Practice Life Issue 7 March/April 2015 by The Magazine Production Company

March/April 2015 www.practicelife.biz

Thinking and Learning Skills What colour are you?

The Zoo in your Computer Animals in SEO

Managing Meetings Effective leading and participating

New Royal Charter Registered Veterinary Nurses and the law

THE MAGAZINE OF SPVS AND VPMA

In the Spotlight: Mike Vaughan, CVS Director of Acquisitions SPECIAL PREVIEW:

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EDITORS’ LETTERS

Editors’ Letters

y the time you read this, VPMA/ SPVS Congress may be becoming a distant memory. However, as I sit writing, it is still very clear in my mind, and my thoughts about the event are, like the vast majority of the comments I’ve heard, very positive; Celtic Manor as a venue lived up to the expectations set by last year, the social programme didn’t disappoint and the lectures and workshops were all excellent (I certainly didn’t attend any that weren’t relevant or useful and all the speakers were engaging, making their ‘take home’ messages easy to remember). Last year, my regret was that I didn’t take advantage of the lovely spa facilities; I rectified that this year by staying an extra night (and I wasn’t the only one – definitely to be recommended!). My regret this year is that I wasn’t accompanied by any of my practice team; sitting in lectures I kept thinking how useful it would have been if others were also present, so next year I hope there will be

s I write this column, it’s just turned 5am on Friday morning at VPMA/ SPVS Congress (and no – not even the hardiest stragglers are in the bar at Celtic Manor!). Despite wonderfully comfortable surroundings my body clock remains in “work mode”, completely oblivious to the fact that it’s allowed a bit of a lie in during the next couple of days! There’s a real buzz about the place this year – a sea of smiling faces – managers, owners, nurses, client care guys – the whole shebang. Whether the economic upturn is being seen and felt in practices or not (and methinks that topic will be being discussed in the next few hours by far better analysts than I) the positivity is palpable. Our talented Congress organisers have put together a fantastic selection

several of us from Mimram Vets to take full advantage of the great learning opportunities that I have no doubt congress will, again, provide. Reinforcing some of the ‘take home’ messages from Congress, in this edition we look at how to manage meetings at work for greatest efficiency (something I’m sure all of us would like to be able to achieve). And then, for those (hopefully rare!) days where meetings just haven’t gone according to plan, staff are moaning, patients are grumpy and customers complaining, leaving you feeling stressed, we have advice on succession planning... perhaps a section you may want to keep for future reference! With SPVS AGM having taken place at Congress, we have a new President, Nick Stuart, and some new Council Members. I’d like to wish Nick all the best for his Presidency and welcome the newcomers to Council; I’m looking forward to working with you all.

Stephanie Writer-Davies, SPVS editor

of themes and deliverers and it’s little wonder that delegates are raving about what’s on offer. From modest beginnings this conference has developed into the perfect mix of learning and leisure. If you are reading this and have never been a part of it, you need to bookmark it now for 2016. Ah well, ahead of that the cut and thrust of the next two days – what to attend, who to see in the exhibition, will Rita Dingwall ever wear her shoes in the Merlin Bar? So many questions! Little wonder this editor is scribbling this whilst (probably) everyone else in the resort is sound asleep. I’m sure Congress highlights will be noted in the following pages and, no, we should not be afraid to celebrate another successful event.

Ian Wolstenholme, VPMA editor

Practice Life is the magazine of SPVS and VPMA. If you are interested in joining either or both associations, visit www.spvs.org.uk and www.vpma.co.uk www.practicelife.biz z March/April 2015 z Practice Life

Contents Editors SPVS Stephanie Writer-Davies BVSc MRCVS steph@practicelife.biz VPMA Ian Wolstenholme, Practice Manager ian@practicelife.biz Publisher Mojo Consultancy Ltd 181 Sandpit Lane St Albans AL4 0BT Tel +44 (0) 1727 859259 info@mojoconsultancy.com www.mojoconsultancy.com Advertising and Sales Enquiries Libby Sheridan MVB MRCVS libby@practicelife.biz Tel:01727 859259 Sales Administrator Eva Lambe eva@practicelife.biz Practice Life is the magazine of the Society of Practising Veterinary Surgeons and the Veterinary Practice Management Association. It is distributed quarterly to the members of both associations as well as a wider mailing list of veterinary practices annually. www.spvs.org.uk www.vpma.co.uk The magazine contains articles on veterinary business and management as well as other topical updates and relevant features. The information contained within these articles is intended for general information only and does not replace the need for advice from qualified professionals in the relevant field. Articles and photographs are welcomed for submission, though publication is not guaranteed and is at the discretion of the editors.

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VPMA NEWS Focus on CVPM

SPVS NEWS RCVS Cert AVP: Get on and do it

NURSE TALK BVNA 50th Year celebrations and Council elections

COLLEGE CORNER Registered Veterinary Nurses and the law

IN THE SPOTLIGHT CVS Director of Acquisitions, Mike Vaughan

WELL-BEING Prioritising staff well-being: One group’s approach

PERSONAL DEVELOPMENT Thinking and learning skills

MANAGING PEOPLE Managing meetings: effective leading and participating

CLIENT CARE AND MARKETING The zoo in your computer: managing SEO animals

BUSINESS HEALTH AND FINANCE Succession planning for owners

PRACTICE DEVELOPMENT Improving the customer experience is good for business

CPD SHARED Congress Special Feature

CPD DIARY Preview of Focus on Technology for Profitable Practice

© 2015 Practice Life All rights reserved. Practice Life is edited, designed, and published by Mojo Consultancy Ltd. No part of Practice Life Magazine may be reproduced, transmitted, stored electronically, distributed, or copied, in whole or part without the prior written consent of the publisher. A reprint service is available.

UPDATE: NEWS & VIEWS 5

WHAT’S COMING UP 46 CPD Programme for 2015 and what’s in next issue

40 28

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

Practice Life z March/April 2015 z www.practicelife.biz

News & Views

INSPIRATION FOR VETERINARY WOMEN A new on-line platform called Veterinary Woman has been launched which aims to provide information and resources of interest to women at all levels of the profession and anyone else looking for relevant insights or viewpoints. The project is the brainchild of vet Susan McKay from Companion Consultancy who saw the need for an online space that would help veterinary women to create a community where they could share ideas and problem-solve. With pages for work-life balance, wellbeing, family, business and leadership, the site aims to be comprehensive, bridging both personal and professional. There are guest blogs, feature articles, updates and advice, and interviews with inspiring veterinary women. Links and references to sources of specialist help are also available. Participation with the site is encouraged and the publishers welcome written content on topics thought to be of interest to the audience. www.veterinarywoman.co.uk

Have You Got Cattitude? International Cat Care launches photo competition for vet clinics and their clients

Take a photo of a staff member with a cat and be in with a chance of winning £400 Thames Medical vouchers for your practice

Oxford Cat Clinic nurse with patient

Leading feline charity, International Cat Care has launched a social media campaign aimed at raising awareness of its global Cat Friendly Clinic initiative, which is supported in the UK by Purina. Vet practice staff are invited to jump on board the ‘selfie’ craze and take photos of themselves or their colleagues in their clinic with a favourite feline friend. They can then upload the photo to the ISFM Facebook page (www. facebook.com/ISFMcats) where their clients and cat lovers from around the world can vote for their favourite. The winning photo (with the most Likes) will be used by the charity to help raise awareness of the Cat Friendly Clinic programme, which aims to promote the wellbeing of cats visiting or being hospitalised in a veterinary practice. Accredited Cat Friendly Clinics www.practicelife.biz z March/April 2015 z Practice Life

fulfil a set of broad criteria that show they recognise the specific needs of cats and their owners, and place cat welfare high in their practice priorities. Cat owners in turn are able to seek out clinics that have taken steps to help them overcome common barriers to clinic visits and reduce the stress of their pet. The Cattitude competition runs from now until the 24th April. The winning staff member will receive £200 worth of John Lewis vouchers and the practice £400 worth of Thames Medical vouchers to be spent on feline-friendly equipment. Practices may upload as many photos as they like to the Facebook page, and will be able to encourage client engagement leading to ‘Likes’ for their photos through campaign support materials, which include downloadable in-clinic display posters, a series of supplied posts for their own Facebook page, written copy for their own clinic newsletter or email along with a proforma press release they can send to their local newspapers and publications. Clinics can find more information on taking part in the Cattitude competition at www.facebook.com/ISFMcats or www.icatcare.org/cattitude. Details of the ICC Cat Friendly Clinic initiative and accreditation can be found at www.catfriendlyclinic.org along with a list of alreadyaccredited vet clinics.

NEWS IN BRIEF

EXTENSION TO RCVS ALTERNATIVE DISPUTE RESOLUTION TRIAL The Royal College of Veterinary Surgeons (RCVS) has extended its alternative dispute resolution (ADR) trial until October 2015 and broadened its remit, allowing more cases to be considered. The trial, which was originally due to end in May 2015, aims to gather evidence needed to develop a permanent scheme. This would provide an alternative form of resolution for the many concerns raised with the RCVS which do not meet the College’s threshold for serious professional misconduct and are, therefore, not taken through its disciplinary process. As well as the time-frame being extended, the trial will now also be widened to include concerns raised about the treatment of horses and other equines – in addition to those raised about small animals. Furthermore, the RCVS has also lowered the maximum financial award that can be recommended by the Ombudsman Services, a

not-for-profit complaints resolution service which is administering the trial, to £3,000 for small animal cases. The maximum financial award that can be recommended by the Ombudsman Services in relation to equine cases remains at £10,000. Nick Stace, RCVS Chief Executive, says: “The trial got off to a slower start than we expected and so we have decided to extend its length and breadth to allow more time and scope to gather the evidence and testimonies which we need to assess the trial. “It’s important to stress again that the trial is free, voluntary, as both parties must agree to take part, and that the recommendations made by the Ombudsman Services are not binding – it is up to either party as to whether they accept them.” The results of the trial will now be reported to the November 2015 meeting of RCVS Council. For further information about the ADR trial please visit www.rcvs.org.uk/adr

Cx Club launched by Onswitch focusing on Customer Care team Client journey specialists and trainers Onswitch have launched a new club centred on customer care and aimed at anybody working in customer experience. The Cx Club, which is supported by a quarterly magazine UpFront has been developed in partnership with a team of like-minded customer-centric practice managers and owners and is particularly aimed at veterinary receptionists and the Front-of-House team. Dawn Kent, Practice Manager at Willow Veterinary Centre and Editor of UpFront, explains: “… Now we have UpFront – a new magazine written with and for the customer care team and packed full of tips and real-life stories from groups across the UK. This is an exciting opportunity for everyone involved in customer care to learn, share and improve, and for the crucial nature of their role to be acknowledged.” To find out more, visit www.cxclub.care. The Cx Congress, a one-day conference focusing on client experience, will be held on the 20th June at the Radisson East Midlands Airport Hotel.

New video series for recent graduates VeterinaryBusiness.org has launched the first of five online videos – totalling 120 minutes of solid content and designed specifically for recent graduates and for vet students planning a career in practice. Presented by John Sheridan, he gives viewers advice on how to take control of their practice career, have clients queuing up to seek and follow advice, gain supportive colleagues and a smiling boss, all with a salary which reflects their value to the practice – all without

compromising their professional standards and values. In a message for practice owners and managers, John adds – “in a nutshell, I tell them all the things that you would like to tell them if you had the time”. The first video in the series is freely available online and students, recent graduates and their employers can view it at www.veterinarybusiness.org/career-veterinary-practicevideo-1/ Practice Life z March/April 2015 z www.practicelife.biz

NEWS IN BRIEF

Norbrook

launches new VET app Norbrook has launched a new Veterinary Excellence Tool (VET) app for iPhones, which includes fluid and nutrition calculators. The app allows users to quickly and conveniently calculate infusion rates based on factors including a patient’s weight, reason for fluid therapy and choice of product to be infused. The nutrition tool calculates weight of food to be given daily to a patient based on animal weight, calorie density of food and nutritional requirements. It also calculates approximate energy density of food based on fat, protein and carbohydrate requirements,

where this information is not readily available. Other features include a ‘Find your Vet Rep’ tool, incorporating geo-targeting functionality, a dosing calculator for Norbrook products and information on the company’s full range of animal health medicines including dosage and administration rates, withdrawal periods, contraindications and warnings, and pharmaceutical precautions The Norbrook VET iPhone app is free to download direct from the iTunes store and an iPad version is due to be launched very soon.

