of Mintel research takes place regularly with UK pet owners, and its data is available to anyone (payable). The latest report was published in June this year, some and top line findings are noted in this article. Other observed trends have a real impact on how clients behave, and show how vital it is that practices not only understand what owners want, but also tailor their services and communications towards meeting these needs: Research undertaken by Ipsos in the summer of 2016 for Boehringer Ingelheim Animal Health provided data that informed the identification of five distinct pet owner profiles. The huge
Table 1. Trends in consumer spending on pets (Mintel)
Consumer spending on pet care is predicted to grow by 15% between 2017-2022. These trends mirror those seen elsewhere in retail, with pet care product development increasingly influenced by health and fitness, as well as technology (trackers, fitness monitors, automatic feeders). Forty-one percent of pet care purchases are made online. Pets continue to be viewed by most owners as a genuine part of the family, and certainly so by women. One in five owners say they are prepared to pay more for healthier food. Half of dogs, 25% of rabbits and up to one-fifth of cats are now classed as obese, according to the Mintel report. The National Office of Animal Health reports that only around half of owners get their cats and dogs vaccinated or use regular preventative treatments. One-person households are growing in numbers, pets offer companionship for individuals (Office of National Statistics). Projected growth in population is concentrated around the over-45s, but pet owning declines among older owners as they fear a pet might outlive them (Office of National Statistics). panEuropean study comprised of 5,000 interviews across France, Italy, Spain, UK and Germany. What is interesting about the Ipsos research is that it finds segmentation of pet owners is less about demographics and more about the emotional motivations and values that guide human behaviour. The study concludes that care and love are fundamentally what drive all owners; they worry about their pet’s health and seek reassurance that they are doing the right thing when making decisions about his or her care. Practice Life z December 2017/January 2018
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Table 2. Types of pet owner
Table 3. Anatomy of a consultation
(BI/IPSOS)
(Ref Louise Corah, Nottingham University, PhD)
Twenty-nine percent of owners consider their pet as “My Child”. This group has high levels of trust in their vets (59%) and overall expenditure on their pet is above average, although what they spend with their vet is not.
“I like a vet to listen to my opinion. Right from the very beginning, so basically, I’ve done all the research I can. We’ve all got Google.”
“My Energy” pet owners primarily value their pet’s appearance and vitality. Trust for their vet remains high at 53%. “My Funny Mate” owners just want a friend to have fun with. Trust for the vet is lower at 43%, and they will often check other sources of information. “My Roommate” owners want the pet to fit in with their existing lifestyle; consequently, there is a higher level of cat ownership. Veterinary trust levels are 51%. “My Area of Expertise” owners feel they are experts in the care of their pets, although 56% completely trust their vet. Forty-one percent would like to be able to access training classes on nutrition or preventive healthcare at the practice. Fifty percent want an annual pet health plan, 40% want veterinary day care for their pets. Ninety percent of pet owners use their smartphone and / or computer daily. Forty-three percent want a post-consultation summary emailed to them, detailing outcomes and recommendations. Seventy-two percent prefer to call to make an appointment, 29% want to book online. The average expected time to wait for a vet appointment is 3.3 days for a dog or 4 days for a cat. Forty-nine percent of owners want separate waiting areas for cats and dogs, 42% want access to educational material while they wait.
The Ipsos research also quantified some of the practical things that owners want from their veterinary practice. Academic studies confirm that owners want to be involved in their pets’ veterinary care. The University of Nottingham’s School of Veterinary Medicine and Science is currently cofounding, with Onswitch, a PhD project exploring the anatomy of a consult. A great deal of qualitative research has already been done with pet owners, proving that client preference is both individual and situational; what your client wants and needs when making a euthanasia, emergency or elective decision varies according both to the individual and the context. Vets and clients taking part in the study acknowledge that it is quicker and easier to reach a decision on care when there is an existing relationship between vet, owner and pet. Clients want to be presented with a range of sensible options, but many also want to know what you would do if it was your pet – your opinion is the thing they cannot access outside the consultation. Reaching a shared decision allows for shared responsibility for the outcome. Once a decision is made, owners want to walk out of the consult room with a better understanding of the presenting problem and a clear plan to address it. December 2017/January 2018 z Practice Life
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“I think that as you walk into a practice that is a, “Oh, do I like being here?” Is it a nice place to sit to wait, are the staff friendly, do they ignore you or do they give your dog a petas you walk past, say, ‘Hi. How are you doing?’ “You want to know that they [vets] are feeling or understanding how you are feeling, because it’s the first time you’ve been told that. So, have empathy towards people’s feelings.” “The relationship – the vets and the nurses took the time to talk to my dog, as they would talk to me – is so important to me.” “[I want not just] a discussion of options and solutions, but why. So to talk through the rationale for the various different suggestions of what needs to happen. Not just to say, well, we could do this, we could do this, we could do this. But why, to help you to be able to make a decision.”
