Practice Life Magazine Issue 20 June - July 2108

June/July 2018

THE MAGAZINE FOR VMG & SPVS MEMBERS

BUSINESS SPECIAL Stakeholder Buy-In Client care Must-asks for junior shareholders

Making practice health plans work for you

MANAGING YOUR TEAM

HEALTHY FINANCES

Ensure fairness in performance management

Employee motivation and retention

THE MAGAZINE FOR VMG & SPVS MEMBERS

Thinking of selling your practice?

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Our joined-up approach means you have a single point of contact for the entire process. Uniquely, we will get you the right buyer, achieve the best sale price, and maximise your tax savings.

To find out more please call Paul Jackson on 01527 880345, or visit our website at www.pps-vet.co.uk @ppsvet

Professional Practice Services

www.pps-vet.co.uk Professional Practice Services is an Appointed Representative of Clarkson Wayman Ball Limited, which is authorised and regulated by the Financial Conduct Authority. Professional Practice Services is entered on the Financial Services Register under reference 785648. Address: 2 The Courtyard, Harris Business Park, Hanbury Road, Stoke Prior, Bromsgrove, Worcestershire, B60 4DJ. Professional Practice Services is a partnership owned by PPS Group Holdings Limited and Dr Paul Jackson.

EDITORS’ LETTERS

Editors’ Letters

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elcome to the final issue of Practice Life magazine in its current form. Being honorary editor has been a pleasure for the past three years and I will miss the physical magazine arriving in my practice for its excellent, relevant articles and browsability. I always learnt something useful from each copy.

Summer has been busy for SPVS, with our board meetings, Peter’s President’s Peaks and of course our fantastic annual, final-year “Your First Job” seminar at Lancaster. The Lancaster event never fails to inspire me as – an official old codger – meeting the graduates of tomorrow

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ello and welcome to our last issue of Practice Life as we know it. It’s hard to believe that when Libby, Steph and I sat down at the 2013 Tech Day in the Midlands to thrash around ideas for a launch issue that, 20 quarterly issues down the line, we would have turned the spotlight on so many practical areas of life in practice.

These include blame culture, wellbeing, flexible working, management buy-outs, client expectations, stress and burnout, stealing, nurse clinics, fees, maternity, retailing, IT, accounting, strategic planning and countless more.

The magazine has been eagerly anticipated in practices across the land and, talking as I have, to readers at events and Congress over the past five years, has consistently been popular. So why the departure from the rest of the cellowrapped magazine gang appearing on office desks? Simply because things move on.

In-house publishing has surged to the extent (and I’m sure it’s the same for SPVS) that our VMG newsletter is as informative and polished as Practice Life, but is delivered straight to your inbox in a more timely manner and thus the news content is still fresh and relevant – so often difficult to achieve with a journal that, because of print and editorial deadlines, has to work several weeks in advance.

Our most recent survey indicated that readers enjoyed

and spending time with the diverse and wonderful people in our profession is always a reinvigorating tonic and muchneeded at times! Congratulations to Liverpool for winning one of the most fiercely contested games nights I can remember. As I sign off, I’d like to thank Libby Sheridan and Emma Dahm for everything they have done to make this magazine a success and wish them both well with the exciting next stages of their careers.

Leigh-Anne Brown, SPVS editor

physically picking it up and thumbing the pages; similarly, others preferred the option of going down the smartphone and tablet digital road. Both rightly have their place. Costs vary dramatically between the two media of course! So the good news is that VMG will be offering both as a member benefit and, because of the greater control achieved, our newsletter (which will doubtless be afforded a shiny new title and image) will be allowed to grow organically with much more member input and contribution.

Even while I’ve had the huge privilege of being one half of the PL editorial team, in my own life I’ve switched jobs, lost both parents, fought legal battles, finally become mortgage-free, semi-retired, won awards, been praised, slandered and so many other joyful and disturbing challenges. We all have. Nothing stays the same or lasts forever. We hopefully make our mark, learn, share and grow. A huge thanks to my PL colleagues who have always turned up trumps and to readers and advertisers similarly.

See you all on the other side for a new adventure…

Ian Wolstenholme, VPMA editor

Practice Life is the magazine of SPVS and the VMG. If you are interested in joining either or both associations, visit www.spvs.org.uk and www.vetmg.com

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Contents Editors

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UPDATE: NEWS & VIEWS 5

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SPVS 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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Vet Wellbeing Awards open g

VMG NEWS

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CVPM workshop g

NURSE TALK

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VN Awareness Month success g

COLLEGE CORNER

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Leadership initiative

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.vetmg.com 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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When’s it time to take action on stress? g

VDS NEWS

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Tally ho or tally no…? g

MANAGING PEOPLE

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How fair are you in performance appraisals? g

CLIENT CARE AND MARKETING

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Enjoy success with practice health plans g

BUSINESS HEALTH AND FINANCE

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Employee benefits and tax implications g

PRACTICE DEVELOPMENT

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Online drug sales… a practice threat? g

© 2018 Practice Life All rights reserved.

WELL-BEING

CPD SHARED

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10 steps to customer service excellence g

CPD DIARY

We’re Havana ball at Congress 2019!

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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

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ISFM to hold first annual conference just for veterinary nurses The International Society of Feline Medicine (ISFM) is to hold its first ever annual conference dedicated to feline veterinary nursing. Being held on 15th September in Stratford-upon-Avon, the conference will cover a range of stimulating feline-specific topics, delivered by a panel of expert speakers.

The day is being sponsored by Ceva, Hill’s and Petplan and will take the format of nine presentations, providing 5 hours of CPD. The topics being covered include, dietary management of CKD, transitioning diets, practical ways to assess quality of life, nursing the oncology patient, behaviour and obesity, and multicat households.

In addition, there will be a talk about the charity’s new CatCare for Life scheme delivered by ISFM’s Veterinary Director Dr Andy Sparkes and an hour-long talk providing nurses with the practical advice they need to implement change in their clinic.

The conference is being held at the lovely Crowne Plaza Hotel, in Stratford-upon-Avon in the West Midlands. Situated near the heart of the town, and less than a 20-minute walk from the station, the spacious venue also offers on-site parking. The day costs £95.00 and includes lunch and all coffee breaks, downloadable proceedings and CPD certificate and use of an event app to communicate with fellow delegates and submit questions to the speakers and ISFM organisers.

To find out more about the conference see: https://icatcare.org/isfm-nurse-conference

BVNA Norfolk Beach Clean The Community Spirit of #VNAM18 This year saw the launch of the Veterinary Nursing Awareness Month Beach Clean. BVNA Council member, Jo Hinde, arranged this along with another RVN, Diane Westwood-Rowland who is an experienced beach clean team leader. The event took place at the beautiful Old Hunstanton Beach in Norfolk on 26th May 2018 and was attended by over 40 people.

Jo Hinde, VNAM Committee Chair, said: “Veterinary nurses are often giving their very little spare time to causes that improve welfare for both humans and animals. Beach cleans are a great example of this. Litter, especially plastics and fishing gear, can cause devastating and often life-threatening problems for our wildlife and eco system. It was super to have the support of nurses and the general public on the day and help raise awareness of this problem as well as highlight some of the amazing things that veterinary nurses do.”

The clean up was a great success and 27 bags of rubbish was gathered. The most prolific offending articles found were plastic caps from bottled drinks, cotton ear bud sticks and baby wipes!

There was also a lot of fishing netting, rope and monofilament lines collected which can be deadly to many animals.

Diane Westwood-Rowland said: “The importance of the beach clean was highlighted when we sadly found 2 deceased animals, a seal and a gannet. We do not know what killed these beautiful creatures, but it reinforces the fact that humans need to wake up to the damage they are causing.”

The event was also supported by Surfers Against Sewage who

©Jo Hinde

provided gloves and rubbish bags for the volunteers to use.

People from all walks of life attended including Meryl Lang from Millpledge Veterinary, one of the sponsors of Veterinary Nursing Awareness Month.

Meryl Lang said: “As a fragile environment, the beach plays such an important role in our ecosystem. Beach litter is at its highest since records began and the amount of plastic found on beaches has risen by 140% since 1994.“ The BVNA is hoping to include the beach clean in next year’s VNAM campaign and roll it out to more beaches throughout the UK.

Footnote: And it’s a goodbye from me....

Sadly, this is my last issue as publisher of Practice Life. Exciting new work commitments have meant less time for me to look after the associations’ magazine, and have opened up the opportunity for a refresh in member communications. It’s been a wonderful 5 years can’t believe it’s been that long! I’ve really enjoyed the publishing

June-July 2018 z Practice Life

journey and want to thank all our contributors, our advertisers, association editors, and my Mojo team of Emma Dahm and Eva Lambe for all their hard work. I hope to stay in close touch with the associations in their continuing journey of member support in this wonderful industry of ours. Libby Sheridan, Publisher.

SPVS News President’s Welcome

Peter Brown

WORK-LIFE BALANCE Thirty years ago I bought a veterinary practice. It had been set up by two veterinary surgeons another 30 years previously, and three days a week they closed at 4pm. They still provided an emergency service of course – there were no out-of-hours clinics in those days – but it gave them time to go off and pursue their own interests.

‘This place has so much potential’ urged the drug company reps, and so the first thing I did, after employing the practice’s first qualified veterinary nurse, was to open every evening. Sure enough, the practice began to grow, and by the time I came to sell it, the turnover was 10 times higher – in real terms – than it had been when I took over. But boy, was I happy to relinquish the responsibility! And as I reflected on those early days, it struck me that those two original vets had got something right.

Long before ‘work-life balance’ even became a recognised phrase, they had achieved a balance that suited them.

Work-life balance is especially relevant today, and one of the commonest reasons for veterinary surgeons leaving a position in practice is the lack of options for flexible working. We have a culture of long working hours so how can we offer more favourable hours while still providing a salary commensurate with a professional position? It’s not helped when competition over fees for the routine work that is the bread and butter of general practice means they have often failed to keep pace with inflation or reflect the improvements in care that have taken place.

Today’s practice owners and leaders need to reconcile these disparate factors by being willing to listen to the needs of their employees as well as helping them to understand the need to charge effectively for their time and structuring fees that accurately reflect the quality of the work being done. It’s a challenge, but it’s what responsible leadership is all about.

Peter Brown, SPVS President

Wellbeing in practice The Vet Wellbeing Awards will soon be accepting nominations again! The nomination period will be opening at this year’s WellVet Weekend, held in Cambridge from August 24 to 26, and the RCVS and SPVS are looking forward to seeing more examples of the incredible work being done to increase wellbeing all across the UK. The Awards were launched in 2016 by SPVS in conjunction with the Royal College of Veterinary Surgeons’ mental health initiative, Mind Matters (MMI), and were designed to highlight those practices that truly value wellbeing. This means something different for every practice, but what it boils down to is demonstrating how a team implements management systems and initiatives that motivate and engage their staff.

It has been wonderful to see the thought and consideration behind all the entries – these are practices that really listen to their teams and develop unique approaches to suit their individual needs, whether that’s by commissioning specific training, lengthening appointment times or providing fresh fruit at break times.

Nick Stuart, former SPVS president and MMI taskforce member, said: “It is wonderful to see the increased focus on mental health in the veterinary professions over the past few years, and with these Awards we wanted to showcase the positives and celebrate the incredible work that practices across the country are doing to support their teams.”

Lizzie Lockett, RCVS CEO and MMI director, added: “Our past winners show what a huge difference small changes can make to a workplace and all those within it. Even simple things such as having daily huddles or ensuring lunch breaks are taken can have an impact on staff morale and communication, and ultimately lead to improved animal welfare.”