New management tool allows tracking of training A new training management tool has been launched by company TrainingProgress allowing tracking of staff training, management of documents and reporting systems, and archiving of materials for clinical and non-clinical staff. The tool came about when vet and company owner, Bob Partridge, wanted to ensure the staff in his busy veterinary hospital were being trained consistently and to a high standard without senior staff being called away from clinical duties. Training-Progress tracks each staff member through their training in a peer supported and reward driven system. Reporting allows quantifiable appraisals and personnel monitoring to ensure no knowledge gaps can develop. Training-Progress also manages

training documents to allow easy and recordable dissemination of new information. Document review reminders and archiving of updated versions assist in practice standards compliance. For more information visit www.Training-Progress.com

Benchmarking Service Launched in Association with SPVS Veterinary Insights’ new veterinary benchmarking service, Vet Viewer, has been launched in association with SPVS and allows participating practices to compare their own activity and results against a broad panel of similar veterinary practices, so that they can better gauge their own market performance. The service provides a range of relevant and comparable business data by activity type for on-going review, including important financial

information and profitability figures. Veterinarians can closely monitor their own performance and then make appropriate changes to working practices as they see fit. The service is provided free of charge to participating vet practices and delivers data monthly, 200 plus clinics have signed up to the service to date. www.vetviewer.co.uk

Don’t forget you can send us your press releases on practice successes and initiatives. Suppliers are also welcome to send information on management-related products and services. Email to libby@practicelife.biz

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VPMA NEWS

Regional Co-ordinator,

Renay Rickard It was lovely to see so many of you at this year’s VPMA/SPVS Congress and also to catch up with the Regional Organisers who also attended. As we move forward into 2015 we are delighted to welcome our new council member Mark Day as part of the regional team as he will now be a joint organiser for the East Anglia Region along with fellow council member Cath Grimsey. As you’ll know, it’s part of the VPMA’s business plan to encourage more meetings around the country for members to meet and discuss relevant and new issues within the industry that will, if not now, be affecting their practices in a few years’ time. Decoupling, the future of TB testing and auto enrolment are just some of the issues that our members want to hear more about - there are many others. We are trying to cover some of these with our Lunchtime Management Update series to reach members who may not have an active group in their region, but as I’m sure many of you will agree that nothing beats the opportunity to meet fellow members face-to-face. So we are calling for more members to volunteer as regional organisers to reach out to others – please consider this if you are in an area that doesn’t have one in place. If you’re thinking, ‘Why doesn’t someone do something in my area….?’ let that someone be you! New VPMA president Howard Brown and I will be attending some of these meetings for a chat with you about the issues of the day and to find out how we can support you further. Come along and tell us what you think! Can I also put out a call to everyone to support their regional organiser – give them feedback on topics, and go along to the meetings. It’s very much use them or lose them!

Renay Rickard CVPM Junior Vice President VPMA & Regional co-ordinator

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. SCOTLAND Gillian Kidd Tel: 01408 622217 ro2@vpma.co.uk

OXFORDSHIRE/WILTSHIRE/BERKSHIRE Helen Sanderson Tel: 07765 338607 ro13@vpma.co.uk

CUMBRIA Pauline Graham Tel: 07803 228720 ro3@vpma.co.uk

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

HERTS/BEDS/NORTHANTS Denise Whitham Tel: 07837 058155 ro4@vpma.co.uk

STOKE ON TRENT/SOUTH STAFFORDSHRE Susan Lunn Tel: 01543 424100 ro17@vpma.co.uk

GLOUCESTERSHIRE/SOUTH WALES Melvyn Wilkins Tel: 07887 895274 ro5@vpma.co.uk

BUCKINGHAMSHIRE Julie Beacham Tel: 07710 317310 ro18@vpma.co.uk

EAST ANGLIA Cath Grimsey & Mark Day ro6@vpma.co.uk

SOUTH WEST Suzanne Headington Tel: 01242 680000 ro20@vpma.co.uk

LONDON mark harwood Tel: 01242 680000 ro7@vpma.co.uk

CORNWALL/DEVON Renay Rickard Tel: 01208 872254 ro21@vpma.co.uk

EAST SUSSEX RITA DINGWALL Tel: 01435 866058 ro9@vpma.co.uk

ESSEX LIZ LA-PAGE Tel: 07772 382465 ro22@vpma.co.uk

Meet Mark Day, VPMA Council Member & Joint East Anglia RO Mark has been in the veterinary industry for over 17 years, initially as an equine veterinary nurse at a 9 vet equine practice in Cambridgeshire and then progressing into management. He joined RxWorks in 2014 where he has the role of Practice System Specialist. In his spare time he enjoys walking his 2 Jack Russell terriers Kyra and Mika, clay pigeon shooting, and going to the cinema and socialising.

Look who’s got to the final... We’re excited and delighted that our Practice Life VPMA Editor, Ian Wolstenholme, has made it through to the finals of the Petplan Veterinary Awards for the Practice Manager of the Year Award. Ian is Practice Manager at Ian McConnell Veterinary Practice in Mossley, Lancashire and is one of three finalists in the manager category. He and the two other finalists (yet to be announced at the time of going to press) will be attending the ‘Veterinary Oscars’ on the 9th of April in Birmingham. We’re keeping everything crossed for you Ian!

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VPMA News

VPMA NEWS

VPMA President,

Support for Practice Managers through VPMA Member Assistance Programme

Well, what can I say having been inaugurated as VPMA President at our very successful recent joint congress with SPVS? First and foremost, what an absolute honour it is to serve in this post and be able to follow on and strengthen the gold star work that my predecessors have done, in supporting our members and raising the profile of the practice manager. Thank-you to all our council members and to Helen for steering the ship so expertly these past two years. My sense of honour is further heightened by the fact that being neither a vet, nor a practice manager, I am (as far as I’m aware) the first person to serve in this post without those credentials. However, what I am bringing to the table is years of VPMA Council experience, a passion for business, and through my day-role at Petplan as National Relationship Manager, a sense of scale and corporate management knowledge, that I hope to translate into providing effective guidance and leadership for the association during my year in office.

Veterinary practice managers are now able to access help for themselves and their families through a new member benefit. The new VPMA Member Assistance Programme was created to fill a needs gap for managers with somewhere to go for help on a range of issues from personal to professional. The programme, provided via Health Assured, provides a 24 hour confidential helpline for VPMA members, backed up by a Wellness portal where they can access range of support tools.

Howard Brown

I’m not planning on re-writing the book; I aim to continue to steer the course that the association already agreed upon in our recent 3 year business plan. This involves placing major emphasis on supporting the grass roots of our organisation: those hundreds of practice managers who work tirelessly for the betterment of their businesses. You’ll know that we recently launched the VPMA Member Assistance Programme to lend support to members and their families on matters of health, stress at work, financial problems, family and relationship matters and more. You can read more about the new programme in this issue. I hope to continue this theme of support throughout my presidency and will be attending regional meetings and congresses where I hope to hear directly from our members about their additional needs. Strengthening the regions is a primary goal for me personally. It is something that VPMA prides itself upon: giving the opportunity for practice managers to come together and share their problems, and together find solutions. In my day-job I’ve experienced pretty much every type of learning platform there is, and I know that nothing beats that direct talking and frankness that a face-to-face meeting allows. I’d urge every member out there to use these meetings and spread the word to your colleagues. They represent terrific value for money too. Next up is BSAVA Congress of course, the first of several that I’ll be attending in my presidential year. I’ll be there for the whole four days and I hope to bump into lots of you there.

Howard Brown

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VPMA Honorary Secretary Julie Beacham stressed the need for such a scheme, “It’s very difficult for some practice managers, who find themselves in a limbo-situation between providing direction and support for employees, while trying to comply with their responsibilities towards their practice principal or employer. We’d had many reports of managers really struggling with no-where to go to find help for themselves. So, working with a provider, we came up with a package that gives each of our members, and their immediate families, support for both work-related issues such as financial and legal support, as well as personal issues such as stress and family matters.” Providing support for practice managers on wellbeing and workplace issues was one of the goals of now senior vice-president Helen Sanderson, “Our members are our central focus – and along with the CPD and networking opportunities that VPMA provides, we wanted to support well-being. We hope that through the programme, practice managers will feel that they are not alone.” The Member Assistance Programme is available free of charge to all VPMA members. Further details are available from the VPMA Secretariat.

VPMA NORTH EAST REGIONAL MEETING

Conflict Resolution Regional Organiser, Claire Bake, has announced details of an upcoming meeting to be held in Bradbury on the 29th April from 12pm to 3.30pm. Alasdair Ross of ‘We do HR’ will talk about Conflict Resolution within the workplace. There will also be the opportunity for networking to help attendees meet and talk to others who experience the same daily problems and issues as themselves. The meeting costs £30 incl. VAT for VPMA members. Non-members are welcome, cost £48.00 incl. VAT. The fee includes refreshments. Full details and a registration form can be found on www.vpma.co.uk

VPMA NEWS

Are you a Practice Owner fed up of the nitty-gritty of Practice Management? I know I am. I still love my clinical work. I like to be given a monthly report on how the practice is doing relative to its KPIs. I wish and need to be involved in the strategic decisions about where the practice is going, what equipment we are going to buy and how many people we employ. However I really would prefer someone else to do most of the HR stuff, manage the marketing, sort out the grumpy clients and fix the washing machine when it breaks! I really, really would like someone else to get the phone call in the middle of the night to say the burglar alarm won’t set! The answer, I was told, was to employ a Practice Manager. So I did: in fact over the years my friends and I have employed several! Some were receptionists who had done well. Some were Head Nurses that wanted a new challenge, some were from outside the veterinary industry: bank mangers, ex policemen, retail store managers. They were all great at part of the job, but we never really felt that we could take our eye off the ball as there were always gaps! The answer, I believe, is to employ a Practice Manager who holds a Certificate in Veterinary Practice Management (CVPM). I have got to know a number over the last 3 years and can truly say that they are the most impressive bunch of people I have met in the industry. Their qualification means that they have comprehensively convinced their peers that they have a deep understanding of all aspects of Veterinary Practice Management, and will manage most of it better than any veterinary surgeon trying to fit it in round their clinical work! The ones I have met are completely committed to their job to the stage that they believe that they are the ones who should get rung up in the middle of the night when things go wrong! They do cost more. According to the SPVS/VPMA survey last year they get £39k median per annum, but to me they are worth every penny! So if you want to pass the buck, get a CVPM! If you don’t believe me speak to Nick Stuart, President of SPVS or Richard Williams of Cinque Ports Vets or anyone else who employs a CVPM.