Ultimately, qualitative research finds that owners are looking for reassurance that they are making a sensible decision and they want to feel they have your support, no matter which option they choose. Feedback from owners involved in the study so far is certainly enlightening. Now you’ve seen the data, it’s clear what owners want. The question is, do you want to act on it? If you’re serious about aligning your business with the needs of your customers (a fundamental requirement for any commercial operation), here’s a suggested course of action. 1. Look at published consumer behaviour research – there’s lots of it about, but I’ve summarised the more pertinent findings in tables 1 & 2. 2. Find out what your clients want – ask for feedback via online surveys, street research, comment cards, Facebook reviews etc. 3. Listen to what your clients say 4. Act on it 5. Repeat. It really is that simple! Biography Alison Lambert BVSc CMRS MRCVS, Managing Director of Onswitch Following qualification from Liverpool University in 1989, Alison worked in practice for several years before pursuing a business career with Hills Pet Nutrition and MARS, where she discovered the passion for the customer experience that her award-winning company, Onswitch, is renowned for today. Established in 2001, Onswitch promotes customercentred practice so pets and horses receive better care; providing research, marketing, CPD and business consultancy with an effective, innovative, straight-talking and client-led approach. Alison is a lecturer at The University of Nottingham Vet School, teaching Customer Understanding. She is published widely and regularly speaks at key international veterinary congresses and events.
www.onswitch.co.uk
BUSINESS HEALTH & FINANCE
WHAT’S THE POINT OF
STOCK CONTROL...? Jane Headley and Richard Hillman discuss the practice issues of the day in their popular series “What’s the point of...”
of your stock value – one used internally to make decisions, another to comply with bank conditions, and others for tax and statutory valuations. For example, the bank manager will take a cautious view and not want us to value open containers of tablets as these wouldn’t have value in a fire sale. But your intention is to keep using all your stock so I think you should be valuing it all.
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ichard chose stock control for this month’s discussion, a subject we both love to debate. I told him if he got to the end of this topic I might pay for his next holiday, something I know he enjoys. Intrigued by this offer, he was keen to get started, beginning with his main bugbear... “Why do we need to keep counting the stock? It’s a timeconsuming activity and believe me, my staff frequently tell me they don’t enjoy it.” JH It’s all about accuracy. If the practice management system (PMS) tells you an item is in stock you want to be able to rely on this information when prescribing and dispensing. If you’re stocktaking monthly and finding very little error between your physical stock and the PMS, perhaps switch to every three months and monitor the level of inaccuracy you see. Decide if you can work within that error level or whether it needs to be closer. Perhaps stock take every other month and assess if that’s better. “Units of measure give me a headache. Did I tell you about the time the wholesaler tried to deliver 2,000 bags of pet food when we only wanted 2,000 grams? My staff only stopped the delivery driver once he’d filled the stock room and begun stacking bags in my office!” JH It’s very easy to use an incorrect unit of measure. Perhaps check your stock valuation report and look for any line where the total value exceeds £100, especially if the washing tablets have been counted individually rather than in boxes… “I can see accuracy is important but sometimes I get confused about what is or isn’t stock; my advisors all seem to have a different view.” JH When thinking about stock we need to decide whose perspective we’re addressing this from – you mention the bank manager often, but I think we should consider our stock primarily as business owners. You can have multiple views
“OK, we’ve agreed what stock, but how do we decide on the basis to value it? I’ve got the wholesaler’s price list but what if I take the prompt payment discount or any annual retrospective rebates offered?” JH Richard, ask yourself do you always take advantage of a prompt payment discount? What if you’ve got a meeting with the bank manager? Your priority may then be to have some cash in the account. Are there other times when cash is a little short ? I guess sometimes you choose to pay when the invoice is due and not earlier. I would suggest for management purposes you use the wholesale price to value stock. You can still keep track of all the prompt payment discounts and annual rebates in your accounts. “Just to double check, when you said value all our stock, does everything we purchase to treat our clients have to be classed as stock?” JH I don’t think so. Consumables like gloves, syringes, needles, bandages and dressings can be charged as an expense when you purchase them, don’t book them into stock. But ask someone to keep an eye on the level for re-ordering purposes. “OK, I think that helps. But what do I do with the short shelf-life stock? Things like multi-dose injection vials where once the vial is broached I’ve got 28 days under the VMD to consume it?” JH I suggest you charge the item in full at the point where you first use it. If you’ve only got 28 days to use it the treatments will be invoiced to the client either in the same month or next month, which should be close enough for tracking profit. If you have a range of these items then you may find they average out as a fairly even purchase cost. “Have you got any guidance on how much stock we should hold? My team are very concerned about never being out of stock on a product.” JH Your main aim is to provide a great service to your clients. If you’re low on stock, but you can issue 20 of the 30 tablets needed, that may give clients two to three weeks to make a second visit. If your practice is in a convenient location they’re probably fine with that. Also, if it’s a regular prescription, have Practice Life z December 2017/January 2018