Entries are accepted across three categories, split by practice size, and can be from either branch surgeries or whole practices. Last year’s winners were: joint winners White Cross Vets and Blacks Vets (large practice), Viking Vets (medium practice), and Meadow Farm Vets (small practice).

This year we went around to the winners to interview team members, asking receptionists, students, managers, veterinary surgeons and veterinary nurses just what it is that makes their practice so special. These interviews will soon be available as podcast episodes through the RCVS podcast, available on Podbean (www.rcvs.podbean.com) and iTunes (search for ‘RCVS’). There will also be a social media campaign providing practical wellbeing tips for practices of all shapes and sizes over the next few months.

For further information and to see past years’ winners, please visit the Vet Wellbeing Awards website www.vetwellbeingawards.org.uk

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SPVS NEWS

Nichola Watson, SPVS Executive Director As I’m sat in the lovely (irregular at the time of writing) sunshine writing this, I feel heartened as I reflect on the great work previously and currently being undertaken by our organisation.

It has been a busy few months at SPVS to say the least; the transition from a council structure to a board, my first congress, GDPR audits, working alongside the fabulous office team and dedicated board developing comprehensive member support and as always, lots of learning! I was also privileged to attend this year’s Petplan awards. This ceremony was a great insight for me to see the inspiring work taking place around the country within this profession.

Networking has been a key driver for my role over the past few months. Forging strong relationships within the profession; enabling me to comprehend some of the issues our members are faced with and what, as an organisation, we can do to support you. Looking at the role of responsible leadership and how we can support our current and future members with this concept has become a working focus for our team.

With ‘responsible leadership’ in mind, SPVS will be launching two new member services for 2018. In September we launch the SPVS Leadership Academy, which is a follow-on from the successful Leadership Academy delivered last year, by our now senior-vice president, Brian Faulkner. This will be delivered by Mike Clare and Carol Foussat of Impact Veterinary, designed with vet owner/leaders in mind with strategic control of a practice.

If you would like more information or to register your interest, visit https://spvs.org.uk/leadership-academy/ We will also be launching GradTrack. This is a fabulous joint initiative with VDS, devised by Brian Faulkner of SPVS and Carolyne Crowe of VDS. GradTrack is a collaborative programme of non-clinical training for both veterinary graduates and those supporting them in practice. This programme also offers a ‘bosses’ day for the employers; supporting you to provide a structured and supportive mentoring programme for graduates, enabling them to become confident, independent and effective members of a team. For further information on this programme and to register your interest visit: https://spvs.org.uk/gradtrack/ We will be communicating with you again soon regarding our fees and salary surveys, along with the annual inspirational Wellbeing Awards. In the meantime, remember to follow us on social media for our regular updates on SPVS activities and member support. Be sure to catch up with all of the highlights from Peter Brown’s President’s Peaks in his fundraising efforts for Vetlife and Vet Support NI https://spvs.org.uk/presidents-peaks/ Thank you for your support of SPVS and I hope to keep meeting many more of you in our continued endeavour to provide the best membership support possible.

Nichola nichola.watson@spvs.org.uk

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Complete the 2018 Fees Survey Questionnaire for the chance to win an iPad plus Apple Pencil!

The SPVS Fees Survey is the only resource of its kind that enables veterinary practices to review their pricing structure and benchmark it against other practices around the country. The survey, which is now an online service, offers personalised results to participants with those members who have taken part able to view the data online and see graphically how their own prices compare, both regionally and nationally, as well as print off a summary table of the results, useful when revising prices.

SPVS is offering all participants in the survey the chance to enter a free draw to win an iPad plus an Apple Pencil. Simply go to https://spvs-fees.datanauts.co.uk and complete the survey to automatically enter our free draw. We are also offering nonmember participants three months’ free SPVS membership. For details visit https:// spvs.org.uk/3-months-free-membership/

VMG News President’s Welcome

CVPM exam workshop

Few people outside the veterinary world realise just how busy life in practice can be. My working days – yours too, no doubt – are frequently hijacked by unexpected events, client problems and team members wanting ‘a word’. I used to find it frustrating that my plans for the day often went out of the window as I arrived at work, until I realised that my dealing with these issues enables the rest of the team to get on with their jobs, improves our procedures and helps the practice run smoothly.

It is an important role.

Over the years, accepting the inevitable demands on my time has made me a better manager and I have learned to be flexible although I have to be strict in setting aside time for strategic planning and important projects.

Since I joined the VPMA (as we were) 12 years ago, I have learned so much from other members and continue to do so. Recently, VMG board member Joanna Mallia has asked us all to share some of our top tips and these will be appearing via our VMG social media pages as ‘Wednesday Wisdom’. Look out for those as there are some really good ones.

Also topical is the fact that May was Veterinary Nurse Awareness Month. Clients often underestimate the range of skills that our RVNs possess and how complementary their role is to that of the vets. Often when grateful thanks from owners come in to the practice, they focus on the expertise of the vets (well deserved of course) without realising that dedicated and skilled nursing is frequently what makes the difference.

Veterinary practices are about the whole interconnected team, but right now I’m taking my hat off to all the student and qualified nurses out there. Be very proud of your role and thank you for all that you do.

A shocking statistic that came up recently was that some three million pets in the UK are not registered with a veterinary practice. Let’s all try to get the message out to our local communities that we are accessible and relevant to everyone. And while we are promoting our practices, we need to tell people about the unsung heroes who enable the vets to do their wonderful work – those in admin and client care, the nurses and, of course, ‘the management’!

On Saturday 21st April 2018 the second CVPM exam workshop was held in Long Hanborough, Oxfordshire, which was attended by six prospective candidates! The workshop covered the Certificate in Veterinary Practice Management syllabus, the core subjects tested by the CVPM and the format of the exam itself. The aim of the workshop was to give guidance to anyone interested in taking the exam, which enables individuals to demonstrate their ability to effectively manage a veterinary practice, hospital or unit.

Keep up the good work.

Julie Beacham, BSc(Hons), CVPM VMG President

All the attendees participated fully, and there was an atmosphere of enthusiasm for the subject in question. The feedback forms indicated that everyone found the session valuable and anyone thinking of sitting the CVPM exam would be encouraged to attend a workshop, if possible. We’re looking forward to seeing all the candidates for their exams later this year and wish them the very best of luck! If you’re interested in sitting the exam, this year or in the future, please contact the VMG office for further details: office@vetmg.com.

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Autumn Roadshows Following the success of our ‘on the road’ format of regional meetings, we are up and running with our next series of events. ‘Client Care During Pet Loss’ run in association with the Blue Cross will run across the UK. For dates and more details, visit the VMG Regions pages or contact the VMG office: office@vetmg.com Practice Life z June-July 2018

VMG NEWS

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CATH GRIMSEY REGIONAL COORDINATOR 16 MEETINGS

have taken place as part of Regional Roadshow 1: Credit Control within GDPR Regulations with dsl (UK) Ltd.

101 VMG MEMBERS & 69 VMG NON-MEMBERS

welcomed to venues including hotels, conferencing centres, village halls and vet practice meeting rooms!

420 MILES

is the longest journey travelled by one committed member to attend a meeting in Scotland.

5 HOMEMADE CAKES & NUMEROUS CUPS OF TEA & COFFEE

enjoyed in the company of veterinary industry colleagues.

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MG is delighted to report that the Regional Roadshows are going from strength to strength!

In collaboration with Mike Brooks and Malcolm Jackson of dsl (UK) Ltd we overcame numerous challenges including the full force and disruption of multiple ‘beasts from the east’ and illness and injury, to deliver quality CPD and enjoyable networking sessions across the country from Aberdeen to Worthing. We thank Mike and Malcolm for all their advice and logistic heroism.

Building on this momentum and success, VMG has partnered with VetLed and the Blue Cross to bring Regional Roadshow 2: Practice Performance and Culture PLUS Client Retention during Pet Loss on seven dates from May to July 2018!

VetLed is delighted to be collaborating with the VMG to bring you the Performance in Practice Roadshow. VetLed’s mission is to enhance performance in practice by inspiring and championing positive workplace culture for our people, our patients and our profession. The roadshow programme is an introduction that will help you to support your teams to enhance individual wellbeing and patient care. Each workshop will include an interactive presentation that encourages

discussion and reflective learning. It incorporates a combination of behavioural insights, interactive exercises and most importantly practical tips for implementation in your own practice. There will be plenty of time for your questions and answers to ensure that the workshop meets your personal needs.

Regional Roadshow 3 Blue Cross Pet Bereavement Support Service has been in existence for more than 24 years. This presentation will cover many aspects that you encounter in your practices daily, from the difficult conversations involved in quality of life, pre and post-euthanasia, as well as tips for do’s and don’ts when dealing with your clients. We look at the importance of self-care for you and your teams, the grief cycle and how the support service can be there for you and your clients, when the time comes.

These ‘double headliners’ are a must for your client care team and anyone involved in team wellbeing and performance.

VMG Members £15+VAT, non-members £30+VAT. Spaces are limited and uptake is expected to be high so please do register soon. Keep an eye on our wonderful new website www.vetmg.com for all the latest dates and info.

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 June-July 2018 z Practice Life

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

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

Nurse Talk

In association with

PETPLAN VETERINARY NURSE OF THE YEAR 2018 Anna Ashworth of Dalehead Veterinary Group in Settle, North Yorkshire, has been awarded the esteemed title Vet Nurse of the Year in the 2018 Petplan Veterinary Awards.

The winners were announced in April during a ceremony at the Town Hall in Birmingham. Now in their 19th year, the awards celebrated the nation’s most outstanding vets, vet nurses, practices, practice managers and support staff.

Particularly impressive for the independent panel of judges was Anna’s education in large animal welfare and her proactivity towards her own personal development. It was also recognised how Anna is a great example of how a registered vet nurse can make an impact in a large practice and a rural community.

On receiving her award, Anna said: “I can’t quite believe it, when I heard the news I was very shocked I thought I was having palpitations! When I watched the other finalists I really didn’t think they would call my name, but I’m very pleased they did and I’m lucky to be a winner.”

Isabella von Mesterhazy, head of marketing at Petplan, said: “We were delighted to host the 19th Petplan Veterinary Awards to pay tribute to the incredible work carried out by some of our country’s best veterinary professionals.

“This year we received more than 22,000 nominations from pet owners and the veterinary community. It’s wonderful that so many pet owners have wanted to thank their local veterinary teams. I would like to congratulate all the winners on their brilliant achievements.”

For further information on the awards and to find out more about the winners, visit https://www.petplan.co.uk/vetawards/

RVN IN PARLIAMENT ON BEHALF OF THE CAMPAIGN ON BSL RVN Shakira Free Miles has spoken in Parliament on behalf of the campaign on breed-specific legislation. Shakira was invited to discuss this controversial subject for The All-Party Parliamentary Dog Advisory Welfare Group meeting.

The meeting, entitled ‘Where are we at with BSL and dog bite prevention?’ provided an opportunity to discuss the concerns across the board regarding BSL and its effects on society.

Shakira spoke alongside Peter Egan (animal welfare campaigner and actor), Victoria Stilwell (celebrity dog trainer) and Dr Kendal Shepherd (veterinary behaviourist), James Parry (Parry and Welch solicitors) and Paula Sparkes (A-LAW, the Centre for Animal Law). The police were invited, accepted then unfortunately declined this opportunity to review the findings and experiences from people directly involved in BSL enforcement, which was a real shame as they are integral in helping to reduce dog bites. The APDAWG platform was established as a discussion forum, rather than a debate platform.

It is a respectful way of meeting people and learning from all sides of the problem.