Roger Wilson, MRCVS

CVPM – it’s like Professional Masterchef for Practice Managers! The Certificate in Veterinary Practice Management (CVPM) has been awarded by the VPMA since 1996 to individuals who have demonstrated their ability to effectively manage a veterinary practice, hospital or unit. The CVPM is aimed at both experienced managers who are new to the veterinary industry and members of the veterinary team who are currently working in a management role. The qualification also provides a benchmark for veterinary employers seeking to employ a new practice manager. The CVPM is unusual in that it is not based on any particular academic course and leaves it for the individual to assess their skills against the syllabus and personal experience. The exam process is then a peer review using a format that allows the candidate to demonstrate their capabilities and expand on certain subjects. The use of an oral technique rather than written allows assessment of ability under pressure and quickness of thinking, all qualities necessary for a PM. Hence more Masterchef than Mastermind! The individual must demonstrate this ability by providing evidence of their managerial skills over six core areas: • General Management • Personnel • Communication • Financial Management • Marketing • Strategic Management The exam or more accurately peer review starts with candidates submitting a 3000 word report on ‘How I have used my knowledge to benefit the Veterinary Environment in which I work’. This should demonstrate as many facets of the syllabus as possible to show the candidates practical ability to manage in their own place of work. The exam day then further assesses the candidates using the following criteria – • 10 minute Presentation on a subject set by the exam board (details released one month before) • 15 minute professional discussion based on the previously submitted individuals report • Oral questions on a fictitious practice (details released 2 weeks before) • Scenario questions – 10 questions to be answered in 30 minutes with no interaction from the examiners Competency must be reached in all areas of the syllabus to achieve a pass, the Glyn Davies Award can be given for outstanding performance in the exam. All the examiners are currently working in the veterinary industry and include practice managers from veterinary and non-veterinary backgrounds and practice owners. Look out for our series of articles which will look at look at the six core areas of the syllabus in more details and give guidance on the level of knowledge needed and reliable sources to expand this knowledge. For more information on the CVPM please visit the VPMA website http://www.vpma.co.uk/education/cvpm.html Practice Life z March/April 2015 z www.practicelife.biz

VPMA NEWS

THE CVPM AND ME – one practice manager’s experience I always knew that I belonged in the veterinary world but the careers teacher in my mid-1970s Midlands grammar school laughed (they don’t take girls you know!) and I dutifully trained as a State Registered Nurse. A couple of years after qualifying I left to become a student again and followed my heart to gain a degree in Zoology and Ecology. Employment opportunities in those fields were scarce so having both a nursing qualification and a science degree took me back into the medical world as a Clinical Scientist, running Phase Two clinical trials for drug companies and seeing patients with odd vascular disorders for five years. When my son was born, we moved out of London and registered our pets at a lovely local veterinary practice. One day I spotted a job vacancy there, working a couple of hours a day at the branch surgery. I applied, got the job and loved it but planned that after a year, I would return to ‘a proper job’. That was 1995 and as you might guess, I’m still here. Wendover Heights is a big and busy, long-established mixed independent practice, now with eighteen vets and over sixty people employed. Since 2000, it has been owned by two Directors and ran without a formalised management structure which led to them seeking help from two firms of management consultants. Both said that a practice manager was needed and identified me as the likely candidate. By this point, I was still working parttime, responsible for stock control, purchasing and health and

safety and applying my medical and scientific background to the veterinary environment. One of the management consultants suggested that I join the VPMA and study for the CVPM so I did, though it took a couple of years to summon up the courage to attempt the CVPM. Studying for the CVPM made me realise that although there were some huge gaps in my knowledge, mainly regarding finance and marketing, seeing the syllabus set out gave me a good overview of exactly what I needed to know. There were chunks of the syllabus that I was quite confident about and by reading management textbooks, going to CPD events and enlisting the help of various people such as the practice accountant, I soon filled in those gaps. Attending a CVPM Preparation Day was also a huge help in understanding what was required. In May 2009 I was appointed as the first overall Practice Manager of Wendover Heights and took – and passed – my CVPM exams a few months later. Gaining the CVPM took a lot of work but it enabled me to do the job and prove to everyone in the practice, including myself, that I do have the knowledge and skills required. My framed certificate sits on the windowsill in front of my desk and at difficult times it reminds me of that. I love being a practice manager and feel more respected and more confident by being qualified in my role, just as the vets and nurses are qualified in theirs. The CVPM is a very practical test – it requires you to think on your feet, stay calm, prioritise and take everything into account when faced with a problem. The skills that I gained are ones that I use every day to help the practice run smoothly and to prevent costly mistakes. I don’t always get it right but my CVPM helps me to do my best. Julie Beacham, BSc CVPM

CVPM Free Information and Examination Workshop The VPMA’s Certification and Training Committee are holding a free information and examination preparation workshop on Saturday 16th May 2015 at St. George’s Vet Group, 8 St. George’s Parade,Wolverhampton WV2 1BD Some of the comments from previous attendees“Helped me make the decision to sit the exam’’ ‘’Very informative and helpful’’ ‘’Great! A Must! I would recommend to anyone thinking of taking the CVPM’’ The purpose of the workshop is to– Understand the overall concept and content of the Certificate in Veterinary Practice Management (CVPM) – Advise on the examination itself, format of questions and presentation and suggested approaches – Provide the opportunity to meet the members of the C&T Committee responsible for examining and awarding the CVPM If you have already registered for this year’s exam in November, are thinking about completing the CVPM in the future or would like to find out how this qualification can benefit you and your practice please come along. To register your attendance: please email secretariat@vpma.co.uk. Closing date for registrations: 15th April 2015.

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SPVS News SPVS CYCLESCENE:

Vets to Ventoux… or the vinery! You’ve heard of SPVS Snowscene and Scubascene whereby you can benefit from tax deductible CPD whilst in a laid back holiday mode?

In September 2015 SPVS members are invited to join us on Cyclescene. We will travel as a group to the picturesque Luberon Valley in Provence, France. There is something for everyone in this area ranging from the iconic Mont Ventoux climb to the laissez faire café-culture of the villages lining the valley. • Eurostar / TGV from St Pancras to Avignon leaving Sunday 13th September and returning to St Pancras Saturday 19th September • Transfer to hotel at L’Isle-Sur-la-Sorgue in the Luberon Valley http:// www.bestwestern.fr/en/hotel-L-isle-Sur-La-Sorgue,Best-WesternLe-Domaine-De-La-Petite-Isle,93594

• Non-clinical CPD. The focus of the CPD is staff performance and development as well as how to navigate the tricky waters of employment law in order to manage under-performing employees if they can’t or won’t respond. • One session in the morning and another in the evening (first session starts Monday 14th am 8 am. Last session Friday 18th 6 pm). Total 15 hours. • Cycling each day Monday-Friday. Non-led local excursions in selfforming groups around the Avignon area, Luberon valley, Mount Ventoux if desired. See the book Vaucluse: 35 parcours vélo de route on Amazon if you’re really keen to plan ahead. • Dinner, bed and breakfast. The standard rate is for sharing a twin room. If you want to sign up in pairs let us know. If you wish to have a single room there is a 40 euro supplement per person per night. Cost: travel, accommodation, breakfast, dinner £600 plus CPD supplement of £375+VAT. Non-SPVS members add £150 supplement – or join SPVS for the price of the supplement! To book: Please call the SPVS office on 01926 410454 or email office@spvs.org.uk

Limited places – approximately 30 participants.

SPVS’ “Crooked Putter” Golf Day 2015 Forest of Arden Golf Club, near Coventry – Tuesday 16th June The popular SPVS Golf Day, sponsored by Veterinary Insurance Agency, Hazlewoods and Dickinsons Financial Management Ltd, will this year be held at the top class championship Arden Course at the Forest of Arden Golf Club. The Arden Course, designed by Donald Steele in 1992, has played host to a succession of international tournaments, including the British Masters and the English Open. The par 72 course, measuring 7,213 yards, is a true test of golf designed to make golfers play a wide range of shots. A variety of different tee boxes, water hazards, trees, which neatly line the fairways, and thick rough make the Arden Golf Course long and challenging but still a very enjoyable test of golf for golfers of all abilities. The day will follow the usual format of bacon rolls and goodies on arrival with a rolling buffet and complimentary bar afterwards. This is a very popular day which books up quickly so reserve your place now by emailling Keith Dickinson at keith.dickinson@shireinsurance.co.uk . If golf is your game, this is a day not to be missed!

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SPVS NEWS

Presidents column Nick Stuart I am writing this a week after our third combined VPMA/SPVS Congress. What a fantastic event it was and a great way to launch me into my presidential year. With over 470 delegates, many of them owners of practice, and 60 exhibition stands, this event is really making its mark in the veterinary calendar. Our CPD 2015 programme has also started very strongly with the first course on training the veterinary receptionist sold out and others filling up fast. I am very excited about the new ‘Focus on HR’ day planned for October which will combine a trade exhibition with a strong selection of related workshops. See page 45. Some of the things I enjoy most about being part of SPVS are these opportunities to network, learn and socialise. As this edition of Practice Life hits your letterbox, 40 vets will be in the Dolomites in Northern Italy for Snowscene 2015. In September we will have a brand new ‘Cyclescene’ in Provence. I am told everyone can choose their own level, be it a gentle cycle to the nearest vineyard or an attempt at the gruelling Mont Ventoux. I suspect there will be pressure on the President to go for the latter so I’d better crank up the effort level in my spinning classes! Alongside the CPD and networking opportunities, another key benefit we offer SPVS members are our fees and salary surveys and we intend to build on these by adding additional surveys and benchmarking initiatives. The first of these, the Vet Viewer Benchmarking Survey, was launched at Congress in partnership with Veterinary Insights. This sort of data, as well as being of real value to individual practices, will make our voice very relevant at debates such as the Vet Futures initiative currently being carried out by RCVS and BVA. The profession has moved on in many ways over the past decade or so and I’m proud of the way SPVS has changed to reflect this. We are attracting more and more younger vets, not only as members, but to our council. In fact council is now very representative of the profession, both in terms of gender and also the types of organisations or practices that they work in, and they are all full of great ideas so watch this space! Now all we need to do is to get the word out to ensure more vets realise the value of being part of this network and I’d like to ask all our members to help us do this. Tell your friends and colleagues, and join us yourselves on CPD courses, Focus Days, and of course Congress 2016 which will be back at Celtic Manor on 29 and 30 January 2016!

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SPVS Dates For Your Diary 2015 16th June Golf Day at the Forest of Arden Golf Club, nr Coventry 3rd - 5th July Lancaster Student Seminar 13th - 19th September Cyclescene, France For more details and to book on any of these events, see the SPVS website or contact the SPVS Office.

It was in the later stages of the evening that Mr Carr began to notice the attentions from Mr Nell out of the corner of his eye...

SPVS FEES SURVEY 2015 The SPVS Fees Survey has just been launched, and all members should have received an invitation to participate. If not, you can access the questionnaire online on the SPVS website www.spvs.org.uk. We’d really appreciate it you could submit your answers electronically, but if you need a paper copy of the questionnaire, please contact the SPVS Office. We know that the SPVS surveys are one of the benefits members value most highly, and we have developments in the pipeline to keep them up to date and relevant. In particular we are excited about our collaboration with Veterinary Insights who analyse data from the practice management system to produce KPIs similar to what was previously offered by some pharmaceutical companies. The service is free, and they have developed an extra level of analysis exclusive to SPVS members. We’ll be featuring more about the service in a future issue, but in the meantime you can visit http:// www.vetviewer.co.uk/ for further information.

SPVS NEWS

RCVS CertAVP

Why not stop putting it off and actually get on and do it? Dr Paul R. Manning, MA, VetMB, MSc(VetGP), DProf, MRCVS. The candidate chooses 4 C modules which could be a group of primary care modules such as consultation skills, clinical audit, professional practice and responsibilities, veterinary leadership and management, clinical governance but clinical modules are available to fit in with individual interests and objectives. The 60 credit Certificate at Masters level is achieved with 10 from A, 10 from B and 40 from C modules. The CertAVP was launched in November 2007 and there are now over 230 certificate holders. Many published testimonials are available on the provider websites. http://www.rcvs.org.uk/publications/rcvs-facts-2014/ There is a list of all the CertAVP modules available from the RCVS: http://www.rcvs.org.uk/education/postgraduateeducation-for-veterinary-surgeons/certificate-in-advancedveterinary-practice/module-subjects/ This list indicates where the modules are available, but leaves the candidate to research the support, type of course offered and costs.

he CertAVP offers a structure which can be tailored to individual and practice needs. Learning objectives work with you and enhance your practice. This is a University accredited qualification and the costs for each provider in meeting the rigorous educational standards are similar. The A module is a 10 credit module covering the fundamentals of advanced veterinary practice in a wide range of important activities that feature in the working life of a vet; communication, ethics and welfare, RCVS code of conduct, HR including training and team development, IT and data management, and legal aspects such as medicines regulations and consumer issues. The B module is species group specific, so a choice needs to be made between eg. small animal, production animal or equine. The 10 credit module requires approximately 5 clinical case studies to meet the learning objectives and encourages and supports innovations in new clinical areas as well as improving existing clinical work.