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you thought about asking clients to give you 24 hours’ notice before collection? Your team can help by flagging any products that are continually running short to decide if stock levels should be increased. On stock levels generally, some good advice I heard recently was to aim to sell all the items purchased before you have to pay the supplier’s invoice. That way you’re getting your stock paid for by your customers rather than using the business cash. I guess the main animal health products, such as analgesics, intravenous fluids and anesthetics should be on the shelf at all times. But for chronic or subacute products you could base stock levels on the usage history. Do you get any issues with space constraints? “Space constraints! My staff can always find space for stock!” JH Hmmm, perhaps you need to make sure they understand all this too? Back to stock levels, one of the times you may be tempted to break the ‘sell before you pay’ rule is when suppliers offer deals. “Good point! How do I decide when to accept an offer or a deal?” JH Everyone loves an offer. I heard even you’d been excited by some “free” shiny dental kit recently, Richard? Sometimes suppliers offer price discounts or “four-for-three” deals. These will improve profit (providing you can sell them) but I’d still be wary of stocking up. Tying up your cash in stock may prevent you from doing other things like investing in equipment or reducing your reliance on bank funding. Non-price offers like clothing, golf days or extra practice equipment can all be tempting. Events may provide networking or well-deserved relaxation. Perhaps remind yourself that this stock could be sitting on your shelves long after the happy memories of the event have faded! “What I worry about is that offers are for the benefit of the supplier and not me?” JH True, they could be shifting shorter dated stock or having a clear out before a new product is launched. If the new product has greater efficacy, fewer side effects, offers greater convenience and treats a wider coverage, you’re likely to want to switch to it, despite your high stock levels having taken up the offer. You’d have a better ability to react if you keep stock levels low. “What about realistic targets for stock? Management briefings often recommend no more than 30 days stock but what’s the benefit?” JH We’re going to have to do a little maths for this one. To calculate stock in days, divide stock by purchases (which I’d call cost of sales) and multiply by 365. This is how many days it would take you to sell that stock (theoretically). Let’s assume stock is £31,773 and the annual purchases are £227,163. £31,773/£227,163 x 365 = 51 days. So in theory it would take us 51 days to sell this stock. If you divide the stock value by the stock days you can see the average value of stock sold per day: £31,773/51 days = £622 of stock sold per day. If you could reduce stock by just three days from 51 to 48 days, that would release £1,866 of cash to the business. What December 2017/January 2018 z Practice Life
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could you do with that to make you happy? You could reduce the overdraft, buy more shiny kit, or draw it out of the business for personal use to perhaps go on a holiday. And it’s not current year profit so it’s not subject to tax (but check with your tax advisor first!). So if I can reduce my stock by three days, I can spend £1,800? Oh, now I see why you said you’d pay for my next holiday, and where the money’s coming from! Where am I going to go on holiday? I’ll tell you next time we meet… Biographies Richard Hillman, MRCVS Clinical Director at Hillman Vets, and MD, Northside Emergency Veterinary Clinic After qualifying, Richard spent 18 months in small animal practice before moving to a Derbyshire mixed practice to gain the experience necessary for a Certificate in Veterinary Anaesthesia. In 1985 he set up his own small animal practice and worked single-handed for two years before taking on an assistant. The practice now has six clinics and 11 FTVEs. In April 2014 Richard sold this practice to Independent Vetcare, where he continues as Clinical Director. He is also Managing Director of Northside Emergency Veterinary Clinic and Clinical Director of a company that owns nine clinics across Birmingham. Richard was SPVS President in 2008/9. Jane Headley, MA, ACMA, SFHEA Senior Tutor, Harper Adams University Jane spent 20 years working in accounting roles before becoming a lecturer. Skilled in making potentially complex subjects accessible and engaging, Jane teaches veterinary nurses, engineers, chartered surveyors and business students at undergraduate level, aiming to link her expertise to their worlds. At postgraduate level she teaches business management to veterinary pharmacists and veterinary physiotherapists in addition to management accounting to agri-business and food students. Jane is also Senior Tutor for the business suite of undergraduate courses and has an active pedagogic interest in improving student learning.