Shakira was honoured to open the meeting with her presentation to share a veterinary review and the concerns regarding the enforcement of BSL on dog welfare. She wanted to share her insights with APDAWG and the other attendees – the topic is not often discussed or talked about openly. Shakira

spoke about how BSL effects the veterinary profession, the expectations from us regarding enforcement, seized dog welfare, veterinary obligation and the extremely important point that there is no evidence to support the continuation of neutering and killing dogs based on their conformation.

BVNA is very supportive of this campaign and has also adopted a position statement on BSL, a milestone for the organisation, and can be found on the BVNA website.

Shakira has also recently filmed a webinar on BSL and dog bite prevention, which is FREE for BVNA members.

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NURSE TALK

VN AWARENESS MONTH HUGE SUCCESS BVNA was delighted to have reached out to more practices, vets, colleges, schools, organisations and members of the public than ever before during VN Awareness Month.

As well as the traditional waiting room displays, open days and careers evenings, BVNA launched daily Facebook posts detailing the varied roles carried out by veterinary nurses and these reached a huge volume of people through our supporters sharing and commenting on these.

There was a new initiative this year, where we asked for professionals to make a quick video (no longer than 30 seconds) that explained ‘Why RVNs Are Important To You’! All videos were then shared via social media during the month of May, to highlight the importance of the RVN role both to the general public and also within the veterinary profession.

BVNA president, Wendy Nevins, said: “I would like to encourage everyone to do their part in helping increase awareness of Veterinary Nursing Awareness Month and the importance of the RVN’s role in practice. The more videos we post and share the greater the awareness, so please take part and help the profession celebrate Veterinary Nursing Awareness Month 2018!”

See the Facebook page for details.

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BVNA statement on brachycephalic animals Concerns about brachycephalic animals have been growing for some time and the debate has attracted passionate contributions from vets, breeders, owners, charities and others, including RVNs and members of the BVNA. It is appropriate and important that representative bodies have a voice in this debate. For example, as long ago as May 2016, and as recently as last month, position statements have been issued by both the BVA and BSAVA on this matter.

BVA and BSAVA May 2016 position statement on brachycephalic breeds: www.bva.co.uk/news-campaignsand-policy/newsroom/news-releases/bva-and-bsavastatement-on-brachycephalic-breeds/ BVA health and welfare of brachycephalic dogs January update: www.bva.co.uk/news-campaigns-andpolicy/policy/companion-animals/brachycephalic-dogs Animal health and welfare is a core value of the BVNA and its members. To this end, BVNA council will be discussing brachycephalia at its next meeting. Any formal position statement will be published after that date.

VN KNOWLEDGE: WEBINAR ON PAIN RELIEF FOR EXOTICS Molly Varga discusses recognition of pain in different species, as well as the differences in neural pain pathways in order to provide a scientific and practical basis for giving analgesia to less well-known species.

This webinar is intended for all nurses who engage with and see exotic pets for treatment. The recognition of pain in different species, as well as the differences in neural pain pathways, will be discussed to then provide a scientific and practical basis for providing analgesia to the less well-known species. The drugs that can be used will be

discussed as well as the dosing and dosing intervals, and how to monitor for efficacy and side effects. A discussion of less commonly used methodologies, such as acupuncture, K laser and physiotherapy techniques will also be included.

The rationale behind this lecture is both to promote welfare of exotic pets and also to reduce morbidity and mortality surrounding painful episodes and to reduce hospitalisation and recovery times.

All webinars are free for BVNA members: www.vnknowledge.co.uk

VNJ: A look back Do you enjoy reading your VNJ? Do you find the articles interesting? Do you relish catching up on the latest news? Do you ever look back at past copies?

Here at the BVNA office we have been sorting through the archived VNJ issues and reminiscing about the old days! We have the first issue – from September 1970 – which was then called the ‘BANAA NEWSLETTER’ and would like to share this with you. The articles included ‘Strong Views on Uniforms’, ‘To Spay or Not to Spay’ and ‘News from the BVNA Regions’.

VNJ has certainly evolved thanks to peer-review and scientific evidence-based articles, providing readers with the useful and knowledgeable VNJ that we have today!

June-July 2018 z Practice Life

College Corner

LEADERSHIP INITIATIVE LAUNCH The Royal College is seeking volunteers for its Leadership Initiative pilot being carried out this summer, as well as updating the Veterinary Surgeons’ Act 1966 and making sure GDPR measures are in place… it’s full steam ahead in Horseferry Road.

Amanda Boag at the launch of the Leadership Initiative

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t this year’s BSAVA Congress in early April we launched an RCVS-led initiative tasked with creating the next generation of veterinary leaders and instilling a culture of everyday leadership among the veterinary team.

The RCVS Leadership Initiative grew out of the research and discussions throughout the Vet Futures project and, in 2016, the Vet Futures Action Plan identified in its aims a need for a programme that would identify and nurture leadership talent in the profession while providing the necessary training and education to support this endeavour.

The initiative, launched by then junior vice-president Amanda Boag and director of leadership and innovation Anthony Roberts, has three key areas of work: • Leadership for everyone: This strand of work will promote the importance of self-reflection and the development of leadership skills as key aspects of continuing professional development and providing resources to support this development.

• Leading the profession: This will ensure that, as an organisation, we become an exemplar of leadership development.

• Tomorrow’s leaders: This will highlight the range of leadership development opportunities available for vets and vet nurses, the roles and positions these could lead to

and the impact that leadership development could have on the future of the professions.

Key to the whole programme is the Edward Jenner Veterinary Leadership Programme (named after the scientist who developed the world’s first known vaccine) a free-to-access online leadership course for veterinary surgeons and veterinary nurses and developed in conjunction with the NHS Leadership Academy.

The full course is due to start in autumn 2018 but this summer we are running a pilot with hundreds of veterinary surgeon and veterinary nurse volunteers to help us fine-tune the content and make sure it is the best possible product before launch.

The course itself will cover key leadership concepts such as the importance of leadership in the veterinary setting, along with the art of good decision-making; how to be a more confident and effective leader and develop a workplace leadership culture; and, active reflection of leadership skills in professional life.

All this is aided by an audio drama that accompanies the course about veterinary professionals working in the fictional county of Glenvern detailing the challenges they encounter in their everyday lives.

We are still looking for volunteers for our pilot (in particular veterinary nurses although all are welcome) so if you are interested in signing up please contact Anthony Roberts on a.roberts@rcvs.org.uk.

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COLLEGE CORNER

For more details about the project, including a video featuring Amanda Boag explaining more about the initiative, as well as two audio clips from the Glenvern-based drama, please visit www.rcvs.org.uk/leadership

Governance changes afoot At the beginning of May we were informed that our Legislative Reform Order (LRO) to reform RCVS Council was approved in both Houses of Parliament and signed off by Lord Gardiner of Kimble from the Department for Environment, Food and Rural Affairs.

The LRO will amend the Veterinary Surgeons Act 1966 to make several key changes to our governing body, including a gradual reduction in the number of elected members from the current 24 to 13 by the year 2021 and a change of composition to include six lay members and two veterinary nurses as well as reducing the number of university-appointed members. Additional reforms include the introduction of consecutive term limits and bolstered disciplinary processes for Council members.

The full details of the LRO can be found on the www.legislation.gov.uk website. One immediate impact of the LRO was on this year’s RCVS Council election results as it confirms that only the first three candidates (in order of number of votes) will take up their four-year terms at RCVS Day on Friday 13 July 2018. The successful candidates were Susan Paterson, Mandisa Greene and Neil Smith, all of whom are currently on Council and re-elected. You can find the full results of the election – including voting and turnout figures –at www.rcvs.org.uk/vetvote18 GDPR-ready The European Union’s General Data Protection Regulations (GDPR) became part of UK law on 25 May 2018 replacing existing data protection legislation.

June-July 2018 z Practice Life

RCVS Council meeting

The new legislation significantly strengthens the rights of individuals in terms of privacy and protection of personal data and increases the regulatory responsibilities and obligations on organisations holding personal data.

The GDPR, which will be enforced by the UK data regulator the Information Commissioner’s Office (ICO), also introduces increased potential penalties for data protection breaches.

While the RCVS itself has been busy preparing for the introduction of the GDPR for a number of years, we have also produced a new information booklet for veterinary practices that sets out the principles behind the GDPR as well as a number of Q&As on how veterinary practices and professionals can best meet their obligations.

To download the information booklet please visit www.rcvs.org.uk/gdpr. For more detailed information about GDPR and how to comply with it please visit the Information Commissioner’s Office: www.ico.org.uk

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WELL-BEING

TAKING ACTION ON STRESS: SOME PRACTICAL TIPS Too stressed or busy to read up on stress? Then you are just the person who would benefit most from reading on, writes Jan Mitchell

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ome occupations are particularly prone to stress and your chosen profession just happens to be one of them. As a vet, you are expected to have excellent communication skills, to think quickly, work long hours and make life or death decisions. That can be a very tall order.

How do we define stress? The Health and Safety Executive defines stress as: “The adverse reaction people have to excessive pressures or other types of demand placed on them.� When we register something as demanding, the body prepares for physical action. If primitive man was attacked by a wild animal, this stress response would have helped him run away or fight.

This response is not so useful to modern man, as the body is frequently preparing itself for action that does not occur. So without a physical outlet, the body remains tense.

Unwanted stress Some stress in our lives can be useful, but when you feel unable to cope with what is expected of you, that is unwanted stress. Stress affects people in different ways.

Major life events, such as bereavement, moving house, starting a new job or having a baby, can have a major impact on most of us. What is important is how someone perceives that stress and each individual interprets whether something is stressful to them. Once stress is perceived at a psychological level, it has an effect at a physiological level. We continue trying to cope until one day, a minor issue makes us explode.

Instead of getting upset about the major issue that is bothering us, our feelings come out over something more trivial.

This is like a safety valve.

What are the warning signs? Ask yourself, honestly, what are the three main signs you notice about yourself when you are under stress? These may include: Practice Life z June-July 2018

WELL-BEING

• irritability; • worrying; • tiredness; • mood swings; • tight chest; • frustration; and • inability to relax.

If you’re not sure, ask a partner, close friend or colleague.

Once you are aware of what these may look like, you need to heed these early warning signs in the future so that you can take action to alleviate the stress before it gets out of hand.

Be a good team member too; look out for signs of stress in your colleagues and ask if you can help.

Quick stress-busters: • clench both fists for a few seconds, then release (most excess energy collects in your hands); • walk up and down purposefully – it gets rid of excess energy; • hunch your shoulders, and then relax. Repeat twice more; and • inhale deeply to a slow count of five, and then exhale slowly to a count of seven. Repeat as many times as necessary.

Short-term action • If you have a problem that is causing you stress, you need to get it out of your head. Get it down on paper, either as a mind map or just write it all down. Constructive thinking is important to help you find a solution. You could also try sleeping on it. Things may well look different in the morning.

The brain still works when you are sleeping and can often present a solution to a problem on first waking.

• Try talking things over with someone else in your practice.

It will help you make better sense of a situation. The RCVS Mind Matters Initiative aims to help encourage vets to share problems.

• Instead of obsessing over a problem, distract your mind.

Read a book, watch a film or do something active. Rhythmic exercise is best, such as swimming, running, cycling or dancing. Yoga is also excellent for relieving stress; some practices have introduced yoga sessions for staff for just this reason. Reminding yourself of the funny side of life will also help – try watching a comedy.

• Get out more! During your working day/evening, try to get a break from the surgery. Go for a brisk walk, preferably in a park or near some greenery. It will make you feel more relaxed to be among nature and away from the stressful work environment.

• Be gentle with yourself. The three-point plan is to try to eat well and regularly; get enough sleep; and be reasonably active.