Navigating the web. Which provider(s) could you choose from and why? • Content: this can be lecture and/or practical days/sessions or webinars. There is a lot more to the content in a course at this Masters level… • Support: this can be a highly significant contributor to the success and quality of the portfolios produced and the benefits achieved. A key area that either candidates struggle with or even give as a reason for not starting out on the CertAVP at all, is essay writing skills and writing up case studies. These are important skills that many vets consider either they never had or have forgotten in the 5 or more years since leaving university. • Learning Journey: this is what really matters. Research has shown how ‘what vets think they do’ and ‘what they actually do’ often vary and differ. Educational support via shared on line or face to face meetings and discussions with peers and/or academic advisers and tutors can transform the learning into significant professional development. The CertAVP provides a safe, positive and productive learning environment. • Assessment: Providers vary; most offer a portfolio approach, but there may be multiple choice questions from, for example, the RVC and an examination. Summary of what to do In a nutshell, you need to do 4 things: 1. Enrol with RCVS, whichever provider(s) you are going to Practice Life z March/April 2015 z www.practicelife.biz

SPVS NEWS

choose. Initial fee of £60, and thereafter an annual fee of £30 until the completion of the CertAVP. You have 10 years to complete the whole CertAVP from the RCVS but individual providers work with University accredited education systems and have shorter designated time scales so be careful of how many modules you commit to at one time. The rules restrict the number of times you can resubmit or resit. 2. A SWOT (strengths, weaknesses, opportunities and threats) analysis of your own professional work is helpful in choosing modules. 3. L ook at the packages available from the various providers, the time commitment, and which suit you the best. Enrol with the provider of choice for a likely cost in the region of £100 per module. CertAVP is now the only RCVS accredited postgraduate Certificate available for new candidates. The Improve GP Cert is not accredited by RCVS, and the BSAVA PGCert is missing the A module. Examples of costs* and choices for doing the CertAVP after enrolment Liverpool University offers the whole CertAVP with full course participation (6 modules at £950-£1000 each including assessment fee equates to £5700-£6000). Alternatively assessment only for each module is £450 giving £2700 for 6 modules.

for acquiring the CertAVP(VetGP), but RCVS is changing this to a Primary Care title which will include all of the previous VetGP modules plus an additional clinical module or module in clinical research or EBVM. There may be a final synoptic essay which at Liverpool for example has an assessment fee of £801. Opportunities You can choose to use your credits in the CertAVP towards a further University qualification such as an MSc. The CVML (C module in Veterinary Management and Leadership) via Vet Learning can be used to claim an award from the Chartered Management Institute (CMI) Candidates can continue their study for a 60 credit Diploma from CMI at Master’s level, which can lead, with three years management experience, to apply for Chartered Manager status. CertAVP is an integral part of RCVS Advanced Practitioner (AP) status. The CertAVP can bring positive benefits to the working life of a veterinary practitioner, so what’s stopping you actually doing this to help you change your aspirations into realities? The views are those of the author: Dr Paul R. Manning, MA, VetMB, MSc(VetGP), DProf, MRCVS. Astonlee Veterinary Hospital, Tickford Street, Newport Pagnell, Bucks. MK16 9BA www.astonlee.co.uk (*Costs obtained from websites Dec 2014 which may be subject to change.)

The RVC offers a £50 ‘essay planning review’ for their A module, or the RVC ‘Webinar plus’ to assist candidates in the development of their portfolios: http://cpd.rvc.ac.uk/courses/webinar-plus-professionaland-non-clinical-skills-–-what-are-they-and-how-canthey-make-me-a-better-vet http://cpd.rvc.ac.uk/certavpwebinars Vet Learning (www.vetlearning.co.uk) offers the whole CertAVP, fully supported, including an allocated facilitator, academic adviser, module leaders and the formative assessment fees for £9000. This includes guidance through the choosing, planning, development, formation and presentation of the portfolio through to final summative assessment. Alternatively an assessment only route for the whole CertAVP with the modules they offer is possible for £1300. In comparison, the BSAVA PGCert (also at MSc level covering 60 credits but without the A module) is £3075 plus VAT for each of the first 3 years of study. Doing an MSc level course requires self directed learning (SDL) and so candidates on whichever course or option they choose need to develop a sense of responsibility for their own learning which links closely with their professional development and practice. Vet Learning captures this in a logo which includes the words ‘Experience the difference.’ Designation RCVS has a limited number of ‘designated certificates’, so choose modules carefully. The Vet Learning route was unique www.practicelife.biz z March/April 2015 z Practice Life

Nurse Talk 16

NURSE TALK

In association with

New website for the start of 50th year The BVNA has kicked off its 50th Year celebrations by launching a new website along with refreshed branding. The new site was designed to showcase the association’s key activities of CPD, member representation and support. User navigation has been improved, along with an increased focus on sharing the association’s news on campaigning and lobbying activities. A President’s Blog will feature updates from association president Fiona Andrew, while non-members can sign up to receive the BVNA newsletter which will highlight both regional and national activities. In response to feedback from consultation last year, which stressed the need of members for advice and support across several areas, the association has expanded its advice pages. Veterinary Nurses can find information here on mental health support, the Members Advisory Service, peer to peer support and financial help that is available through the Daphne Shipman Benevolent Fund.

Goodies Galore for 50th Celebrations As part of its 50th anniversary celebrations BVNA is ‘giving back’ to its members with a monthly prize draw of some lovely goodies. Better still, the draw doesn’t require any specific action to be taken to enter – winners are drawn at random from the full list of members every month. Fingers crossed it’s you next!

The new site can be found at www.bvna.org.uk.

Doublecelebrations celebrations Double “We would like to send our thanks and congratulations to the RCVS for the effort that has taken place to make what once seemed like an impossible dream a reality. BVNA has welcomed the support from the BVA in recognising the importance of Veterinary Nursing in the development of the whole profession going forward.” BVNA has been pleased to cement its positive professional relationship with the RCVS and recently accepted an invitation to spend some time in London learning what goes on behind the scenes in Belgravia House.

BVNA has two big reasons to celebrate at the moment: this year is our 50th anniversary, a very worthy reason for events and competitions galore; in addition, we are pleased and proud to see the RCVS introducing the new Royal Charter. Fiona Andrew, BVNA President commented: “BVNA is delighted that the new Royal Charter has come in to effect last week. Successive Councils of the BVNA have worked tirelessly over the years to have Veterinary Nursing recognised as a profession, and it is a delightful co-incidence that that recognition comes in the 50th year of our Association.

Council members were welcomed and toured the offices, including education, professional conduct, administration and registration. At each point there was plenty of opportunity to ask questions, and background information about the function of each department was provided. The day was well attended, by BVNA council members and regional representatives, who left London feeling that the RCVS was continuing to work hard to support and include VNs in all aspects of its work. The association looks forward to working further with the RCVS on many projects and would encourage anyone offered the opportunity to attend the RCVS open days and learn more about what goes on behind the scenes.

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NURSE TALK

We need your help!

Do you have a potential BVNA council member amongst your veterinary nursing team? Someone smart interested and motivated who would enjoy working alongside leaders of the veterinary profession to ensure that the voice of veterinary nurses is heard? This year the BVNA council is looking for student and qualified vet nurses to complement our existing line-up. Potential members need enthusiasm and a passion for the profession. Council meets every six to eight weeks and all reasonable expenses are covered. Many of the projects that our council members get involved in can be counted towards their continuing professional

development. Currently we have a member working through a publishing course, to support her role as editor of the Veterinary Nursing Journal. We have council members who are involved in the current review of the RCVS Practice Standards Scheme to help ensure that veterinary nurses are represented along the way as the discussion continues. Council members plan our scientific content for our congress, develop CPD strategy, run our annual veterinary nursing awareness month, write press releases, debate and discuss, all with the common goal of providing representation of the veterinary nursing profession.

Photo Credit: Harper Adams

60 hours of CPD !

Delving Deeper into Wounds Accredited Course

Would you like to learn more about wound healing physiology, management techniques and how to optimise healing? The Delving Deeper into Wounds course, run in association with the Veterinary Wound Library comprises 4 distance learning modules and one practical attendance day. You have 6 months for completion in your own time. For more information or to register your interest for a place on the course, please contact Debbie Gray on debbie@bvna.co.uk Booking now for 2015: £600 BVNA Members £700 Non-Members

Delving Deeper into Wounds is a course run by the BVNA in partnership with the Veterinary Wound Library. For information about the Veterinary Wound Library, contact Georgie Hollis, Veterinary Wound Library, 93 Back Street, Garboldisham, Diss, IP22 2SD or call 01953?681452. info@vetwoundlibrary.com, www.vetwoundlibrary.com Intelligent Wound Care Ltd. Company, Registered in England and Wales: No. 06571239, Vat reg. 138631213

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Being on council is rewarding, interesting and fun. Members are encouraged to develop their own area of interest. We have an excellent record of members leading on specific projects close to their hearts, including mental health support within the profession, increasing exposure to primary nursing research, marketing, branding, and CPD. Every meeting, phone call or email may contribute towards a council member’s professional and personal development as they gather a depth of understanding about the profession and a broader awareness of the issues affecting it. In turn, this increased awareness and understanding helps VNs in their role at work. Key transferrable skills include a better comprehension of financial and business issues, experience of managing staff, coordination skills, networking and project planning, all of which may be used daily in practice. For the first time, in our 50th anniversary year, we are inviting student VNs to stand for election. BVNA council are really keen to hear directly from students about their worries and their triumphs so that we can check we are supporting them properly. We know that your students are busy; they have college, practical work, on-call duties and an all important social life. However we are committed to ensuring that they will be supported while on council and will not be pushed into running before they can walk. They will be paired with a mentor and only when they are ready will they be encouraged to take on student-related projects. We have lots of exciting ideas and hope that any potential student council member will also bring a few ideas with them! So, think again, reflect, is there anyone who springs to mind in your workplace? If there is, by showing them this article and supporting their application, you are investing in your staff, and your practice. Encourage them to join us and represent veterinary nursing. If you would like to talk to an existing council member to see what the role entails, or would simply like more information please contact the BVNA office on 01279 408644

COLLEGE CORNER

College Corner

Registered Veterinary Nurses AND THE LAW As all members of the profession know, veterinary nurses are integral members of the practice team with responsibility for a range of different activities – from providing care to recovering animals and assisting during surgical procedures to clinical cleaning. However, the remit and limits of what veterinary nurses can undertake is not always as well known or defined as that of veterinary surgeons. Here Luke Bishop, Communications Officer at the Royal College of Veterinary Surgeons, looks at some of the key legal issues for veterinary nurses. In mid-February our new Royal Charter came into effect meaning that those veterinary nurses who were previously on the List automatically became registered veterinary nurses (RVNs) and associates of the College. This means that veterinary nursing finally gets the recognition it deserves as a fully regulated and qualified profession with responsibilities to undertake continuing professional development, adhere to the Code of Professional Conduct and be subject to disciplinary proceedings in cases of professional misconduct. In addition, the Charter also shines a very helpful spotlight on the profession in terms of its role and responsibilities within the veterinary team at large and in everyday practice life. Veterinary nurses can, and do, engage in a wide range of clinical and other activities. There are, however, also legally defined limits as to what they can do. Schedule 3 and registered veterinary nurses The most important piece of legislation that determines what veterinary nurses can and can’t do is the Veterinary Surgeons Act 1966 (Schedule 3 Amendment) Order 2002 – better known as just ‘Schedule 3’ – which provides an exemption to allow veterinary nurses to carry out limited veterinary surgery in certain circumstances. Under Schedule 3, therefore, veterinary surgeons can direct registered veterinary nurses who they employ to undertake medical treatment or minor surgery which does not involve entry into a body cavity. Before giving direction, the veterinary surgeon must be satisfied that the veterinary nurse is qualified to carry out the procedure or administer a medicine. So what does this mean in practice? At the RCVS we have been very careful not to (outside of the definitions provided in Schedule 3) provide a prescriptive list of what veterinary nurses can and can’t do because it is very much dependent on the individual nurse’s level of competence and the procedure itself. However, we do carry specific guidance for registered veterinary nurses in areas such as the maintenance and monitoring of anaesthesia, the vaccination of companion animals and dentistry. This can be found in the ‘Delegation to veterinary nurses’ chapter of the supporting guidance to our Code of Professional Conduct which you can access on our website (www.rcvs.org.uk/delegation) or by downloading our Code app for smartphone users (www.rcvs.org.uk/codeapp).