All solutions great and small Expert accountancy advice for every practice From accounting and tax through to valuations, benchmarking and bookkeeping software advice, there is nothing Hazlewoods doesn’t know about the veterinary industry. Our 20+ years’ experience working with veterinary practices means that not only do we understand the problems you face, but we can also provide tailor-made solutions to help you maximise your potential. To find out more about our services, please contact the Vet Team on 01242 680000 or vets@hazlewoods.co.uk
www.hazlewoods.co.uk @Hazlewoods_Vets
ACCOUNTANCY - TAX - AUDIT - ADVISORY
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PRACTICE DEVELOPMENT
Making the most of your CPD budget The practice CPD budget is a precious resource for which we should expect a good return on our investment and here, Laura Shaw, from Training Progress offers some tips.
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irstly, we should consider which team members would benefit from training and CPD in your practice. Your reception team and support staff are the face of the practice and will be drawing in new clients and providing an (ideally) consistent service that is so important to bonding clients to the business. Ensure this group’s training and development needs are catered to and that this is an ongoing process. There are a number of “front of house” CPD providers and they can really boost your team’s confidence, but make sure momentum is maintained with a structured, ongoing in-house programme. The message that your front of house team is an essential asset to your business must be reiterated through your training so that it becomes part of the practice culture. My next tip is to plan. All too often nurse and veterinary CPD is based on convenience, economy, last-minute time fillers and who has the best buffet, rather than the benefit it is going to reap for the business. CPD planning should be included in annual appraisal and development meetings. What has the team member achieved through training and CPD in the past year and where do we go from here? This should include an open and frank discussion about where an individual’s weaknesses lie. All too often we can stick within our comfort zone. The RCVS has a list of acceptable forms of CPD on its website which is useful as refererence. Familiarise yourself with the list as many of the alternatives to traditional “attended” CPD courses can be pretty economical. The RCVS also reminds us that “Continuing professional development, or CPD, is the process of continually maintaining, improving and broadening your skills and knowledge, as well as developing personal qualities, which help to ensure you remain professionally competent. “Progressing your professional learning in whichever way is most relevant to you, will help you to develop and improve the professional service you provide.” It is really important that management or senior team members help colleagues to plan their CPD, hence the development meetings. New grads may be afraid to spend the money (or may splash the cash too freely), meaning they choose courses based on cost rather than the benefit to themselves or the business. They may also avoid a subject they are not confident in, rather than embracing it and developing these skills. This leads me to the “elephant in the room” or is it the ultrasound or the ECG? Is there an item of equipment the practice has invested in that is not being used by an individual or indeed the whole team? Don’t let those expensive bits of kit lie idle, consider why it is not in use as much as predicted. The smart money is on the team members who are not confident in how to use it. Use CPD time to develop familiarity with the
equipment. Most suppliers will provide training sessions, which will be free (as part of a service contract), or for a reasonable cost, to give confidence, improve usage and allow you to see a return on your investment. This is a good place to mention maintenance of knowledge. When you buy a new piece of kit and everyone is excited to learn how to use it there is a level of momentum. But what happens when you have staff turnover? Will new team members be as keen to use the scary machine under the dust cover? Familiarity with equipment must be an important part of any induction process, and this can only be achieved if you are running a consistent training programme.