• Keep thinking positive. When you are under stress, what you actually think will affect how that stress develops. Negative thoughts will make it worse. Block and replace such thoughts with ones like: ‘I am in control; I can deal with this.’

Long-term strategy You have chosen a career with a high level of responsibility, which frequently entails making difficult decisions. Yet, at the same time, you are aware of the immense job satisfaction and fulfilment that this career affords. So, it is essential to get the balance right between your working life and your home June-July 2018 z Practice Life

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life, particularly in this line of work. Try to keep the two areas separate, otherwise it will be harder for you to cope with any effects of stress. If you are stressed at work, it can often affect your home life even if you’re not aware of it.

Make sure you get enough time to yourself, however difficult this may be to achieve. Work in a veterinary practice often means long hours. Why not explore the option of more flexible working hours? Say ‘no’ more often, so you don’t put yourself under too much pressure. This isn’t being selfish, it’s a survival tactic.

If you become concerned about your stress levels, consider contacting a confidential listening service. There is the 24-hour Vetlife Helpline, call 03030 402551, or visit www.vetlife.org. uk for anonymous email support. You can also talk at any time to the Samaritans (about anything you like), call 116 123, free, from any phone (24-hour), or email jo@samaritans.org Finally, just remember – we don’t usually become stressed overnight, so don’t be hard on yourself and expect miracles.

It could take weeks, or even months, to get yourself back to a more relaxed state of mind. You can start by taking action today. Take back control of your own life. Your primary aim should always be to look after yourself as well as you look after your patients!

Biography – Jan Mitchell Jan is a public health specialist, with over 25 years’ experience gained in the Health Service and local government. She delivers short training courses in stress management, and also health and wellbeing. Jan is regularly invited to speaker on health subjects to community groups and other organisations. She particularly enjoys writing articles on health-related topics and has had a number of articles published.

Buying groups’ memberships declined by 5%* this year, predominantly through the sale of veterinary practices to acquisition companies. The impact of a shrinking member base means less purchasing power for most buying groups.

Our increasing rebates set us apart from the rest - and our members are the ones benefitting. Our buying power continues to grow due to our parentage and increasing member numbers.

With two buying group offerings, we are bound to meet the needs of your practice. We offer a transparent, no obligation purchase data comparison to asses which group is right for your business.

Contact us on 0800 756 6636, email admin@vetshare.co.uk or visit our websites to find your local account manager.

www.vetshare.co.uk

Tel: 0800 756 6636 Email: admin@vetshare.co.uk Web: www.vetshare.co.uk

www.mivetclub.com

(*5% decline from GFK data)

VDS News

SECOND SIGHT Tally ho or tally no?

Peter and an old college mate had decided to set up their own equine practice in a prosperous area of hunting country, and despite the presence of plenty of competition from other practices locally, within a couple of years had found business surprisingly good.

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eter tended to do most of the vettings and was pleased to be asked by a purchaser way up in Yorkshire to look at a horse locally, which he was thinking of buying.

It was a lot of money too, and although Peter’s knowledge of the north was limited to an awareness of a preponderance of flat caps and whippets, he knew they no longer dealt in white fivers. His client was really keen for him to inspect this particular animal, which sounded almost too good to be true.

He told Peter he intended to use it for hunting, but if it came up to expectations he might enter some horse trials.

He requested not only the standard PPE but also wanted x-rays taking of its hocks, front fetlocks and feet, just to be on the safe side.

Having recently invested in a digital x-ray set-up, Peter arranged for the vendor to bring the horse into his clinic,

and was pleasantly surprised to find that the horse seemed to be as good as his client had claimed. Having completed the routine part of the Prior to Purchase Examination without encountering any potential clinical problems, he took all the radiographs as requested and peered at them on the computer screen. Seeing nothing to cause him any concern, he rang the purchaser with the good news, and the animal was soon enjoying its new surroundings in Last of the Summer Wine country. He posted off the images to the new owner’s local practice and thought nothing more about it.

A couple of weeks later, Peter was surprised to receive a call from the purchaser. He said that he had applied to have the horse insured, and had sent off a copy of Peter’s disk at the insurance company’s request. To his dismay, they had declined to cover any veterinary treatment that might be required for Practice Life z June-July 2018

VDS NEWS

the horse’s off forelimb, on the grounds that the company’s veterinary advisor had seen something on the images which he wasn’t happy with. The owner was very angry with Peter for not spotting whatever it was himself, and said he wouldn’t have bought the horse, particularly one so expensive, if he’d known he wouldn’t be able to insure it. He held Peter responsible for his predicament and warned him that he would be hearing from his solicitors shortly.

The letter arrived a few days later. It alleged that Peter had been negligent in his interpretation of the x-rays which, the solicitors claimed, had been confirmed by the opinion of the insurance company’s vet. On the owner’s behalf, they were seeking the difference between the purchase price and what they considered the horse was now worth, plus transport costs and keep, to which they added the refunding of all Peter’s fees.

As soon as Peter had read it, he rang the VDS, and was immediately relieved to hear the claims consultant say that the Society would take over the handling of the claim there and then. He was asked to send a copy of the completed PPE form and copies of his digital images, and VDS engaged a highly experienced equine veterinary surgeon as an expert on Peter’s behalf. Having viewed the images, the expert decided that Peter’s advice had been appropriate, and that the conclusions

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drawn from the films in question by the insurer’s veterinary advisor were a matter of personal interpretation, rather than having any definite clinical significance.

Fortified by this conclusion, the Society vigorously defended Peter’s position, and rejected the solicitors’ claim for compensation. After a few months of desultory correspondence they appeared to lose heart with respect to the threatened litigation, and the claim eventually faded away.

When the VDS consultant decided it was time to close his file and rang Peter to let him know that the matter was at an end, he had some interesting advice for him. The advent of digital radiography has made it much easier for films to be examined at a later date by either a purchaser’s vet, or in this case, a veterinary surgeon acting as advisor to an insurance company. They therefore represent the only part of the PPE examination which can be re-interpreted at a later date.

To avoid finding himself in the same position in future, Peter was advised always to assume that his radiographs would at some point be inspected by another veterinary surgeon.

These days it is therefore always a good idea to ascertain a purchaser’s intentions with regard to insurance.

He could then advise that the radiographs be submitted to any proposed insurer before going ahead with the purchase of the horse. That way he would be sure to keep out of trouble.

VMA Events: Special Rates for SPVS & VMG members!

Seeking to improve your marketing skills and achieve excellence with CPD, training and topical events, then look no further than the VMA’s events, created just for you. Unmissable bespoke CPD for anyone working in animal health; Workshop: 20th September: Advertising: The Interesting Truth (10.00hrs – 16.00hrs), DDB Remedy Offices, London An exclusive, one-day, interactive workshop.

Develop your understanding of how to create great advertising and practice this first hand, with the benefit of guidance from leading London creative agency DDB Remedy – home of the recent John Lewis adverts!

This is a truly unique opportunity but places are strictly limited. So don’t delay, secure your place today, go to: https:// www.vma.org.uk/vma-advertisingthe-interesting-truth/

June-July 2018 z Practice Life

Annual Seminar October 5th 2018: Dare to win: Making your creative work (10.00hrs – 16.00hrs) IPA (Institute of Practitioners in Advertising) London.

A unique seminar, presented by a panel of top creatives and researchers; including judges for the VMA and PM Society Awards. Learn how marketers and creative agencies can optimize their partnership, working together to develop winning campaigns that deliver business and creative success.

To know more about this event and reserve your places, go to: https://www.vma.org.uk/vma-annualseminar/ Like and follow us on LinkedIn and Facebook! https://www.linkedin.com/company/ veterinary-marketing-association/ https://www.facebook.com/ VeterinaryMarketingAssociation/

MANAGING PEOPLE

MANAGING PEOPLE

PERFORMANCE FEEDBACK: HAVE WE BEEN FAIR? Giving honest feedback to our staff isn’t always easy, but can we be sure that we’re offering more than just an assumption, asks Claire Newton-Ransom

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t is perhaps unsurprising that bravado is so rife in management roles. We have to have the guts to have uncomfortable conversations with our staff and it’s often that very specification that can deter people from going into management in the first place.

How often have we seen people dubbed ‘leadership material’ basically because they have minimal problem bossing people around? There’s almost a badge of honour for the person who can be the most direct, cut-throat and decisive. While there are advantages to these characteristics, are they always the most effective, and are we at risk of getting away with just being incredibly rude?

A common defence following a frank conversation is that we are ‘just being honest’. Honesty is imperative, but there is also a duty of care to be fair and respectful. To paint the picture, we all know the person who is prone to a power-trip, but they’re just being loud; they aren’t necessarily being clever.

I’m yet to meet someone who felt empowered after being spoken down to. The ability to truly consider another person’s viewpoint requires a certain openness of mind. A ‘strong’ character isn’t always a genuine strength. Can we be sure that we are always looking at a situation without our own bias dictating how we communicate?

Don’t make the mistake of seeing this as liberal fluff.

The industry is in a recruitment crisis and recent analysis

by US research-based management consulting company, Gallup, concluded that 75% of employed workers leave their jobs because of the unhappiness caused by their bosses, not the position itself. The ‘worst manager habits’ were further surveyed by UK recruitment site, Glassdoor. This 2017 study revealed that the most perceived ‘bad boss’ trait was being disrespectful. In particular, this included ‘confrontational behaviour’ and being ‘spoken to badly’. Those interviewed confessed to taking sick days in order to avoid their boss or leaving their employment entirely.

If feeling respected is the key to being a happy employee, how do we make sure that we are truly delivering respect?

As obvious as it sounds, active listening is one of the simplest ways to show respect, yet it is one of the hardest skills to truly master. When someone is speaking, we often ‘hear’ them, but we aren’t truly attempting to understand their complete message. We often spend a lot of the ‘listening’ time producing counter-arguments in our own head while we wait for them to stop talking. There’s a good saying that if we know what someone is about to say, then we aren’t really listening.

Let’s be honest with ourselves - if someone is turning up late for work on a regular basis, an easy response would be to jump straight in and tell them that it is unacceptable. Or perhaps we’ve kept a log of arrival times that we then use as ‘evidence’ for this person’s misconduct. We’ve objectively measured the

situation, but have we been fair? Would it not be better to take the time to enquire, genuinely, if everything’s alright?

Maybe this person is just slacking, maybe they no longer care about their job (which needs an entirely different conversation altogether), but maybe, just maybe, they’re struggling to fit in the care of an aged parent or even suffering from clinical depression. Wouldn’t we rather be in a position to help someone out and in return gain their hard work and loyalty, rather than come across as inattentive and risk losing this employee altogether?

Of course, if we wish for our team to open up to us, then we need to ensure that we have created an open and respectful environment in the first place. There is no point bluntly asking across a crowded prep room floor if someone is feeling ok and expecting an honest reply. Ideally, have it explained to all new employees at their induction that they can always come to you if something is troubling them, and really mean it. Keep this ‘safe’ environment going by regularly checking-in on their wellbeing. Ask how they are feeling outside of work, if they are Practice Life z June-July 2018

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sleeping well and what stress management tools they use, if any.

No mention about KPIs here – this is just a friendly and caring chat. We’ll then be in a far better position to understand what motivates individuals to work well, and whether something may be affecting their performance.

When we’re so busy being in charge we can be at risk of forgetting that we’re not in the business of selling consumer goods. Our service is our people and we can’t operate without them. The veterinary industry by its nature attracts those who care, who seek value-driven work and who are sensitive to the dynamics of others, even to those outside our own species.

These are the people who will gladly stay late to make sure a patient has recovered after surgery (because they care) and will notice if a client is upset and will instinctively make them a cup of tea (because they’ve had bad days too, so they know

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how it feels). These are the people we need to retain and attract.