Student veterinary nurses Much like registered veterinary nurses, student veterinary nurses may also be directed to carry out limited veterinary surgery. However, in their case, medical treatment or minor surgery must be supervised by a veterinary surgeon or registered veterinary nurse – with supervision meaning that the supervisor is present on the premises and able to assist if needed. In the case of minor surgery this must be ‘direct, continuous and personal supervision’ meaning that the veterinary surgeon or registered veterinary nurse is present and giving the student his or her undivided attention. When to delegate As stated above, before delegating procedures to a registered or student veterinary nurse the veterinary surgeon must think very carefully about a range of factors. The obvious consideration is whether or not the procedure would be Schedule 3 compliant but other considerations include how difficult the procedure is in the light of any associated risks, whether the nurse is qualified to treat the particular species and whether they understand the risks and have the necessary experience and good sense to react appropriately should a problem arise. The importance of being registered While the information above relates to what a veterinary nurse can do – practices must also consider the registration status of the veterinary nurse before allowing them to undertake a procedure. It sounds obvious but, in order to carry out limited veterinary surgery under veterinary direction, the veterinary nurse must either be on our Register or be enrolled as a student with us. Otherwise, the Schedule 3 exemption is not in place and the ‘veterinary nurse’ is undertaking limited veterinary surgeon in breach of the Veterinary Surgeons Act and therefore illegally, even if they possess a qualification that enables them to register. Practice Life z March/April 2015 z www.practicelife.biz

COLLEGE CORNER

While the Royal Charter, by discontinuing the List, may have formalised the regulation of registered veterinary nurses, what it is unable to do is protect ‘veterinary nurse’ as a title as this can only be done through primary legislation. However, by recognising veterinary nurses as professionals, the Charter strengthens our hand in arguing that only those who are qualified and registered should be able to refer to themselves as veterinary nurses. However, we have recently been made aware of practices that have employed ‘veterinary nurses’ via locum agencies who, we have subsequently discovered, were not on our Register and therefore would be undertaking limited veterinary surgery illegally. It is for this reason that we always encourage practices to use our Check the Register search tool (https://www.rcvs.org.uk/registration/check-theregister-list/) to check the status of prospective new staff or before taking on locums. Likewise, student veterinary nurses must be enrolled with us through a higher or further education institution which is recognised and accredited by the College. ‘Student veterinary nurses’ who are taking part in courses which we do not recognise will not be enrolled and, therefore, will not be able to legally undertake acts of Medivet_PracticeLife_150315.pdf

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limited veterinary surgery. Student veterinary nurses can also only carry out Schedule 3 tasks in their designated Training Practice (‘TP’) – therefore they could not locum outside of their TP and carry out limited veterinary surgery, for example.

We would encourage any practices that are unsure about the status of their student veterinary nurses to contact our Veterinary Nursing Department on 020 7202 0788 or vetnursing@rcvs.org.uk. Further advice If you are a veterinary surgeon or a registered or student veterinary nurse and need further guidance on Schedule 3 and delegation then please contact our Professional Conduct Department on 020 7202 0789 or profcon@rcvs.org.uk To read the Code of Professional Conduct for Veterinary Nurses and its supporting guidance in full please visit www.rcvs.org.uk/vncode

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IN THE SPOTLIGHT

in the CVS Director of Acquisitions Mike Vaughan gives us an insight into the CVS group’s journey and their acquisition model, as well as how his own career path led him to this role.

Mike, tell us a little about your role at CVS and your career journey that led you there. MV: I am responsible for the majority of all CVS’s practice acquisitions. These now encompass small animal, large animal, mixed practices, equine and referral practices, ranging in turnover from £0.5 million to in excess of £6 million. I qualified from RVC in 1973, moving straight to large animal practice in Swindon. I was totally focused on large animals and considered nothing else. Unfortunately the reality was far removed from my experiences as a student. I became disillusioned with the lack of surgical cases and the economic constraints which governed the treatment of the animals. Contracting a severe case of Brucellosis, was the nail in the coffin; well, not quite! I moved to Cheshire and ran a busy small animal branch surgery for over two years. The bright lights of London beckoned in 1978 and I joined a four site North London small animal practice. Partnership followed in 1986 and the practice expanded to eight sites.All good things must come to an end and the partnership dissolved and the practice was sold in 2000. I undertook varied

work until 2005, when I found myself locuming for a practice that was being sold to CVS. Intrigued, I discovered that Brian Pound (whom I had had a lot of dealings with previously in his roles at Fort Dodge and Solvay Duphar) had set up CVS in 1999, after deregulation. More locum work followed and then I was asked if I would join CVS, assisting Brian in buying practices for the company. I took over from Brian, as leader of acquisitions in 2011. He still works in a consultative role, so I can still rely on my very patient mentor to help find a solution to any seemingly insoluble problem! Is there a typical day for you? Can you describe it for us? MV: There are a few types of working day but nearly all revolve around the phone! I work from home, on the Suffolk coast and spend most of my day talking to vets, solicitors, accountants and CVS. Home days also involve reading and answering a huge number of emails, discussing sale agreements, service contracts and preparing offer letters. The day can start quite early, talking to vets before surgery and carry on into the evening, again talking to vets after evening surgery! Weekend work is inevitable, as is email contact throughout holiday periods. Visiting practices and owners usually involves an early start as I can be travelling as far afield as Scotland or Cornwall! Again the journey is nearly always taken up with phone-calls. Overnight stops are much more common place now, especially if the meeting is held after evening surgery. I am probably away on average about one night a week and cover about 35,000 miles a year. On most practice visits, I am accompanied by

Simon Innes (our CEO) to whom I report directly. Motorway coffee stops are where a large number of decisions on purchasing practices are made! What is the best part of your job? And the hardest? MV: The first answer is the actual completion of a practice acquisition, for a number of reasons: Being able to provide an exit strategy for owners, where the partnership model is not available. This is becoming all too common now with the demographics of the profession changing. Female vets exceed 80%, students graduate with large debt and also join practices with no OOH, vet schools recommend more and more case referrals. This together with the ever growing threat of litigation has made young vets very risk-averse and less likely to go down the partnership route. Helping the owners to sell their ‘baby’ (a lot of the time this has been a life’s work for them) and to be rewarded with a deserved consideration, is a positive outcome. We also enable them to be our landlord and to receive 8% rental of the commercial value of their owned property and of course for them to continue working in the practice, on a salary reflective of a vet of that level (i.e. in line with the SPVS salary survey). We find that so many vets start to enjoy ‘vetting’ again, once the burden of ownership has been removed. They can also go on to develop a second career, like myself; Tim Davies has become our Head Vet, Egbert de Vries is our Large Animal Director and Sue Gorman is a Regional Director, to name but a few.

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IN THE SPOTLIGHT

Above all the staff is our main focus; without them, we are buying nothing! Reassuring them through the quite naturally worrying period, just prior to acquisition, is a challenge. It is so gratifying, however, meeting them postacquisition and seeing them happy in their work; carrying on as normal with the care of their patients. The answer to the second question – the hardest – is having to tell an owner that their practice is not profitable and we are unable to make an offer for it! CVS is now the largest of the corporate groups, with over 250 practices, two crematoria and five laboratories. What factors do you think have led to this success? MV: It’s actually 275 sites and three crematoria and is changing monthly! We employ over 730 vets and nearly 3000 staff, in total. We don’t change the practice name and often the owners will continue to work for us. We are justifiably very proud of our reputation within the profession; we always do what we say we are going to do. For example, we make very good offers for practices and have never used due diligence as an excuse to reduce the price. Our ex-owners are happy to recommend us to prospective sellers. We are not owned by private equity having listed on AIM in October 2007; we are therefore ‘in it for the long-haul’! Unlike private equity owned companies, we are not forced to acquire at a highly accelerated rate; this purely to make a tidy profit for the private equity owners who sell the business, every 3 to 4 years! We are therefore able to invest heavily in our staff, buildings and equipment. We recently spent over £3 million on two high field MRI’s and seven 16-slice CT scanners. John Innes, our Referral Director, has already assigned these to various specialist sites within the business. He is currently involved in developing a new multi-discipline referral centre at Lumbry Park, near Alton in Hampshire, as well as another new centre at Harcombe Cross just south of Exeter. It’s this sort of investment that cements us as the market leader of the profession! The way CVS is structured is also key. We have a Board consisting of Simon Innes (CEO), Nick Perrin (FD) and two very experienced non-executive directors. We also have an Executive committee which leads and

manages the business strategically and on a day to day basis. This Exec consists of 10 key Directors, three of whom are vets, representing all aspects of the business. The Director of Operations, supported by Tim Davies, our Head Vet, leads a team of 17 Regional Directors (most of whom are vets) who give regular support to the practices and to the Clinical Directors, who lead them. Everything we do is done democratically and we pride ourselves in listening and acting on all of our employee’s opinions. We have a number of programs that are designed to develop and support our staff; here are a few: Aspirational Leadership Program, New Graduate scheme, Nurse Academy, Cert AVP, Reception and Nurse training. Our Healthy Pet Club, which now has over 200,000 members, gives huge benefits to our clients; one of the many is 20% off life-time drugs, such as Atopica and Vetmedin. What things do you look for when considering whether or not to buy a practice? MV: We tend to buy successful, well-run profitable practices. We now buy every type of veterinary practice, not only small animal. High turnover (£1 million) single owner, single sites are very attractive! Own car-parking, visibility and location are all considering factors. The practice needs to be presentable and have had regular investment in the property. Also there needs to have been up to date investment in equipment. Most of all it needs to have a happy work force that is proud to deliver great veterinary care to its patients. Describe the acquisition process and what practices should expect from it. Are there any common stumbling blocks? MV: Normally the owners approach us with the initial discussion by phone. Latest accounts are then sent to us and these are analysed by one of our team of three business analyst accountants, to reach an EBITDA (Earnings Before Interest Tax Depreciation and Amortisation) figure, to which we then apply a multiple. EBITDA is a true figure of profitability under our ownership. I then visit the practice and later make an Indicative Offer; either for the Goodwill and Fixed Assets or for the entire issued share capital of the business. If this is accepted then financial and legal

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due diligence is commenced with a view to completing in 12 to 16 weeks’ time. All relevant information is supplied to both Accountants and Solicitors and it often helps to make a Practice Manager or senior administrator aware, to help with this information supply. There is nothing more suspicious than owners asking for a lot of info or constantly coming into the practice at night to source it! When the legal process is sufficiently progressed, I will set a completion date with a staff meeting/ Transfer of Protection of Employment (TUPE) consultation meeting, 2 weeks before this. This can be a very emotional time for both owner and staff. We have, however, been through the process well over 100 times now. Under TUPE, all staff continue to receive all the benefits that they previously enjoyed. We continue with their contracts, so that years of previous service are continued with us. After the staff meeting there is open contact with the practice to provide information and to help smooth the acquisition day, which is normally a Monday. The owners will normally have conducted a stock-take at the weekend and we will check this on the Monday. We have support from a large HR team, property team and Health and Safety. Completion normally occurs early afternoon with the full consideration deposited in the owner’s bank-account! The major problems we have are with property; especially those owned by external landlords. They are often out of the country and assigning leases can be time consuming, so the sooner it starts, the better. Bank charges on property and worse, on the business, also need to be acted on in good time to be removed. Dealing with sellers’ solicitors who are only used to conveyancing is very difficult and time consuming! So my advice would be to engage a solicitor that has experience in buying and selling businesses and who also has a property department. One of the biggest challenges I imagine you have to deal with is managing the cultural shift within a practice from independent to corporate. What things help you with this? MV: There are some changes, postacquisition but generally the practice carries on in much the same way as it has done previously. Supplier changes to NVS, vaccines to MSD and our labs are used from day 1. If the team concentrates

IN THE SPOTLIGHT

on delivering good client care then most things take care of themselves. The Ops team take over supporting the practice and the staff can take comfort in the fact that they are now under the protection of a large caring organisation. It is also worth mentioning that we run a very popular, government-backed Share Save Scheme, (with over a quarter of our staff currently participating), whereby all employees can buy shares in CVS, at a much discounted rate and benefit from the company’s success over the subsequent 3 years. The major change is with the ex-owners, who have now become employees and this can be a slightly difficult mind-set to embrace initially! Decisions on, say the purchase of a new ultrasound, cannot be taken without first running it past the RD. It really is no

different though than one partner deciding that the practice needs an ultrasound and running it past the other partner with a rough business case to justify the purchase! We have an annual conference in November which all the Clinical Directors, Head Nurses and practice managers attend. This is useful internal CPD but is invaluable with great communication, the exchange of ideas and the realisation by all that they are part of an organisation that is going somewhere! You’ve recently adapted a strategy to start acquiring practices within close proximity of each other. What are the advantages (and any disadvantages) of this? MV: This is not at all a strategy! It is more a

result of acquiring a business in an area and other practices taking notice and deciding to sell as well! We do, however, tend to buy smaller practices that wish to sell, (which in isolation we would not consider), that are close to an existing practice. What key things do you think independent veterinary practices can learn from larger groups like CVS? MV: Use the fact that you are the owner and give personal attention to your clients. Be visible in the practice and lead by example. Deliver outstanding service and client care. Join a buying group and benefit from better drug discounts. Beware though, all is not what it seems and we see practices that are not benefiting nearly as much as they should be. We offer membership of our buying group, MiVet Club, to any practice. What do you see as the biggest challenge(s) to the veterinary profession at this time? MV: The predatory Corporate. We the profession need to understand that there are fundamental differences between the Corporates! We pay a good price for veterinary businesses; there are, however, predatory Corporates who set up directly against private practice and steal their business!