Confidence Familiarity also develops confidence. Confidence is another important theme. New vets are often reluctant to charge clients for investigations or procedures about which they are not confident. The result is they won’t practise using the equipment, further draining confidence and enthusiasm. So, I know we all hate the words ‘free or reduced’ but... how about, when a vet returns from a CPD course fired up about a new technique, or if you are onboarding them to a new piece of equipment, how about they get a small, restricted number of “goes” at a reduced rate of charging to the client? Repeating a task is the best way to cement that knowledge and give team members confidence – it should be viewed as a continuation of their professional development. They can then go on to charge full price, far more frequently than if they were meekly offering a procedure or test without the conviction of a dab hand. Critical incidents or issues highlighted in clinical audits are also an excellent starting point for CPD. Use your CPD budget to help develop better knowledge in these areas. Excitingly, for those of you with your eye firmly on the budget sheet, exercises, such as running clinical audits, count as CPD hours. That’s right – all it will cost you is the vet or nurse’s time (presumably they have this allocated anyway), and they can investigate issues which Practice Life z December 2017/January 2018
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are causing problems in your business. Issues which are costing you money to put right. That sounds like good value to me. Make sure any changes of processes that result are disseminated to the practice team. Another low cost and highly valuable way to spend your CPD budget is to document your processes and protocols. Use CPD time to ensure you are using the best practice and evidence base when scrubbing up; advising on parasite control; developing nurse clinics or cleaning the kennels. Many of the veterinary associations, including RCVS Knowledge, have information to help clinicians develop the skills to do this. Online courses are also available such as those through OncoreEPD which can help you develop the skills needed to develop robust evidence-based protocols. Another reason for management or senior team member input into an individual’s CPD is that we don’t always know when we need assistance and team members may also not be aware of the breadth of courses available. This is especially true of non-clinical and the soft skills. Helping vets to develop consulting skills, sales skills and resilience are just a few examples of where you are likely to see a great return on your investment, both directly but also in developing and retaining confident, resilient staff.
Non-clinical CPD This issue has been discussed by, among others, VPMA president Renay Rickard. She said: “During my presidency I have spoken to many people who are finding themselves moving into management and leadership roles, but with very little training or support. Unfortunately, non-clinical CPD is seen by many as a waste of their limited CPD budget and so is just not a priority. “Many people are unsure if it even counts as CPD when trying to meet the RCVS’ requirements. Personally, I think the RCVS should have a minimum percentage requirement for personal development that is not focused on clinical skills and knowledge. There is a whole world outside the veterinary one from which we can learn so much. Often, because it is not specific to the veterinary industry, it is less costly to attend (often free) and also more widely available so travel costs and time can be reduced.” This idea is borne out in practice. Peter Orpin, director at the
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Park Vet Group in Leicester, told me: “In our business we spend about £50k per year on CPD. Much of this is based on the five per cent of work we do dealing with more challenging cases. The challenges facing vets is not in this area! “We have found training on consulting skills, decision making and risk management much more beneficial as it has allowed our vets to be more effective and efficient, thus, helping vets to be on top of their jobs and delivering an excellent service to clients, while maintaining mental wellbeing. We have used Training-Progress as a tool to deliver and store our presentations and videos to deliver a structured program of development for all our teams.” Finally, and just as importantly, is dissemination of information. When you have spent your budget on CPD for your team, it is reasonable to expect to see a return. CPD should not be about simply doing 105 hours over three years to satisfy the RCVS, it should bring benefit to the individual by bringing increased confidence and job satisfaction, it should benefit our patients by improving clinical outcomes, and it should benefit the business by improving the service provided. However, none of these things happen if the information stops with the vet or nurse when they leave the lecture theatre or shut down after a webinar. All practices should have an efficient way of disseminating new information and changed processes to the whole team. When they can be managed, clinical meetings are excellent, but in many practices they are an aspiration rather than a reality. Another option is to disseminate the information through a standardised training programme to ensure all relevant team members are signed up to new ways of working. Empower your team by having agreed protocols that can evolve and develop with your team members’ knowledge and be disseminated to benefit the whole business. It is a requirement of the RCVS’ Practice Standards Scheme Awards that not only should CPD be regularly taken in the designated area, but that there is proof that this has changed practice protocols and been disseminated to the team (see 1.15 PSS p 14).