Even in black-and-white business terms, they are the people who your clients will love and will readily return for. These people are valuable; they just don’t need to yell about it.

The ability to be honest with our team is vital. If someone has done something well, let’s make sure we tell them. If someone is struggling, then we again absolutely need to feed that back, but it’s so important to remember that until we’ve allowed them to speak and we have actively listened to what they have to say, then all we have is our own opinion.

References https://www.mindtools.com/CommSkll/ActiveListening.htm https://www.glassdoor.co.uk/blog/bad-bosses-glassdoor-survey-reveals-worstmanager-habits/ https://www.linkedin.com/pulse/people-dont-leave-bad-jobs-bosses-brigette-hyacinth/

FIRST IMPRESSIONS COUNT

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often wonder how churn rate is influenced by perceived poor customer service. I don’t mean blatant staff misconduct, but more the subtle behaviour that may not even be fully conscious. It is important to note that this responsibility does not lie just with the reception team. Each staff member must be fully aware of their mannerisms and how they may be interpreted. Psychologist Albert Mehrabian concluded that only 7 per cent of communication is received through words alone, 38 per cent is interpreted through tone, and an enormous 55 per cent is down to body language. Here are some quick tips your team can use to make the client journey a positive one.

Instant acknowledgement The client walks in to your practice and the receptionist is busy on the phone or frantically trying to complete a note on the record. Receptionists should consciously make eye contact immediately, smile, and make a friendly nod of acknowledgement (if on the phone) or kindly say, ‘Sorry, I won’t be a moment’. This may sound glaringly obvious, but I am always astounded at how often this does not happen in many customer-facing businesses. This quick gesture will

make sure that the client feels valued. Don’t forget to thank the person for waiting, too!

Carry the cat carrier When a vet calls in a client for a consultation, it is a thoughtful gesture if they approach the client in the waiting room, pick up the cat carrier and carry it to the consulting table for them.

Equally, when the consultation ends, how lovely if the vet then carries the cat carrier back out to the reception desk (if you have the time, even to the car!). This small act of consideration just says to the client, ‘I care about you’.

If you don’t know, ask You may be surprised to learn that it can be genuinely intimidating for receptionists to ask the clinical team for answers to client queries. It’s often met with an eye-roll or an impatient, ‘I’m busy’. But failure to empower a culture where it’s ok to ask questions risks your clients being met with the response, ‘I don’t know’. Create an efficient messaging system so that the front desk team can confidently say to the client, ‘I’m not sure myself, but let me find out for you’ (with a smile, of course).

Biography – Claire Newton-Ransom Claire Newton-Ransom is an experienced practice manager who has worked in the UK and Australia. She has a particular interest in utilising emotional intelligence in both leadership and client services for optimal performance. A keen interest in the human-animal bond led to her research into Equine Assisted Therapy at university, for which she was awarded distinction.

June-July 2018 z Practice Life

CLIENT CARE & MARKETING

Success with practice health plans Part 1: smoothing the path to launch Health plans have made a big contribution to practice profits in recent years. Can it really be that easy? The answer, of course, is yes and no. Practices should be able to turn a profit from the word go, depending on which provider they use. However, some practices are much more successful at launching their health plans and recruiting clients. What could make it work for you? And if you already offer health plans but are struggling to make them work, where is it all going wrong?

Loyalty in a competitive marketplace Putting it simply, a health plan is a monthly payment scheme that clients sign up to, which covers preventive health products and services. The client benefits from being able to spread their payments for those products throughout the year and from discounts. They also gain peace of mind, knowing that they are doing their best for their pet. The practice benefits by having a guaranteed monthly income and can use the plan to improve the uptake of other products and services by offering discounts that promote volume sales. Everyone wins.

Steve Holman is the National Training Manager at Simplyhealth Professionals – the UK’s largest provider of health plans – and says the majority of practices will have around 15-18 per cent of their client base signed up to a health plan, but the more successful practices exceed 50 per cent. He also says the benefits are not purely down to the steady monthly income a practice health plan generates. ‘If I had to say why a practice should have a health plan, I could sum it up in one word: competition. I’ve been in this role for less than five years and one thing I always ask practices I visit for training sessions is how many practices there are within a five-mile radius.

Most now have around five to eight direct competitors and I’ve seen those numbers creeping up year on year.’

He explains that health plans are great for promoting loyalty. ‘A health plan helps to bond your client to the practice.

In my own case I have a practice on the other side of my garden fence, but I drive five miles to the practice where my health plan is set up. Of all the things that health plans do for practices, bonding is undoubtedly the most important in my opinion.’

Steve says a good analogy is that someone with gym membership is highly unlikely to pay £10 to go to a swimming pool elsewhere.

Footfall and compliance Health plans can also help improve footfall. Clients visit a practice on average 1.2 times in a 15-month period. By asking them to collect their preventive health products from the practice, quarterly, we have already increased that by five and each time there’s an opportunity to make them aware of products and services and create a positive client experience.

There’s lots of competition from outside the profession – pet shops and websites provide preventive health products with similar purposes to those usually included in a health plan.

Steve’s other big message is education.

‘Pet owners have exposure to products in other locations – many will be picking up flea and worm products with their weekly food shop. When the profession talks about health plans they are also talking about effective flea and worm treatments and a customised recommendation that will help protect the pet from the parasites relevant to the area and their lifestyle.

‘Once pet owners know they are giving the best products for their pet it’s very difficult to go back to their old over the counter shopping habits.

‘It also reinforces the value of a veterinary recommendation – so if the plan offers discounts on pet foods the client might also start to seek advice on the best products to feed. On average, clients with a health plan spend around three times more on veterinary products that will help keep their pet healthy,’ he adds.

Compliance is another big issue – most clients only purchase 3.4 months’ worth of parasite treatment each year. Health plans help ensure pets are treated all year round in line with best practice. The PDSA PAWS report shows that basic preventive healthcare, such as vaccination, are not adopted by enough pet owners. In line with the growth of preventive health plans those figures are slowly increasing. The potential for improving pet health and welfare should mean that veterinary teams are happy to recommend them. In Steve’s experience, introducing health plans isn’t quite that straight forward and involving teams from the outset is critically important.

Putting plans into practice So, if health plans are great for pets and great for practices, what can practice managers do to ensure that they are Practice Life z June-July 2018

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implemented in the right way? Steve feels that buy-in from staff is the factor that has the biggest influence on the success of health plans.

‘It doesn’t matter how good the plan is that you have put together – what the price point is, what inclusions you have decided on, or any other factor. If your team doesn’t believe in it, you won’t get the most out of your health plans.’

‘At Simplyhealth Professionals we try and make this part easy. We’ll put together a training session and sit down with your team to find out what they think should be included.

It’s often your front-line people who are best placed to know what’s attractive to the people in your area and what services they might like to be included. We can give some examples of what other practices offer and the pros and cons of inclusion.

Some elements have to be included, but many are discretionary, as is the choice of products. Being involved at this early stage is so important as then people understand why certain decisions have been made and they have also had the chance to voice their opinions and share what they know.’

Armed with the information from this session, decisions can be made about the best design for the health plan. Keeping everyone informed as the plans progress will help keep people engaged, involved and motivated to play their part in success.

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Ease of process Practices are busy enough and no one wants to add to their work load. It’s vital to allay any fears and design the plan so that it’s simple to implement and run. Agreeing protocols that fit for various scenarios is the answer. For instance, if your client wants flea protection and signs up to the plan, do you allow them to leave the practice with their first three months’ supply without taking full payment for the product, or is this product paid for and their first payment made the following month? Deciding all this up-front will mean that everyday ‘problems’ have ready-made solutions that fit the practice ethos and have been thought through in advance. There’s no need to make rushed or reactive decisions on the day or worry about what to do.

Dealing with questions or updating details can also put a burden on stretched front-line staff. Consider whether you need your healthcare plan provider to have a customer care team in place so that clients can be referred to people who can answer their questions promptly.

Once your plan is ready to launch a whole new set of challenges comes into play.

Part 2: stepping up to sign up So you have a practice health plan or are about to introduce one. How do you make sure it takes off like a rocket, rather than a damp squib? In part 1 we talked about gaining staff buy-in and help with formulating the plan and the protocols that need to be put in place to allow you to deal with client queries efficiently. It’s now time to think about how to help your team make recommendations and encourage clients to sign up both immediately and over the long term.

Reward and recognition Steve Holman, Training Manager at SimplyHealth Professionals, says the whole team needs to be involved.

‘In some practices, getting clients to sign up to health plans is a front-office function, but actually clients listen to and respect the recommendations made by vets and vet nurses.

It’s important not to make this an activity that takes place in silos; everyone should reinforce the recommendation.’

June-July 2018 z Practice Life

In some practices there is a feeling that if individuals sign up clients they should be rewarded; in other cases it’s positioned as part of everyone’s usual job and is not specifically singled out.

A phased approach is also sometimes used, with rewards being given in the launch phase to get the programme running.

Steve feels this should be handled with care, as it’s not motivating to offer something then take it away.

‘It can work well to offer a team reward when you get to a specific target – such as bringing in cakes for everyone when the first 100 clients are signed up. Modest rewards that demonstrate your appreciation for the effort made are often well received.

We sometimes run national campaigns with sweet hampers or other rewards, so we will also help support the practice efforts.’

Some practices have offered a points scheme where the first person to recommend the plan receives a point when the person signs up. At Christmas the points are turned into pounds in the December wage packet. Depending on the practice, this can work well but Steve says that generally seeing sign-up as a team responsibility works best and, while it’s good to recognise and reward the team’s efforts, it’s also best if health plan recruitment is seen to be part of everyone’s day-to-day work.

Setting targets is a popular approach, but again, Steve explains that it can be seen as a negative ‘if staff are told to mention the plan to everyone, they can start to feel pressured

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and it doesn’t always harness the power of the whole team approach. I’ve found that if I ask team members to mention the plan to 10 people a day, it means that on average every member of staff will help two people sign up each day they are at work. That’s a good result, it can be sustained over the long term and will allow the plan to grow. It also means that team members feel more comfortable and can make sure that they are making recommendations in the right context to the right people. Clients also feel as if they are receiving a personal recommendation rather than being ‘sold to’.

‘Each situation is different, but I always encourage people to frame recruiting people to the health plan as being part of everyone’s usual job so that it becomes an ingrained habit,’ he adds.

Our approach is to hold a team meeting to help management motivate employees to recruit clients to health plans. Steve will often raise the issue of increased practice profits but asks the team to reflect on what that might mean for them – it could be a coffee machine in the staff room or tablets for clients to use in reception to fill in their details and take pressure away from the reception desk. It’s key that the rewards are seen to filter down to all levels of the practice and don’t just stay at the top.

Find a champion Setting up a healthcare champion in each branch of the practice can be a good next step. Steve says that initially the team tends to sign up more people and it’s easy for that first burst of enthusiasm to wane as new campaigns or promotions launch in the practice and attention is diverted. A champion can help keep everyone on track.

This is sometimes an activity that a manufacturer will support, especially if their products are included in the health plan. Their support could include providing tools such as tablets to make the mechanics of signing up away from the front desk easier, or CPD vouchers or congress passes for staff based on the number of new members recruited.

Maintaining the momentum is undoubtedly the biggest challenge. Steve says that most practices slow down and will often sit at the 500-client point. ‘This is why it’s important to have ongoing training and visits from our support team.

Signing up clients really has to be ‘business as usual’ and part of the regular routine.’

Sticking points and stepping stones Always review processes to ensure they are clear and assess work flows to find out where there are sticking points.

The more clients who sign up, the more administration fees can be reduced, making the plans more and more profitable over time.