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What are your goals (personal and professional) for the next 5 years? MV: I was very proud to serve as a member of SPVS Council for 5 years and especially, as Chairman of Vet XML Consortium, to help introduce electronic insurance claims, to the veterinary profession. I would like to think that I could return to veterinary politics but I fear that a decided lack of available time will prevent this from happening! So I will, therefore, definitely be buying a lot more practices; close to 100 in the next 5 years! Personally I will try and lose at least 2 stone; difficult with my working practices though! And finally, how do you relax? MV: You should ask Angie, my wife, this and she will say that I don’t! I am a passionate salmon fly fisher and fish the Tweed, Oykel and Helmsdale. I really don’t mind not catching anything; just being in a beautiful unspoilt part of the country, wading in the river, looking at wonderful wildlife, is just bliss!

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WELL-BEING

Prioritising Staff Well-being Since 2013, Medivet has offered counselling to students enrolled at its veterinary nurse training college. The service has proven so beneficial that the partnership is now extending it to the whole company. We spoke to Debbie Frost, RVN Cert. Ed., Safeguarding Officer and Quality Assurance Manager at the Medivet partnership, about the power of counselling and why she wants her colleagues to have access to it.

Medivet Counselling Service In 2008, as part of a new Government initiative at the time, we had a duty to support the well-being of students enrolled at our in-house VN training college. Through this Safeguarding scheme, as it is known, we offered guidance on mental health problems (MHP) and emotional stress. My interest in this area had been growing for some time, so I decided to train as a counsellor. I am now in the last of my four years of training and when I finish, I will be a qualified counsellor with a Diploma in Therapeutic Counselling. I’ve also spent the last year volunteering as a counsellor in a local drug and alcohol service, which has given me invaluable experience. Our Safeguarding scheme developed into a full counselling service in 2013. Through this, we help our student nurses deal with the stresses that can come with the combination of a demanding course, full-time work, being on-call and having weekends on duty. We found it such an effective way of supporting student nurses that only a year later we have extended this free service to our entire staff of over 800. Support is either from me or through a telephone service.

What Counselling Can Help With Staff and students most often come to counselling with stress, anxiety or depression. These can also manifest as behavioural changes such as eating disorders, addiction, obsessive compulsive disorder (OCD) or anger management problems. Counselling is not only for mental health-related problems, however, it can help an individual through the difficult times that we may all experience at some time in our lives, such as bereavement or relationship breakdown. It also supports people who are feeling unhappy, perhaps under pressure at work, or feel that they are just not coping.

Person-Centred Counselling There are three main types of talking therapy. CBT (Cognitive behavioural therapy); Psychodynamic, based on interpretive or Freudian techniques; and my own preferred style, PersonCentred therapy. A typical counselling session with me is fifty minutes long and is “non-directive”. That means that the session involves whatever the client brings up. As a therapist, I do not offer advice or tell my clients what to do. Neither do I interpret, diagnose or www.practicelife.biz z March/April 2015 z Practice Life

attempt to intervene. I do, however, provide the right conditions for clients to harness their own strengths to make any changes needed to improve their situation. It’s about empowering my clients, not acting on their behalf. Staff and students can access the service by contacting me directly or they can be referred by one of our Area Managers, Head Nurses or Practice Principals.

Mental Health Stigma The importance of early intervention in getting people back to health and happiness is beginning to be understood more widely. While attitudes towards mental health are improving, there are still many barriers to people seeking help. Mental health is burdened by a stigma: society has traditionally seen those suffering from mental health problems as “weak”. These cultural attitudes are extremely difficult to combat and put people under unnecessary pressure. In my experience, those who ask for help show great strength – quite the opposite of what many people believe. What’s more, under the Mental Health Act employees can’t be discriminated against or lose their job for having mental health problems. They are protected in exactly the same way as for any physical illness or disability. Just as physical disabilities were once stigmatised, and we wouldn’t dream of doing that now, attitudes to mental health have to change because too many people still battle on by themselves for far too long.

Relationship of Trust Barriers to seeking help are not just cultural, they can also be practical. Vets work long hours and can find it hard to take time off to visit a counsellor. There may also be a reluctance to come forward to your employer because of potential confidentiality issues. It is vital to establish a relationship of trust between the client and the counsellor; this is something I’ve been made especially aware of in my voluntary work at the drug and alcohol clinic. The client and I establish a contract at the start of our first session which sets out exactly what is and what is not confidential. I have a duty of care to report serious issues, for example if my client is threatening suicide or is putting a child at risk. Everything else remains confidential, including their attendance.

WELL-BEING

Working With Staff It is really important that we normalise the topic of mental health. We do whatever we can at our partnership to raise the profile of the support that can be offered. Because the senior partner team are all vets, they are well aware of the particular stresses associated with veterinary practice. It’s a regular item on the agenda of our area managers’ meetings too. Area managers are in close contact with staff and so are often the first to flag up problems. We also raise the subject of mental health in our internal staff newsletter and distribute leaflets from the Veterinary Benevolent Fund, who offer an excellent support and counselling service for veterinary professionals. Mental health is discussed as part of the induction day of every new employee. New employees are asked to complete a confidential disclosure form. This lets us know of any mental health issues right at the start, so that we can develop a support plan, make adjustments to work schedules and so on. This is a responsibility that we take very seriously. We know it requires a lot of trust to make these disclosures. This information is just as important to us as knowing that an employee has a medical condition, and it’s treated in exactly the same, supportive way. We try to work with staff as closely as possible and will adjust their working hours or their responsibilities according to their mental health needs as far as we are able, while still meeting the needs of our practice. It is very important to include staff in these discussions. The emphasis is on keeping our staff safe.

In-house Counselling It is still relatively unusual for an employer to have an in-house counsellor, but we see it as a vital service. Waiting times in the NHS are typically around three months, and are usually longer. We are able to see people much more quickly than that, often within a few days. While it is possible to discuss issues over the phone, being able to offer face-to-face sessions is a big advantage. Counselling is about finding root causes, working together to provide tools to resolve problems and helping people get themselves back on their feet.

An Effective Therapy Counselling provides clients with a safe, confidential environment where they can explore their problems in a non-judgmental manner. In this environment, and given the right tools, clients are often able to find their own solutions to their problems. Although we won’t be able to assess the full impact of our counselling service for a few years, we have begun collecting data to demonstrate its effectiveness in improving staff retention and general well-being, and in reducing absenteeism. Students who have taken advantage of counselling tell us that it made them feel valued and supported by the company, and that counselling acted as a vital safety net at a challenging time in their lives.

Individual Responses Younger people and women to be more likely to come forward for counselling, but this should not place an extra burden on men suffering in silence. Many people suffer from anxiety and many have periods of depression or feeling low. The real challenge comes when those feelings start to affect our quality of life. It is not necessarily stress that is the enemy – some studies show that short-term stress can be a good motivator – but stress can tip over into something more serious. Counselling can provide the emotional tools to understand and alter problems in a positive way. It’s also important to remember that everyone is different. One person may thrive in an environment that could leave another feeling out of their depth. Each individual has to be met on their own merits in a safe, trusted and non-judgmental environment.

debbie.frost@medivet.co.uk

The Power of Counselling To be diagnosed with an MHP isn’t the end of the world, although it may be enormously challenging. Most people with MHP learn to live full and satisfying lives. Some find that their MHP resolves itself, others accept it as a part of them and learn to live with it. Talking therapies such as counselling can help, as can medication and some alternative remedies. The strength that is gained through the act of sharing and talking through a problem is often immense. It can be liberating and healing in a powerful way as it comes from within the clients themselves. The strength gained from therapy can stay with the client for the rest of their lives. I’ve now counselled many clients through difficult times in their lives, due to MHP or other issues. This has been a rewarding experience for me. To witness someone recovering, being empowered and then leaving the counselling process demonstrates the power of the human spirit. It both humbles me and makes me feel very privileged indeed. Practice Life z March/April 2015 z www.practicelife.biz

WELL-BEING

Thinking of improving mental health and well-being in your practice? Communication is the key to successfully managing any mental health problem

t the start of employment, or returning to work following time off for a mental health problem, bereavement or other emotional trauma: • Encourage staff to disclose mental health problems. • Promise to treat disclosures with discretion but NEVER promise complete confidentiality (you may need to refer on to another professional e.g. GP). • Ask your staff member about their needs. This could include adjusted workload or times. They may require no extra support – but knowing it is available can be a great relief in itself. • Give your staff member time and space to formulate responses to any questions. Don’t make assumptions about their needs and don’t put words into their mouths. • Try empathically listening to the employee. Put yourself in their shoes and see the world from their point of view. • Don’t judge. Accept what your employee is saying without casting your opinion on it. Saying things like ‘But you don’t have anything to be depressed about’ will not help and often causes people to ‘clam up’. • Agree a timescale for reviewing arrangements and to ‘See how things are going’. This could be weekly, fortnightly or monthly and should be carried out by the same member of staff.

OPENING UP

As part of the on-going SPVS-VPMA into the promotion of mental health within the profession, we’d urge you to read Rosie Allister’s blog on the Vet Futures website and share any comments you might have.

Rosie is the Chair of the Vet Helpline and a Director of the Veterinary Benevolent Fund. In her blog, she argues that members of the profession need to be more open about the mental health challenges they experience and not be afraid to seek help. For example, she says: “Looking to the future, we need to better understand who is most at risk, how to reach out to them, and how we can start to change our culture so that it is OK to ask for help.”

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Raising awareness within the organisation • Consider raising awareness of mental health issues. Displaying posters is a simple, cheap way of achieving this. • Assign a senior member of staff within the organisation to be the main point of contact for all mental health-related issues. Providing training is relatively cheap and easy to do. Mental health charity, Mind, offer training (see below). • Consider providing basic mental-health training for managers. This will give them the confidence to deal with this type of situation. • Check the organisation’s employers’ liability insurance. Policies often include free use of a telephonic counselling service for all staff members. For more information on supporting mental health and emotional wellbeing within the workplace, go to http://www.mind.org.uk/for-business/mental-health-at-work/ taking-care-of-your-staff/useful-resources/ The most useful piece of advice I can give on supporting mental health and emotional wellbeing in the workplace – is talk about it. Each person is individual and needs will also be individual. We can only find out what these needs are by talking about them, so don’t be afraid to ask questions.