Conclusions Getting the most from your CPD budget is not so much about how much you spend, but ensuring that it is targeted to the needs of the individual and those of the business. That knowledge must then be disseminated through the whole team, ensuring that it improves patient outcomes and represents a return on investment for the business now and in the future, through its maintenance among the changing team. www.training-progress.com
Biography Laura Shaw, BVSc, MRCVS Laura graduated from Bristol Vet School in 2000 and spent 13 years in mainly small animal practice. While working in Harrogate at the OakBeck Veterinary Hospital she took on the nurse manager role. It was at this time that Training-Progress was initially developed to overcome some of the training problems encountered in the hospital. This was followed by a long period of primary work within a referral hospital. Laura rejoined the Training-Progress team in a development and support role when it was launched as a web-based, commercial venture in 2014. December 2017/January 2018 z Practice Life
CPD SHARED
MANAGING, MOTIVATING & ENGAGING YOUR TEAM Gillian Page reports....
SPVS/VPMA held two CPD days at Norton House Hotel, Edinburgh in October and I was fortunate enough to go along to both as the VPMA representative. I was especially interested to attend the team management day as I’ve long held a fascination for the psychology, behaviour and interactions of people. The day was entitled Managing, Motivating and Engaging your Team and the speaker was Carolyne Crowe from VDS.
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ne of the things that is heartening about attending a day like this is that when I started in veterinary practice 30 years ago, we had little or no awareness of the motivations or personalities of the people that we worked beside and, in many cases, it was thought to be unimportant. Fortunately, our profession seems to be having an increased awareness that we work better when we feel good and a way of feeling good at work and at home, is to understand ourselves and others better. This understanding can lead to a better knowledge of ourselves and this knowledge can increase our confidence, perhaps leading to better communication and with better results. Carolyne started with the reassuring thought that people are different and people respond differently to the same stimuli. It’s not a question of a wrong or a right way but rather that it’s important to understand the differences between people. To be able to engage and motivate others it helps to understand them – and yourself – better. Carolyne posed the question of how many people in the room had colleagues that just never seem to be on the same wavelength. We all raised our hands! She then suggested to the room that perhaps it just all comes down to an individual’s personality. Carolyne is a master practitioner in DISC behavioural profiling and believes that there is growing evidence to say that applying this in practice can be an incredibly useful tool for those managing teams to gain a better understanding of themselves and those they work with, to maximise team performance and harmony. The day was packed full of interesting questions, exchanges and interactive group work. For those delegates who had not completed a profile prior to the day, Carolyne talked us through the individual personality types in DISC profiling and encouraged us to identify some of those personality types in our own practice and in ourselves. She then went on to explain how she has successfully used DISC profiling in practice to help individuals work better together and managers to get the most from their teams. Very often an understanding of different personalities can help everyone in the practice manage the more challenging clients. I hadn’t completed the online DISC profile prior to the day, but from the work Carolyne showed us, I did feel able to identify myself as having an IDSC profile. I decided in the weeks following the course to use this tool to improve my working with a particular colleague who has a CSID profile and, although there has always been a liking between us, communication and approach can be problematic at times.
Carolyne Crowe (centre) talks delegates through the DISC personality profiling process.
The event was well received by delegates.
What I can report is that although the working relationship is not better as a result, the energy needed to successfully interact is noticeably less. That is a definite positive and something we both feel good about! Gillian Page BSc, RVN, Cert (B&PS) VPMA council member
Practice Life z December 2017/January 2018
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CPD DIARY
CPD
Events for the whole team in 2018 The SPVS-VPMA CPD 2018 programme will see 16 events taking place around the country, offering something for every member of the practice team. The full programme will be launched later in December, so keep an eye on the events website – www.spvs-vpma-events.co.uk – or register your interest on there in the meantime. Based on feedback and requests, we’ll be adding some exciting new events to the programme but also repeating some of our popular days from previous years. Read on for details of some of the days returning next year – if you didn’t manage to catch them this time, don’t miss out in 2018.
PLANNING YOUR PRACTICE’S FUTURE Alan Robinson, Vet Dynamics and Rebecca Leask, HCR Law Whether you are starting up from scratch, thinking you might like to sell now or in the future, or seriously looking at succession planning, there are things every business needs to consider in terms of planning for the future. With the profession changing rapidly, it has never been more important to have a clear plan and direction. Alan Robinson from Vet Dynamics shares his experience as a consultant to vet practices and as a vet practice owner. He will show you how to plan, look at the pros and cons of partnership, the options for selling internally or externally, an understanding of how your business will be valued and easy steps to increase the valuation. Rebecca will look at the legal side of partnerships, both in terms of what you should consider before taking on a partner (or entering a partnership), but also partnership exit strategies.