Reminders for staff on the back of consulting room doors, processes that help the front-line staff follow up on or reinforce a recommendation or implement the sign up process and dispensing leaflets explaining the benefits with repeat prescriptions or on discharge after routine ops, such as neutering and dentals, are all ways of integrating sign up into day-to-day practice life.

Added value services can also be provided. These include client profiling, which helps practices understand the demographics in their area and target marketing efforts more

effectively. For anyone thinking of opening a new practice, this is especially valuable data. Mystery shopping is available, as are client surveys that can be used to track satisfaction or identify new opportunities.

It is a good idea to periodically review the plan in the light of new information – new products or new parasite threats may change the best practice recommendation and it is important for clients to feel that they are benefiting from a gold standard recommendation. Knowing what competitor practices are offering and making a decision based on their success, and being aware of new products or disease risks, can also inform what the plan includes. This helps to keep it relevant and broadens the appeal to as many pet owners as possible.

Some practices also choose to expand the type of plans on offer after the initial launch to include different life stages, or other pets, such as rabbits, or horses. Where puppy or kitten plans are offered, this can simplify a consultation that already has to cover nutrition, behaviour, parasite control and dental care by wrapping everything up into one package that meets all of the pet’s needs. The excitement of a new, tailored product can also act as a good focus for staff and rejuvenate sign up.

Make it easy Practice health plans do offer exciting opportunities to even out peaks and troughs in practice performance and also help keep clients loyal. While they can transform a practice, they are not magic. Like any change to practice systems and procedures, they need to be thought through, embedded in day-to-day processes, supported and maintained. Choose a health plan partner that will help you do all of those things and life gets a whole lot easier.

Practice Life z June-July 2018

BUSINESS HEALTH & FINANCE

EMPLOYEES BENEFITS AND TAX Everyone is different and offering a range of employee benefits is key to staff retention and motivation, writes Moore Scarrott’s Andrew Law

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he end of the tax year is always a good opportunity to consider employee remuneration packages and any tax changes that have come into force, but it is good practice to take a look on a regular basis. While we can’t cover every topic, the following areas crop up regularly so these will be our focus for this article.

Optional remuneration Rewarding employees appropriately is key to staff retention and motivation, as well as controlling staff costs. The tax effect of alternatives can influence the structure of remuneration packages and it has been increasingly popular to give employees choices in flexible remuneration arrangements and salary sacrifice schemes. The Government appears to have taken the view that these are undesirable and have legislated to change the tax implications of these schemes, but in doing so have created a great deal of uncertainty.

The new legislation changes the way benefits are taxed where the employee has a choice. The tax laws call this “optional remuneration”. The easiest way to explain this is to look at an example.

Example Suppose an employee is required to be on site at a practice premises, or close by, in order to fulfil their duties of employment. In the past, if the employer provided free accommodation, at or near the practice premises, it would be common to claim this as job-related accommodation, which is a tax-free benefit. The employee may find this attractive and would often agree to a reduced salary in return, which of course means they would pay less tax overall.

June-July 2018 z Practice Life

The new rules change the way in which the accommodation benefit is taxed. The taxable benefit of the accommodation is now the higher of 1) the normal benefit charge (in this case nil), and 2) the salary given up in exchange. This means that the accommodation is now subject to tax as a benefit on the amount of the salary sacrificed, so there is no longer a tax saving.

However the new legislation only applies where the benefit is optional. If there is no salary/benefit choice for the employee, the accommodation would still be tax free.

These new rules apply to most benefits, not just accommodation, and mean that the way in which packages are offered to staff needs to be carefully considered. Existing salary sacrifice arrangements in place on 5 April 2017 may have continued until 5 April 2018. If the scheme involves accommodation, or school fees, then existing arrangements may continue until 5 April 2021, unless they are renewed or varied before that date. Salary sacrifice for pension, low emission cars, childcare vouchers and bicycle schemes, will continue to be permitted indefinitely.

Recruiting new staff There is some uncertainty as to how new employees’ arrangements are to be treated as it is normal for there to be some negotiation over the package when an employee is recruited. Not all new employees would value free accommodation, for example, and may prefer a higher salary.

It is arguable that if this negotiation is conducted before a job offer is accepted it does not fall within the “optional remuneration” rules – that is, they have not given up any salary as they are not yet entitled to anything. Whether HMRC will

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accept this view in the long term will remain to be seen but until it is challenged this would seem the appropriate position to take. Retention of evidence may become important to support the position taken so that the wording of letters and timing of discussions should be carefully considered.

Tax-free benefits Everyone likes to have tax-free benefits and here are some that might be useful.

• Job-related accommodation • Pension contributions • Childcare vouchers (within limits) • One mobile phone per employee • Workplace parking • Social events – eg, Christmas parties, up to £150 per person, per year • Trivial benefits – up to £50 per person per occasion • Air miles • Bicycle schemes • Business vans used for commuting (no other private use) • Interest-free loans up to £10,000 • Approved scale rate subsistence allowances • Approved rate mileage allowances for travel in employee’s car Space does not allow a review of all these, but it is worth considering a few in more detail.

Childcare arrangements Arrangements for workplace nurseries are tax free. However, relatively few employers have sufficient numbers of staff in one location to justify setting up their own workplace nursery scheme, so these are relatively rare.

Childcare vouchers schemes have been in place for many years and involve a tax-free voucher, which can be used to buy approved childcare. There are strict limits on these schemes depending on the amount the employee earns. Basic rate taxpayers can have up to £55 a week in tax-free vouchers.

These schemes have been closed to new entrants from April 2018 but existing schemes will be able to continue.

In their place a new Tax-free Childcare Account is being introduced. Instead of attracting tax relief, these schemes will gain a tax refund direct into the scheme. The employee can invest up to £8,000 per year and HMRC will add a basic rate tax refund of up to £2,000 per year.

There are strict rules including the requirement that both parents are working. Whether it is better to switch to the new system will depend on the particular circumstances of the individual.

communication systems. Devices with VOIP or satellite connectivity may not qualify. Legislation tends to lag behind technological change and you may need to take a view if you have cutting-edge technology.

However, the use of computers will not give rise to a taxable benefit provided the private use is insignificant. If computers are provided as an essential tool for business use then private use is likely to be insignificant but there is no definitive guidance.

Trivial benefits A new exemption was introduced in April 2016 as a means to eliminate unnecessary argument over small amounts. In the past, when you gave your PA a box of chocolates, it would be considered a taxable benefit, although in practice this would rarely – if ever – be accounted for.

An exemption was therefore introduced to eliminate these questions. Gifts with a cost of less than £50 will fall within the exemption. Surprisingly, there is no limit on the number of such gifts, but there are some rules to prevent abuse.

In particular the gift must be in kind and not in cash. That can include gift vouchers, provided they cannot be redeemed for cash. Anyone who is a director of the company is limited to a total tax-free benefit of £300 per year under this heading.

The gift must not be a reward for work done and must not form part of the employee’s remuneration package. If gifts are given regularly there could be an argument that they become an entitlement over time so that the exemption ceases to apply. Sensible use of this exemption could be a valuable staff motivational tool.

Summary The area of employee remuneration and benefits is complex and surrounded by many rules and regulations. It is important to be sure you are aware of the obligations imposed on you as an employer as HMRC will look to you to put things right and recourse to the employee may not always be possible.

Mobile phones, smart phones, tablets and computers Mobile phones are often valued by employees as the employer can pay for all costs, including any private use, without any tax implications. The phone contract must be in the employer’s name and is limited to one phone per employee.

The increased functionality of smart phones and tablets has brought into question what is meant by a “mobile phone”.

HMRC takes the view that a mobile phone is a device that is primarily for spoken communication over public

Biography – Andrew Law Andrew joined Moore Scarrott in 2017, having worked in accountancy practice throughout his 30-year career. He specialised in tax work shortly after qualifying as a Chartered Accountant in 1984 before moving on to become a Chartered Tax Adviser. His experience spans the many facets of tax faced by the owner-managed business and wealthy individuals.

Andrew.Law@moore-scarrott.co.uk

Practice Life z June-July 2018

BUSINESS HEALTH & FINANCE

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Buying into a veterinary business?

SIX QUESTIONS YOU SHOULD ASK Buying into a company as a junior shareholder is exciting – you have a stake in the business you work for! But what kind of stake? Will you be permitted to place a hand on the wheel or be confined to the back seat? David Hughes of Canopy Law addresses six of the most important questions to ask

1. Does the business have a shareholder agreement in place?

2. How are key business decisions made?

If you are buying into a business that is run through a limited company, find out if there is a shareholder agreement that you can review before committing.

A shareholder agreement is a private contract between the owners of a company that sets out the ‘rules of the game’. It is a method of agreeing in advance what will happen in various scenarios that may occur in the life of the business. For that reason, it is sometimes known as a ‘Business Will’.

As for a Will, there is no legal requirement for the owners of a company to make a shareholder agreement. But in the absence of such a document, the business owners will need to consult the Companies Act 2006 to determine their rights, which inevitably means having to consult a lawyer. A shareholder agreement will put in place rules to address the other questions set out below.

Some key decisions in a small business have a big impact on all shareholders. The shareholder agreement can set out which of these ‘big’ decisions need the unanimous consent of all business owners and which ones simply require the majority to consent.

Some examples include: • Should a shareholder be allowed to be have a stake in a competing business? Or in any other business, competing or not?

• How many directors should be required to authorise large payments on behalf of the company (for example) greater than £10,000?

• What level of approval should be required to engage or dismiss a senior employee?

• What level of approval is needed to change the nature or direction of the business?

June-July 2018 z Practice Life

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BUSINESS HEALTH & FINANCE

• What level of approval is needed to invite a new shareholder into the company?

There is no standard answer for deciding the level of consent needed for these big questions. But it is worth knowing in advance what level of involvement you might be allowed and whether your voice will be heard.

3. How will shareholders share profits?

The net profits of a company (what is left after overheads, salaries and other expenses have been paid) are split between the shareholders in proportion to the shares that they hold.

These payments are the dividends. The directors decide each year, by a simple majority vote, on how much of the profit will be paid to shareholders and how much will be retained for investment in the business.

Some businesses will retain all profit for reinvestment.

Others will distribute it all to shareholders. A shareholder agreement can establish a set of rules for determining when dividends will be paid. This can ensure that a fair distribution of net profit is made to each shareholder.

4. What happens if a shareholder dies?

Shares are a personal asset and as such they pass under your Will to your next of kin. They do not automatically pass back to the company on the death of a shareholder. This can lead to some potentially undesirable outcomes: either, the surviving shareholders may wish to buy back the shares from the next of kin, but they may not wish to sell them, in which case they can hang on to those shares. Or, the next of kin may wish to sell those shares back to the company to realise some cash for the shareholding of the deceased shareholder, but the surviving shareholders may refuse to buy those shares, which leaves the next of kin with a paper asset that they cannot convert into cash.

The answer is to have a clause in a shareholder agreement that gives the next of kin a right to sell the shares back to the company and gives the surviving shareholders a right to buy the shares back from the next of kin.

5. What if a shareholder wants to leave the business in future?

A shareholder may need to voluntarily leave the business (for example, due to a new job, relocation or personal circumstances). Shareholdings are not automatically connected to your employment, which means that they do not automatically pass back to the company on you leaving your employment. This is potentially detrimental for both the company and the shareholder.

The company might be left with a shareholder who no longer works in the business but hangs on to shares in the business.

Meanwhile, the shareholder retains a minority shareholding that is impossible to sell and cannot be converted into cash.

The solution is to have a set of rules in place that give the leaving shareholder a right to sell his or her shares back and give the continuing shareholders a right to buy the shares back from the ex-employee.