Her blog also proposes that, due to the caring nature of the occupation and high client expectations, members of the profession routinely put work and animal welfare ahead of their own needs and that, in order for there to be wider cultural change, individuals need to change their own attitudes towards asking for help. This includes the discussion of ‘taboo subjects’ such as suicide. “Perhaps all of us have to start trying to change our culture to one that is more accepting and supportive and looks out for those in need even when they aren’t able to reach out themselves”, she writes. To read Rosie Allister’s blog, take part in the poll and contribute to the debate please visit: www.vetfutures.org.uk/discuss For confidential support practice members can call the Vet Helpline on 0303 040 2551 where calls are answered 24-hours a day by trained volunteers who have experience of the profession. Alternatively, they can use a confidential email service which can be accessed through https://helpline.vetlife.org.uk

WELL-BEING

Five myths

about mental illness that veterinary professionals MUST dispel… Caroline Johnson from Vetpol attended VPMA-SPVS Congress in January and shares her take-home learnings from the mental health stream the room’ though it’s clear that much more needs to be done in recognising, understanding and addressing mental illness within the profession IF the statistics (depressing in themselves!) are to improve. Max’s presentation within the wellbeing stream and the great work done by Vetlife are a good start in creating awareness and better understanding of this crippling condition... I could produce “War and Peace” on Max’s content but wish to share the practical part of his presentation that (for me) was the highlight. Max busted 5 myths about suicide which I think are worth sharing if we are to be able to put ourselves in a better position in helping those around us who may be thinking the unthinkable:

Caroline with husband Jeremy and Peppa the dog

epression, anxiety and stress can lead to suicide and these conditions are likely to affect every single one of us, one way or another, at some point in our lives. Reports reveal that 1 in 6 of us will suffer from the above, but note that the figures do not include those who never seek help – men in particular. This means that even if not afflicted ourselves, we will more-than-likely know others whose lives are blighted by mental illness. The above figures are true for members of the general population. Vets however are TWICE as likely to suffer from depression, anxiety and stress with 1 in 4 reporting suicidal thoughts and a shocking 2 in 3 vets being classified as “at risk” drinkers! As a consequence, vets are 3-4 times more likely to actually commit suicide compared to the general population; this figure is twice as high as for doctors, with vets citing work intensity, duration of working hours and feeling undervalued by senior staff/management as the most common problems. It’s a pitiful state of affairs and one reason why one of the three streams at this year’s VPMA/SPVS Congress was devoted to the subject of wellbeing (well done VPMA & SPVS!). I was there and delighted to benefit from the wise words of Dr Max Pemberton, Consultant Psychiatrist and a personable speaker who gave an interesting, informative and engaging presentation on the subject of mental illness. It is him I have to thank for the facts, figures and excellent advice presented in this article. It’s great to see that people are finally tackling ‘the elephant in

1. People who talk about suicide won’t really do it. False: 2/3 of people tell someone. So get your ‘listening ears’ on and tune into those who describe feelings such as hopelessness. 2. You must be crazy to try to kill yourself. False: Most people are simply upset, depressed or despairing. 3. Nothing will stop a person determined to kill themselves. False: Most suicidal people simply want the pain to stop and their feelings are transitory. 4. People who commit suicide are unwilling to seek help. False: My recent personal experience tells me this is not true – often the help that is required is not available at the time they most need it. 5. Talking about suicide may give someone the idea to do it. False: In fact, the exact opposite is true. The best advice appears to be simply to listen and talk when friends/colleagues tell you they’re unhappy, especially when they describe feeling of hopelessness or despair. Even if you struggle to understand how they’re feeling or why, respect them and their emotions, demonstrate empathy and be patient. Mental illness is a common problem – all too common in the veterinary profession – and the time has come for us all to improve in our dealing of this issue. Remember too that next time it might just be you needing someone to talk to… caroline@vetpol.co.uk Practice Life z March/April 2015 z www.practicelife.biz

PERSONAL DEVELOPMENT

Thinking & Learning Skills Their Impact on our Clinical Reasoning & Life Skills Dr Jill Maddison BVSc, DipVetClinStud, PhD, FACVSc, MRCVS Jill is a graduate of the University of Sydney. She is currently Director of Professional Development, Extramural Studies and General Practice at the Royal Veterinary College (RVC) where she is actively involved in undergraduate teaching and CPD in the areas of clinical problem solving in small animal medicine and clinical pharmacology.

s practising veterinarians we are all concerned, and rightly so, that we develop and maintain our clinical knowledge and skills so that we may serve our patients and clients well. Most of us recognised (even if we vowed in those first few months of “freedom” never to study again!) that graduating from veterinary school was just the first of many steps in a lifelong learning process. The variety of options for undertaking CPD is almost infinite in form and function – from lectures, webinars, practical courses, interactive online learning courses, post graduate training or degree programmes and more. Sometimes, the learning experience is not particularly pleasurable and/or little of what we learn at the time “sticks” – it is forgotten by the next day. Other times, the learning experience is enjoyable, deep, meaningful and lasting. A colleague may attend the same course we are raving about and find it of little benefit. What makes the difference? Is it entirely due to the course structure and content – the dynamism of the lecturer, the quality of the notes provided, the topic itself? Or is there a component that relates to us – how we think and learn? Understanding our own learning and thinking preferences and those of others we communicate with (work colleagues, clients, family, friends) can enhance our own learning, provide insights into how we clinically reason and also help us understand our reactions to stressful clinical situations and how to ameliorate that stress. There are several different broad categories of thinking/ learning styles and various theoretical constructs to explain them. Many papers and books have been written about the different models and many HR managers, psychologists, executive coaches and educational experts are gainfully (or not so gainfully!) employed in interpreting them. The model of thinking and learning that I have found most useful for my development as a clinician and educator is based on the

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Hermann Whole Brain model (www.hbdi.com). One of my richest and most rewarding educational experiences was through attending a workshop facilitated by the University of Sydney Centre for Veterinary Education run by Julia Atkin (www.learning-by-design.com). By introducing me to the Hermann Whole Brain model and her own work, Julia has transformed my teaching, and indeed understanding of others in many different contexts. I hope in this article to provide you with some of the insight I gained. Our physical differences are obvious but our “brain” differences are not so obvious! The Hermann Whole brain model is based on the concept of left and right brain thinking with which many are familiar. It and Julia’s work particularly concentrates on the impact of our thinking styles on how we learn. Within the left and right brain concept the brain is further divided into sections. Left brain thinking can be divided into Rational thinking (logical, planned, quantitative, technical fact based) or Practical thinking (planned, organised, detailed, sequential, conservative, controlled). Right brain thinking is further divided into Visceral thinking (emotional, musical, humanistic, expressive, sensory, interpersonal, feelings based or Cognitive thinking (holistic, metaphoric, intuitive, synthesising, visual, conceptual). See Figure 1. Most of us will have a natural preference for one or two styles over the others (but will usually recognise some elements of ourselves in all styles) and it is very important to appreciate there is no “right” or “wrong” thinking style. The educational concept underpinning this model is that engaging the whole brain and developing less preferred thinking or learning styles or at least recognising that they exist, enhances learning and understanding of others. Educational activities that recognise and work with this model ensure that learners preferred

PERSONAL DEVELOPMENT

thinking styles are accommodated and less preferred thinking styles are developed. It is also important to recognise that we may not always be the same in all situations – for example, you may find that your preferred thinking style is different depending on whether you are in a work or home situation. And you may find that you have had to develop certain thinking styles to facilitate your career that now seem natural but were not so initially.

Figure 1: Thinking/learning style description

OUR FOUR THINKING SELVES

The following questions will help you identify your preferred thinking and/or learning style. Each style poses different questions The first question to get the ball rolling is to consider the question you are most likely to ask when presented with new information – for example when told that your own pet or you yourself has been diagnosed with a particular disorder. Cognitive: Why? What if? Visceral: What do I feel? What does my client feel? Practical: How? How can I use this? What can I do? Rational: What is the proof? What is the reasoning? Reaction to a big, new idea Our first, instinctive reaction to change can also give insight into our preferred thinking style. How do you react if you are presented with a really big new idea – something that is totally different from what you have been asked to do or consider before – a new way of working or a totally different family plan for Christmas or summer holiday? Do you think..? Cognitive: “Fantastic! I can really see the potential in this!” Visceral: “Oooh – this sounds great, it’s making me feel all tingly with excitement!” Practical: “Hmm – what problems is this going to create? Is this really necessary?” Rational: “Yes the details look doable but we need to cost this properly” The different styles have different preferred thinking/ learning activities Next – consider what thinking or learning activities you prefer – which of these groups of behaviours describes you best? Cognitive: Infers, speculates, qualifies, conceptualizes, is intuitive (to ideas), imagines, takes risks, is impetuous, bends the rules, is curious/plays

Visceral: Is spontaneous, is sensitive to others, is intuitive (to feelings), likes to teach, is supportive, is expressive, is cooperative, is emotional, talks a lot, feels/flows Practical: Takes preventative action, is task focused, likes to know the facts, establishes procedures, is reliable and organised, is punctual, is neat, plans Rational: Analyses, clarifies, quantifies, is logical, is critical, is realistic, is direct, likes numbers, knows about money and how things work Different styles enjoy different activities Imagine you are having a discussion within your practice – a clinical case discussion or discussion about future plans for the practice. What would be your preferred style of discussion or meeting? Cognitive: One that allows me to use my initiative and imagination, allows connections with other approaches to the problem, is a new way of interacting and is fun. Practical: Has a structured approach with low risk to myself and where we are given concrete examples. Visceral: There is a personal touch and harmonious group discussion. Rational: We have a really vigorous debate, critically analyse all the issues and frankly air our differences. Different styles expect different teaching/ learning approaches Thinking about how you prefer to learn, what you expect from a CPD experience: what style most closely matches your primary expectations (in other words if this was missing, your learning would be significantly hindered) of the structure and presentation of learning material? Cognitive: I prefer to see the big picture – be given an overview and conceptual framework of a topic rather than details and where analogies, metaphors and visuals are used to communicate ideas. Practical: I prefer step by step unfolding of information, a detailed programme, punctuality, and an explanation of how to do things, not necessarily why. Visceral: I prefer involvement with others in the group and hearing personal anecdotes. I prefer an experiential approach and want my feelings to be considered Rational: I prefer brief, clear, concise information, well articulated ideas, a logical format, accuracy and certainty. What work do you like to do? Thinking about the tasks you enjoy and how you like to work is also a useful way to identify your preferred thinking and learning style. And equally, thinking about which of the following activities you really don’t like doing can highlight which is your least preferred thinking style. Which activities do you strongly prefer, prefer, use or actively avoid? And then what would be the average result for each column? Different styles have different downsides and reactions to stress This is a very important aspect of understanding yourself and to develop ways to manage stress levels. The different thinking styles have different reactions when placed in a very stressful Practice Life z March/April 2015 z www.practicelife.biz

PERSONAL DEVELOPMENT

Taking risks

Getting people to work together

Being in control

Working solo

Inventing solutions

Expressing ideas

Having an ordered environment

Analysing data

Providing vision

Building relationships

Paperwork tasks

Making things work

Having variety

Teaching

Preserving the status quo

Putting things together

Bringing about change

Listening and talking

Planning things out

Solving tough problems

Opportunity to experiment

Working with people

Administrating

Explaining things

Selling ideas

Being part of a team

Getting things done on time

Clarifying issues

Persuading people

Helping people

Structured tasks

Logical processing

Designing

Expressive writing

Attending to detail

Being challenged

Imagining

Counselling

Providing support and stabilising

Analysing and diagnosing

Table 1: What work do you like to do?

situation. Imagine you have a case that is going badly – the patient is getting worse, the client is getting angry and the diagnosis seems elusive. Do you.? Cognitive: Become scatty, chaotic, grasp at straws, go off on tangents, become illogical. Visceral: Become over emotional – become too stressed or involved with the patient or owner and therefore are unable to focus or problem solve. Practical: Become obsessively organised, want action now – expediency at expense of knowledge, have insufficient curiosity and drive to get to the correct answer or understanding. Rational: Retreat, become aloof, go solo, get bogged down in detail and can’t rule out even unlikely diagnoses without perfect proof. Recognising your thinking preference and its impact on your stress reaction can be useful in developing strategies to cope when things go awry. For example, if you recognise that you have very strong red thinking preferences and find yourself too involved with the patient emotionally, it can help to develop problem based clinical reasoning skills to assist you move into more green/blue thinking, where you are more likely to be able to solve the patient’s clinical problems. On the other hand, if you have very strong blue thinking preferences and are getting bogged down in a case searching for the perfect solution, recognising this tendency can help in developing a more pragmatic, green based practical approach and move from worrying about the proof to finding ways to help the patient. What colour are you? So having read this far have you decided what colour or colours you are? Many people find it hard to choose just one colour but more easily identify with two. Usually, but not always, people identify colours that are adjacent in the circle – thus you may feel you are blue/green, red/green, yellow/blue or red/yellow. Those who strongly identify with two opposite colours e.g. red/blue or yellow/green are less usual and may have seemingly contradictory aspects to their thinking styles which can be of great benefit or may create tension. Similarly, partners in work and life with opposing colour preferences may find their difference complimentary to the partnership – e.g. the big picture yellow thinking person’s vision can be translated and made a reality by the practical approach of the green thinking person. Or it can create tensions – green people are www.practicelife.biz z March/April 2015 z Practice Life

usually punctual, yellow people are often late! Occasionally a person (who has honestly reflected and has personal insight) can genuinely have no colour preference – they really do have a balance of all styles. But in my experience at least, through discussion with many, many veterinarians and students, this is very, very uncommon. What do we need for our clinical cases? Cognitive: What is the big picture? How do all the clues fit together? Intuition and pattern recognition Visceral: How is the owner feeling? How can I help them understand and accept? What’s my gut feeling? Practical: What are the facts? What can I do to help this patient? Rational: What is the diagnostic proof? Problem solving. Thinking further about our clinical cases and the skills needed for successful clinical reasoning, case management and client communication it is clear we need all styles of thinking and reliance on only one style can hamper our potential to do the very best for our patients and client. Veterinary school teaching tends to be mostly in the blue/green zone so vets will have all developed some of this to get into and survive veterinary school. Blue/green thinking works best for problem-based clinical reasoning and is fundamental to reinforce and enhance the potential of yellow thinking (intuition, pattern recognition) in solving clinical problems We love animals but ours is also a people profession. Red thinking style is essential in clinical practice – some are natural reds, others are learned reds and some will or should go into other areas of clinical practice or areas of the profession, or even other areas of work that require much less red thinking. Developing our whole brain So how can we develop our “weaker” thinking styles to enhance our whole brain thinking or structure our teaching or communications to assist learners develop? Reviewing these activities can also help further identify your preferred or least preferred learning activity. Cognitive: Models, analogies, graphic representation, brainstorming. Visceral: Drama, stories, discussion and group work, mind journeys. Practical: Methods and procedures, step by step working,