HOW TO REWARD, DEVELOP AND RETAIN YOUR PEOPLE Margaret Burnside, Cake People Development Recruitment is arguably the biggest challenge for the profession so it is crucial that you retain your existing practice team members. A key differentiator for you as a manager will be how well you identify and bring new talent into the practice and manage them once they are there to ensure they feel fulfilled and appreciated. If you do need to recruit, or move existing staff into new roles, then you will need well-defined and realistic job descriptions. Margaret will cover this together with tips on induction and mentoring. She will also give you the tools to have more useful and productive annual development meetings. This practical workshop offers the opportunity to learn how the best companies do it from a top consultant who has worked both within the veterinary profession and across a wide range of other sectors.
MOVING INTO MANAGEMENT Fiona Nichol, VetPartners Moving into a management role can be daunting, particularly if you are promoted within your practice and so find yourself managing colleagues. But if you make the transition smoothly, it can be very rewarding both to the practice and to you personally. There are some key things you can learn, such as how to give positive feedback, the art of delegation and the importance of consistency. This course from a business consultant with many years’ experience of working with practices, will describe different leadership styles and management techniques. Fiona will include role-specific case studies and scenarios to help you tailor the advice to your specific situation.
DIFFICULT CONVERSATIONS Major Cathie Gregg, GLCM and Stephenie Malone, HCR Law Grumpy bosses, disruptive colleagues and unreasonable clients are all part and parcel of managing a vet practice. But businesses thrive on a mix of different personalities and approaches and sometimes it is just a case of analysing the situations that make people appear difficult. By understanding different personalities and learning to manage expectations, you can learn techniques to handle those difficult conversations, possibly even turning them to your
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Get ready for Congress 2018! The joint SPVS-VPMA Congress is the best in the business and the line up of speakers for 2018 is no exception. Here’s a quick reminder of some of the key sessions...
Having it all in practice: happy pets and people, healthier pets and profits – Jonathan Bloom The ‘fear free’ approach to veterinary practice has been taking North America by storm but is still little known about in the UK. The evidence-based premise is that 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. Jonathan will present in Boehringer’s Business Breakfast on Saturday morning and afterwards demonstrate step-by-step how this looks in practice in a follow-up double session.
Mind Matters Stream – Dr Max Pemberton
Image courtesy of Wilde Fry
Psychiatrist, journalist and author, Dr Max Pemberton will chair the congress Mind Matters stream. Max is determined 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. Max will talk about the recovery process and chair a session on the importance of management in team wellbeing and resilience.
In Partnership with RCVS Mind Matters Initiative
advantage. This day is led by Cathie Gregg with contributions from Stephenie Malone, employment lawyer at HCR Law. Cathie will describe techniques to help identify and analyse common situations and understand personalities, including your own, so that you are better armed to deal with difficulties in your day-to-day work environment. The speakers will include examples of commonly occurring ‘difficult situations’ and different personality types. Stephenie will consider how to avoid overstepping the mark legally and when an informal conversation needs to shift to a more formal procedure.
THE CONSULTING NURSE Brian Faulkner, The Colourful Consultancy & Clare Hemmings, Royal Canin Brian shares some top tips from his vet consultation courses reworked for nurses and, together with Clare Hemmings, considers the content, design and marketing of nurse consultations. Brian will look at the different types of nurse consultation and explore common issues and the communication strategies that will deal with each. The theory is brought to life with examples from Brian’s own experience of running a successful practice and from his one-to-one training sessions at a wide number of practices. You will learn the psychology of client satisfaction as well as top tips on how to work effectively with other nurses, your manager, and of course the vets… plus the importance of keeping to time! Clare, who worked in practice as an RVN, will run through some options for nurse clinics, from weight management to managing diabetes; animal behaviour to geriatric care, with tips on how to promote nurse-led activities, run them and measure outcomes in terms of increased compliance, vet appointments or client loyalty.
For the full CPD and Congress programmes and to book visit www.spvs-vpma-events.co.uk or call Charlotte on 01453 872731 December 2017/January 2018 z Practice Life
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