6. How are shares valued?

There are as many different ways of valuing shares in a private company as there are companies, but ultimately, the price paid for shares will be a compromise between what a buyer is prepared to pay and what a seller is prepared to accept.

However, disagreement is achieved as commonly as a compromise.

There are different measures that can be used to place a value on shares: a) the company’s total asset value; b) its net profit; c) its future potential. For reasons of convenience, a shareholder agreement will often state that, in the absence of a compromise agreement, the question of share valuation will usually be referred to the company’s accountant or an independent accountant to determine. Much like a Will, this can provide a method of avoiding bitter disputes after the event.

As anyone who has attempted to play Monopoly with friends and family members will know, not all business ventures end amicably. Sometimes, building an empire doesn’t bring people together. Establishing a clear set of rules at the beginning is like putting in place a fence at the top of a cliff, which stops company owners from falling over the edge and into the hands of lawyers who wait in the ambulance parked beside the rocks below!

GDPR Help Guide David has written a short booklet to help companies with information about GDPR - with a twist! David’s book is illustrated with his amusing cartoons and he’s giving them away to readers of Practice Life. For a copy of the booklet either go to http://canopylaw.co.uk/home/other-law-stuffwe-do/ and sign up for the newsletter or send him a request directly at david@canopylaw.co.uk. Remember to include an address as it is a hard copy booklet.

Biography – David Hughes David is a company ownership lawyer, specialising in helping business owners through the process of buying and selling a business. He runs law consultancy Canopy Law, which is set up to make business law straightforward. The company only works on a fixed price basis. www.canopylaw.co.uk

Practice Life z June-July 2018

PRACTICE DEVELOPMENT

Drugs and profitability: an online threat?

In light of one insurance company’s advice to ‘buy your pet drugs online’ SPVS president Peter Brown examines the impact that this may have on practices

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t is 13 years since a change in the law required vets to offer prescriptions to their clients as an alternative to obtaining medicines directly from the veterinary practice.

Since then, the number of online veterinary pharmacies has mushroomed and most vets will be familiar with clients asking just for a written prescription without filling that prescription.

In a recent development, Direct Line Insurance has teamed up with Pet Drugs Online to encourage pet owners to buy medications online, claiming they will be paying over the odds at their veterinary practice. So should practices be concerned?

According to Mark Harwood of Hazlewoods Accountants, product sales typically account for 37-38% of practice turnover, and this figure has not changed dramatically since the introduction of the new law. It would seem that most clients still prefer the convenience of purchasing medicines directly from their practice, particularly for short-term treatments, but this is no reason for complacency in my book.

At 38% of turnover, and assuming an average mark-up of 50% (probably a conservative estimate for many practices) the gross margin on products would account for 38x50/150 = 12.7% of practice turnover.

June-July 2018 z Practice Life

Profitability benchmark The significance of that figure becomes clear when you consider the results from the Profitability Survey run by John Sheridan of Veterinary Business on behalf of SPVS. John has analysed 164 sets of practice accounts and calculated a ‘true’ profit figure after taking into consideration a salary for each partner and a commercial rent for the practice premises (if these are not already included in the accounts).

On that basis, the median profit for all the practices surveyed was 10.2%. In other words, for more than half of veterinary practices the mark-up on products sold accounts for all the practice profits. Even after taking into account the costs associated with selling products (including a proportion of staff and overhead costs), John estimates that the margin achieved on product sales is a healthy 15-18%, emphasising that, for many veterinary practices, it is the pharmacy that keeps the business afloat.

This should concern us for two reasons. We may heave a familiar sigh when clients complain about fees and mutter about the NHS obscuring the true cost of healthcare, but the fact is that while you can argue over the cost of a consultation, it is

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much easier for tabloid journalists to shout ‘rip off’ when they can directly compare the cost of medicines with those bought online. But secondly, and more importantly, our reliance on income from product sales reflects a chronic and ingrained problem vets have with recognising their own worth and charging accordingly.

The difficulty is compounded by our attitude to the fees we charge for routine preventive work. The table below contains data form the SPVS Fees Survey, which shows how some fees have changed over a 10-year period compared with the Consumer Price Index (CPI).

2007

2017

% Increase

Consult Hourly Rate

£113.40

£132.00

16.4%

Puppy Course

£43.82

£49.99

14.1%

Kitten Course

£50.91

£54.17

6.4%

Cat Spay

£45.15

£60.00

32.9%

Bitch Spay

£143.55

£191.67

33.5%

Increase in CPI over same period

24.5%

Inflation Significantly, vaccine costs have not kept pace with inflation and neither have consultation fees, once the move to longer appointment times is taken into account. The cost of neutering has risen above inflation, and arguably this is because factors such as more sophisticated analgesic and anaesthetic agents and improved monitoring during and after surgery have added to the costs, but they are still low compared to other surgical procedures. Clearly this is partly a response to market forces, but it means, for example, that clients often end up paying more to have a simple skin wound sutured than they do for spaying,

which is, after all, abdominal surgery.

We further exacerbate the problem with special offers, such as vaccinations for £20 or dentals for £99. Much as we may justify such pricing decisions on business grounds, what message do they send to our clients – and to us – about the true cost of our services? At the very least they make it harder to explain our ‘normal’ fees to clients, especially as they have probably been increased to compensate for the cost of our special offers. This is not to say that intelligent marketing should not be a part of our business plan. But unless we first appreciate the true value and cost of our services we risk taking blood from an already anaemic patient.

Although this initiative by Direct Line is not likely to make a dramatic difference to our clients’ buying patterns, at least not in the short term, both Mark Harwood and John Sheridan agree that as practising veterinary surgeons we need to be much more focused on fees as a source of revenue if we are to have thriving and successful practices.

SPVS senior-vice president Brian Faulkner, said: “At the end of the day we have three unique rights; the right to diagnose, the right to prescribe and the right to perform surgery… and so we should be able to make our living doing what we are uniquely entitled – and privileged – to do.”

Product sales can contribute to that, but they should arguably be the icing on what is a professional cake.

So what about your practice? Are your product sales subsidising your services? Maybe it’s time to look again at the fees you charge for your professional expertise. It’s not only good business sense, but it’s also about valuing you and your professional colleagues. Because, as a well-known cosmetics firm would like to remind you: you’re worth it.

Providing Perfect Solutions PPS GI provide a full portfolio of general insurance products and services exclusively to the veterinary profession.

Veterinary Insurance & Services Tailor Made Surgery Insurance Locum Insurance Equipment Finance Private Medical Insurance Motor Fleet Home Insurance Practice Sales & Goodwill Valuations

CALL 01527 909200 PPG SI

PPS GI is authorised and regulated by the Financial Conduct Authority.

WWW.PPSGI.CO.UK Practice Life z June-July 2018

CPD SHARED

TOP TIPS:

THE GOLD STANDARD FOR RECEPTIONISTS Practice Life editor Ian Wolstenholme interviewed Liz Stokoe and Magnus Hammenn of Loughborough University, during Cx Congress in June

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year on, and I’m joined again by Liz Stokoe, to discuss what works well in veterinary practice.

A year ago, Liz had just conducted research within the medical profession – and torn it to shreds! – now, you’ve done the same research within the veterinary profession, so what were the main findings?

‘Firstly, we’re here to find out what people do in the vet profession that works and what doesn’t work – not to tear people to shreds! Sometimes people want to shoot the analyst when we do this type of research because they find things that are counter to what they’ve been taught or that they don’t particularly like,’ says Liz. The study involved conducting research by making calls to ‘real life’ veterinary practices, in the manner of ‘mystery shopping’ but with no prompting or prior knowledge.

From this body of knowledge, the pair produced a list of 10 top tips for receptionists.

Top tips: the gold standard for client care 1. Answer questions. If a caller is asking questions make sure you answer them. For example – can I make an appointment? how much is it? Callers were not finding out the answers! Sometimes the receptionists were putting loads of other information into the call, so the answer – or appointment – gets lost.

2. Remove caller burden. Don’t leave customers dangling or having to push for confirmation of their appointment or price, for example. Make the caller’s question the priority and ensure they get an answer.

3. Empathy not sympathy. While many callers are trained to build rapport with callers, often this can lead to them mistaking sympathy for empathy. For example, if something bad has happened, don’t say ‘I’m sorry…’ but say something like ‘That is horrible…’

4. Cancelled appointments. It will happen, and when people do call to cancel an appointment, don’t push them to re-book, but do leave this option open to them.

5. Don’t over-sell. Receptionists may be encouraged or mandated to sell other products, in response to ‘how much does it cost to do X…’ Listen to what the caller has asked for, and what it is they actually need, and don’t push the ‘sell’ conversation if it’s not appropriate – ie, if they sound like they’re rushing off to work.

Liz Stokoe and Magnus Hammenn

6. On hold… Think what’s appropriate for when you put people on hold. For example, a client whose rabbit has died calls in, in tears, and is put on hold and some terrible, jolly music hits their ears. Think about what a client hears when you press that hold button. A better way is to let the client know you need to speak to a vet and that you will call them back.

7. Offering time slots. Making open offers is not the best way to offer appointments to clients – saying ‘so, when can you come in?’ means they have everything to choose from. Often, when you take this approach, they will suggest a time that doesn’t work for the practice, so you have to reject it. Instead, provide the caller with multiple options, then you’re still offering them choice, but within the times that suit the practice.

8. Cost of the service – although this is talked about a lot at conferences and the like, what the client cares about is whether the problem is ‘doctorable’ or ‘vettable’ – the owner needs to know that their problem is definitely something the vet can solve. Make sure the caller knows that you can solve their problems and then the cost doesn’t matter so much to them.

9. Safety net/vet call backs – when a client asks whether he or she really needs to bring their animal in, and the receptionist says they’ll speak to the vet or get the vet to call them back, the owner is usually very happy with this answer. It’s progress, and the client isn’t left dangling. Add to that a confirmation that the client can always call back if they’re still worried, means that the client feels there’s a safety net in place.

10. Avoid ‘is there anything else I can help you with?’ – it’s very impersonal and suggests the call is being wrapped up, and it relies on people feeling helped. This is especially irritating for clients when they feel they haven’t been helped in the first place so is best avoided.

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Summing up, I do feel that the reception function has become very scripted and just following set rules. ‘Take the robot out of the call takers and put the people back in,’ suggests Max. People are trained to ‘build rapport’ from the second they answer the call, but, through our work making calls to practices, we’ve found that even when a client calls a practice and is clearly not going with the ‘Hi, how are you today’ type chat, the receptionist still pushes the idea of building rapport, which simply doesn’t work.

Unfortunately, this can lead to you losing customers, even though you’re doing the things you’ve been trained to do. It’s not actually achieving the thing you think it’s doing. What you can do is record some of the conversations from clients who call to make an appointment and use a conversation analyst to listen and comment objectively on it. If you’re not an expert, you can find

that you’re commenting on the wrong things and picking up on the wrong areas of the conversation.

Personalising the experience to each client is something the profession has improved on in recent years, and we’ve got to get away from giving the ‘practice sales pitch’ approach, particularly to new clients wanting to register.

Something else to consider is that answering questions briefly and being to the point is not a bad thing. Listen to clients and then answer in the way that gets to the point quickly if that is appropriate is going to work. Clients can always ask for more information if they need to, but, being succinct when appropriate is very important.

The research by the team is ongoing and they will be presenting further results in due course.

WHAT CLIENTS REALLY WANT KEEPING AN OPEN MIND

Vet Louise Corah presented research at Cx Congress in June as part of her PhD; Ian Wolstenholme caught up with her afterwards for a chat

Ian So, customer service… don’t you vets just sit behind a consult desk and do all the clinical things and leave all the harassment to the people out front?

out of the library, they may read research journal articles, and have all that prior knowledge before coming into your consultation. So it’s really important that we understand it’s not just that 15 minutes any more.

Louise

Ian

Well, some vets might do that, but I think it’s really important – you’ve got that 10-15 minutes with a client to make a good impression and do the things that vets do. I think clients are very susceptible to first impressions and I feel it’s all about being a team – understanding that everyone in the practice team has a really important role to play and that no person is more important than another and that they all contribute to that client’s experience and journey.

Many vet nurses, practice managers, receptionists, snigger in the background at many clients who say they’ve looked on the internet, that this is happening, and so on, but this is real life and we just have to get over it. How do we overcome the problem when a client comes in and says they know what is wrong with their pet, and they’ve made a decision, before you’ve even laid eyes on the animal?

Ian

First step is to understand they’re doing that, and then come to terms with it, however alien it might seem to some of us!

Then I think it’s really important not to be judgemental, and to be less paternalistic in what we’re doing. It’s important not to judge what it is they do and don’t know before you’ve found out what it is or isn’t that they know. As I said in my talk, the role of the vet is changing rapidly, we’re not the be all and end all, we’re not the only place they can get information. What’s left is that we’re the people with the technical skills, and we’re the people who empty anal glands, who do euthanasias, and who listen to hearts – all those technical skills they can’t get from the internet. Then we also have the fact that we remain animal welfare advocates so that if an animal is suffering or in pain, that we have that as our backstop. We should get involved at that point, but beyond that, most clients want to do the absolute best for their animal and they’ve done this research because they want to do the best for their pet.

What struck me was that at the start of your talk you mentioned that clients expect the consultation to begin long before what we would call the consultation begins.

Are those boundaries now being blurred in a client’s mind?

Louise Vets are no longer the only place you can get information.

Twenty, 30, 40 years ago the vets went to vet school, they had the lectures, they had the text books and clients were pretty much in the dark about a lot of what goes on, but that’s not how the world works now. Everyone has the internet, everyone Googles, even my granny has an iPad – she’s 90! – that’s the way the world works. I think it’s naive to assume that a client will come into the consultation and see that 1015 minutes as an isolated thing.

So it all starts at the beginning; an owner notices a problem, they’re going to Google it, ask their friends about it, get books

Louise

Practice Life z June-July 2018

CPD SHARED

I think we need to stop disparaging them and judging them and work with them, rather than proclaiming from our ‘high cloud’ behind the consult table what the best thing for them to do to their pet is.

Ian In your research, you haven’t just spoken to clients, you’ve spoken to an awful lot of them, you’ve also got the opinion of your veterinary colleagues. What do they make of all this?

Louise It may be that the colleagues I spoke to are interested in these sorts of things; there’s always going to be some bias in the people you speak to. There is mainly positive feedback but there is some client-bashing going on in the profession in general and a lot of judgement around what clients know and Dr Google. I think we need to take a step back and look at what is the role of the vet today, and I don’t think it is what some people think it is. It comes down to decision partners – we’re making that decision together, we’re animal welfare advocates and we have the technical skills. Beyond that I think we need to be a little bit more open and flexible as to what the role is; we are in a service industry and we need to be providing these services, albeit with the caveat that animal welfare is the most important thing. That’s what most of our clients want too.

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animal in that situation, but for other people it would be to control the pain and give that dog a good quality of life, before perhaps reaching another decision. It’s not that gold standard is a bad thing, we should all be trying to do the best every single time, it’s just what does gold standard mean. I would argue that needs to be a bespoke, individual thing for that patient and that client on that day.

Ian It’s fascinating research and you’re well on the way through, but how much is there still to do?

Louise It’s nine months before the hand-in of the thesis. And then I’m looking for a job!

Ian What is the most striking thing you’ve found from your research? What is that clients want above all others?

Louise They want a voice. They want to be heard, they want to be involved, they want this to be a partnership. That partnership is a variable thing; some want to be involved but with you leading the decisions, whereas other clients want to make all the decisions themselves. That’s the biggest surprise – not that it should come as a surprise, really!

Ian You made me smile at the end of your presentation – when you said you hated the term ‘gold standard’, as do I! We get told by ‘pundits’ a lot of the time that we must offer gold standard service, but how much flexibility is there in providing that level of service?

Louise It’s about redefining what the term gold standard means.

It should be the best thing for that client at that time and for that pet in that situation. A tailored approach. The gold standard term is often used at a referral centre, for a dog with just one problem, and this is what you should do. That’s wonderful but actually there’s not an awful lot of evidence for an awful lot of what we do in veterinary medicine, unfortunately. The strengths of the trials we have at the moment isn’t always fantastic, so we should be looking at these cases on a one-by-one basis and working out what is best for that animal. For some people, that will be doing absolutely everything, which is fine for that person, and that June-July 2018 z Practice Life

Biography – Louise Corah Louise is a Notts vet PhD student who has worked in the corporate sector, referral practice and at PDSA. She is conducting research into client consumerism and what the demands are nowadays in veterinary practice.

CPD DIARY

VMG & SPVS launch Congress 2019

Registration is now open for VMG and SPVS members for your 2019 Congress. Places and accommodation fill up quickly, so we advise you to book as early as possible. Why not take advantage of our exclusive members-only early-bird discount available until October 31, 2018?

LECTURE PROGRAMME Each year we present interesting and innovative CPD content from speakers both within and outside the veterinary profession. In 2019 the focus will be on recruitment, retention and strong leadership.

Susan Room

Kate in action

Nuala Summerfield

Emma Mamo

Highlights include: • Our Congress opener, Kate Richardson-Walsh, OBE, who led the England and Great Britain hockey team for 13 years, culminating in a gold medal win at the 2016 Rio Olympics.

• Two streams dedicated to recruitment and retention of the whole practice team.

• Susan Room, professional voice and executive coach, builds confidence, listening and communication skills with her four-stage model.

• A brand-new Vet Stay! Stream explores options for developing fulfilling careers without leaving veterinary practice, alongside the ever-popular New to Management Stream.

• New for 2019: Practical Mindfulness in the Workplace with Sean Gilgallon, Citation.

• Caroline Clarke and David Knights discuss new research around gender bias within the veterinary profession.

• Nuala Summerfield presents the business case for telemedicine, analysing threats and opportunities for practices.

• Emma Mamo from Mind shares experience from other sectors of managing mental health in the workplace.

• A repeat of our equine stream, plus a second run of the large animal stream, including case studies from large animal owners and managers.

The exhibition will again take place in the dedicated exhibition hall, with plenty of space to chill out while meeting a wide range of suppliers with advice on marketing, management, relevant products and business development.

Practice Life z June-July 2018

CPD DIARY

We’re ‘Havana’ ball

We may not have the tropical breezes and shady palms, but be prepared for an abundance of flamboyant fun at this year’s Presidents’ Banquet, where the theme will be a touch of Cuba. Our high-energy festival and party band, RPJ, is headed by Rick Parfitt Jnr and supported by some of the finest session musicians in the country. Congress will start on Thursday night with a cabaret evening featuring magicians, time-travellers and all-round spiffing chaps, Morgan and West.

We’re delighted to back at the five-star Celtic Manor with its luxury spa, multiple restaurants, comfortable bedrooms and spacious bars. All congress delegates are welcome to use these fabulous facilities, not just those staying in the resort.

Congress offers something for everyone within the practice team, from owner to veterinary nurse, from veterinary surgeon to practice manager, so don’t miss this chance to bring your team together for two days of inspiring content, memorable networking and dazzling entertainment.

Practices that bring three or more members will benefit from a 15% group discount when registering. To register and for full details of the programme and our sponsors, visit www.spvs-vmg-events.co.uk

June-July 2018 z Practice Life

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CPD DIARY

THE CONSULTING NURSE September 12, near Gatwick, September 26, Edinburgh

Coming UP

Brian Faulkner shares 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 which 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, 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 watching to managing diabetes, animal behaviour to geriatric care, with tips on how to promote them, run them and measure outcomes in terms of increased compliance, vet appointments or client loyalty.

FIRST AND LAST IMPRESSIONS October 3, Milton Keynes Do you ever consciously try to view your reception area through the eyes of a client? Are you making the most of your retail space? Are the marketing messages in your waiting room loud and clear?

The reception area is the public face of your practice and it is where your clients will form their first and last impressions – yet too often the day-to-day management and layout is left to untrained or overworked reception staff or nurses.

This day from Clare Hemmings from Royal Canin and Emma Mapletoft from Bayer will ask some hard questions about what the reception area is actually for. Both Clare and Emma trained as VNs and have extensive experience of sales and marketing in the petfood and pharmaceutical industries. There will be a guest appearance from a manager of a well-known, high-end supermarket, who will share techniques used within the retail sector.

CHIMP MANAGEMENT October 18, Bristol We all have an inner ‘chimp’ who can be our best friend or our worst enemy… this is the Chimp Paradox, a mind management model first devised by Dr Steve Peters and applied to his work with elite athletes. Do you sabotage your own happiness and success? Are you struggling to make sense of yourself? Do your emotions sometimes dictate your life? Leonie Lightfoot has lectured in applied sports psychology and worked with both England Athletics and British Equestrian. She is one of a small team who have worked with the model for a number of years. She understands the stresses of working in a pressured environment and is passionate about using the chimp model to support individuals, teams and organisations to find a greater sense of wellbeing and purpose. Leonie will outline the model and will show how we can all achieve better balance, happiness and be more effective leaders by managing our inner chimps.

MANAGING BEREAVEMENT AND END OF LIFE CARE October 31, Coventry Eighty per cent of pets will make their final visit to the vets for euthanasia and for many pet owners it is the only clinical procedure they will witness – and one they will remember for the rest of their lives. It is not only an emotional experience for owners, but also for the whole team from reception to nurse to vet.

Suzen Gregersen has been leading a movement to better end-of-life and palliative care for many years and she makes the business and welfare case for starting and preparing this process earlier in a pet’s life. She encourages the planned management of terminal disease and old age, as well as preparing the final highly emotional consultation for the best possible, most consistent outcome.

Doug Muir will be discussing how to embrace the whole bereavement aspect of helping your clients have a better journey through the stages of loss and how the whole veterinary team can support this journey.

By ensuring the whole practice team is competent and confident in helping owners in the final stages of their pet’s life is at the core of this session. Suzen and Doug will show how you will reap the benefits both in repeat business from grateful clients when they get a new pet and from reduced emotional fatigue among staff.

Visit the website for details https://vpma-spvs-events.co.uk/cpd-2018/ Practice Life z June-July 2018

BVNA CONGRESS 2018 Outstanding CPD for the whole healthcare team Friday 12th to Sunday 14th October 2018 Telford International Centre, Shropshire

New in 2018

Emerg ency a nd Cri Care S ympos tical ium

For Registration event information please visit www.bvnacongress.co.uk | www.bvnacongress.co.uk opens early 2018 Full Page Congress Advert - Revised 17.indd 1 1 BVNA10899 - Congress 2018 AdvertNov V1REPRO.indd

30/11/17 15:30:36 14:10:11 19/09/2017

National Veterinary Specialists Accountants, taxation & business development specialists Our range of services include: Consultancy

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Veterinary team partners: Andy Moore andy.moore@moore-scarrott.co.uk Steve Headon steve.headon@moore-scarrott.co.uk Nick Lawrence nick.lawrence@moore-scarrott.co.uk Simon Biles simon.biles@moore-scarrott.co.uk

Offering veterinary practices comprehensive legal support

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We offer a free of charge, no obligation initial meeting and discussion anywhere in the UK