PERSONAL DEVELOPMENT

flowcharts and timelines, structured worksheets, goal setting, lists. Rational: Develop rules and formula, compare and contrast, graphs and pie charts, analysis of theories. One crucial question is – how easy is it to develop our whole brain and enhance the areas we feel less comfortable with? Developing stronger green thinking is probably relatively easy if needed for survival in your job. But it can feel painful – especially if you hate lists and deadlines and like to procrastinate! Blue thinking is a little more difficult to develop. One needs to mentally focus and concentrate on the details and it requires mental discipline. A logical problem-based approach to clinical reasoning is centred here. Most of us have, or learn enough, red thinking skills to survive in practice (or we don’t and so leave) although as discussed earlier it comes more naturally to some than others. Enhancing yellow thinking can be quite difficult. It is hard to see the really big picture when you are grounded in the reality of the details. Risk taking is very hard for those who don’t have a reasonable yellow thinking preference and intuition

cannot be taught. Interestingly, pattern recognition (“what disease do I know of that will cause this pattern of clinical signs the patient is presenting with?”) uses more parts of the brain than any other mode of thinking. It is usually the least favoured type of thinking by veterinarians yet is often the only clinical reasoning method they have available (hence the benefit of developing a structured problem based approach to complex cases). And finally As the final test of your preferred thinking style or styles – what do you think of all this? Cognitive: What a great concept – I wonder how I can take this further in the future? Visceral: This is so interesting – I can’t wait to tell my family, friends and colleagues what colour/s I am and discuss what colour/s they are! Practical: OK, but is it going to be useful in practice? Is there anything more practical in this magazine I can read? Rational: This is a load of touchy feely hogwash – show me the proof!

Practice Life z March/April 2015 z www.practicelife.biz

MANAGING PEOPLE

Managing

Meetings Dr Ben Hardy qualified from Edinburgh Vet School in 1995. After working in academia, general practice and the pharmaceutical industry he studied management, completing his PhD at Cambridge. He now lectures at the Open University and researches morale in organisations, the effects of hormones on decision making and the role of language in surveys.

re you lonely? Are you tired of working on your own? Do you hate making decisions? Then hold a meeting. You can see people, feel important, impress your colleagues and eat biscuits. Meetings have a terrible reputation. You seldom hear someone say ‘I’m really looking forward to that meeting’. But meetings are vital to the effective functioning of any organisation. The problem is that they tend to be used indiscriminately, for all sorts of situations where they are not the best solution. Worse than that, many meetings are poorly planned, badly run and never acted upon. So, how can we make our meetings more effective? There are a number of simple issues that you can address which will help you run your meetings better. The first thing to ask is whether you really need to have a meeting. This a bit depends on what the meeting is for. Broadly speaking there are three categories of meeting: a) To distribute information b) To decide on a course of action c) To coordinate action The question you need to ask yourself, as the person setting up the meeting, is whether a meeting is the best way of achieving your objective. If you are trying to share information then is there a more efficient way of doing it? If it’s to delegate tasks then could you not just inform those affected? A lot of the desired outcomes in meetings could be agreed by an email, a phone call or a simple conversation. So think carefully about whether you need a meeting. Once you’ve decided that you need a meeting then the second thing you need to do is to work out what you want to achieve from the meeting. This doesn’t mean ‘can I get what I want?’ – indeed, many meetings are a waste of time because the chair has decided before the meeting what the outcome should be and so there is little point in consulting or coordinating action. There is a difference between ‘I want to agree a plan as to how we deal with bad debts’ and ‘I want everyone to agree with my plan as to how we deal with bad debts’. Working out what you want to achieve by the meeting is vital as it focusses the whole activity. www.practicelife.biz z March/April 2015 z Practice Life

Now that you know that nothing else but a meeting will do and you’ve got a clear idea of what you want to achieve, it’s time to think about practicalities. The next question to ask yourself is ‘Who am I going to invite?’ This is a crucial question. If you don’t have the right people in the room then the relevant peoples’ expertise won’t have been tapped, or they will not know what is going on, or tasks won’t have been delegated to the best person. People are busy, however, and so it is important to try and make sure that all the relevant people can make it to the meeting. Giving people plenty of notice or using tools such as Doodle to help find suitable times can ensure that the people you need are there. The fourth issue you need to tackle is what the agenda will look like. Far too many meetings are run without agendas. I have a basic rule for meetings. No agenda? No meeting. This sounds slightly priggish, I realise, but there’s a serious reason for it. Meetings without agendas ramble, they don’t achieve what they need to, they stray off topic and the people attending are ill informed. I’d rather not have my time wasted so I need an agenda. Putting together an agenda is an art. If you write something of the length of Tolstoy’s ‘War and Peace’ then no-one will read it. Equally, if you simply have a brief sentence for each topic, it can be hard for people to work out what they are going to be asked to contribute to. What’s wanted is a brief sentence which will help those coming to the meeting think about the topic in advance. For example, an item ‘Working with local practices’ doesn’t really tell you very much. An item such as ‘Working with other practices to share on-call rotas for small animal work’ is more useful. Better still would be a brief bit of detail such as ‘Working with other practices to share on-call rotas for small animal work: how best to handle illness, holidays and swaps’. Now we’re at the fifth issue, that of the meeting itself. Chairing a meeting is a real skill. It’s not simply a question of turning up and having a meeting. The chair’s role is to frame the meeting, lay out the route map for the meeting, and hold to high standards of behaviour, allowing all the relevant

MANAGING PEOPLE

How to be an effective meeting participant Your role, as a meeting participant, is to provide your knowledge, expertise and wisdom, to the topics under discussion in the meeting. You have to assume that the reason you’ve been invited to the meeting is because you have something to contribute. To make your contribution effective you have to do two things. Firstly you have to be familiar with the agenda and issues which are going to come up in the meeting. You should have thought about them before hand and ensured that you have something useful to say. The second thing that you should do is be prepared to contribute. It’s too easy to stay silent but you owe the meeting your thoughts. Make sure you share them and help others to share their thoughts. You may not agree with someone but that doesn’t mean that their thoughts aren’t worth an airing.

voices to be heard and ensure that any actions are clearly delegated and minuted. Making sure that the relevant people are heard in a meeting is critical. Reticent participants need to be brought out of their shells. You may need to bring to book those trying to push people back into their shells. Suppression of dissent is all too easy both by the chair but also by others in the meeting. Remember, meetings are not there to prove how good you are, they are there to try and do the thing right. This involves properly exploring all the options and soliciting the views of others – no matter how unpopular those views may be. Skilled chairpeople are very good at getting all the views onto the table so that the group can make informed choices. All too often, however, meetings are turned into status arenas where people try to show off, dominate the discussion or bully those that they can bully. The chair’s role is to temper these issues and ensure that the meeting achieves its purpose.

The sixth thing to think about is the minutes. Minutes deserve greater importance than they are often given. They are the collective memory of the meeting. Because of this the person writing them is in a position of power. They can shape the summary of discussions in such a way as to slant the view of a particular topic. Minutes should be short enough to be interesting but long enough to cover the subject. It’s often helpful, if you’re chairing the meeting, to have someone else (whom you trust) taking the notes. You’ve got enough going on running the meeting properly without trying to summarise and write down the discussion. At the end of the meeting we arrive at the seventh thing that needs to be considered: actions. Too often meetings finish and there is no concrete list of actions and no proper assignment of responsibility. This makes it difficult to hold people to account. Clearly listing the expected outcomes of the meeting and linking these outcomes to individuals focusses these individuals on what they should be doing, and it makes it noticeable if they have not done it. One of the useful techniques that one of my colleagues uses is circulating a separate ‘action points’ document along with the minutes which lists each outcome and the people responsible for it. This is not, of course, an exhaustive guide as to how to conduct meetings. But by thinking carefully about the various questions we need to answer when we decide to hold a meeting, we can ensure that they are more effective. The reason meetings persist is because they can be so useful – so take the time and follow the steps to make them as useful as possible. Practice Life z March/April 2015 z www.practicelife.biz

MANAGING PEOPLE

CASE STUDY: HOW I MAKE MEETINGS WORK Chris Aylott is Head Vet at The Wheelhouse Veterinary Centre, a 3-branch practice in Buckinghamshire.

ur practice is organised with the various teams being led by Heads of Department; so we have two Head Nurses, myself as Head Vet, 2 Directors, a Client Care Manager, and the recent addition of a Head of Administration. We have a system of Heads of Departments meetings, group team meetings and one-to-one meetings. The Heads of Departments meet once a month and there we bring to the table discussions from our individual team meetings, as well as decide on matters that need to be filtered down the line again for team discussion. Team meetings follow similar patterns between the departments: our vets’ meetings are held every two months in the evening. We tried lunchtime but it just wasn’t working, and actually it was the team who voted to switch to after-work. The nurses similarly have an evening meeting every 2 months (for the same reasons). The client care team also adopted a similar pattern. The individual teams are free to do what suits them best and they all ended up preferring evenings! That said, we always order in a take-away meal for everyone just before the meetings start – mine are usually Thai! I should stress that these evenings meetings always aim to finish on time, even if the agenda hasn’t all been covered; no-one makes good decisions at 10.30 at night! The administration team are quite small at the moment and so no meetings are needed just yet. We see them face-to-face every day in the office and so can have informal catch-ups. In addition to the team meetings, we have one-to-one catchups between the head of department and their individual team members. Every head catches up with every team member for about 20 minutes every month. This works well for both parties: we don’t have to do formal yearly appraisals any more as there’s ongoing discussion, and it takes away the stress for both sides. It helps to encourage a spirit of openness: things don’t need to be bottled or saved up – the team member always knows there’s an opportunity to bring something up.

Prior to our team meetings we ask our group what they would like to talk about at the meeting – we want to keep the agenda manageable, so we pick a few topics to address each time. We also need to schedule items that have come from the Heads of Departments meetings. An agenda is sent 2-3 days prior to the team meeting via the internal message system (computerised – this is how we communicate between us on a daily basis). Because we want these meetings to be effective and make good use of time, some things don’t get included here: if it’s just a point of information that needs communicating, then this is done on the internal messaging system, rather than hogging meeting time; if a particular person is doing something that needs addressing, this is raised outside of the meeting, directly and privately with the person. Whether that waits until their scheduled one-to-one meeting will depend on the issue. If it’s urgent you need to have a discussion straight away, while still respecting any half day they’re due or other time off. Thought is always given to the order of the agenda for our team meetings: for the vets I try to have the engaging stuff – mostly the clinical stuff – mixed with the boring stuff so no-one switches off. My one-to-one individual team member meetings usually happen in the afternoon, though they’re scheduled to avoid a busy time so it doesn’t lead to income loss. I usually dedicate about 30 minutes each for them, and if necessary I will block out two 15 min appointments. All these meetings add up to a lot of hours talking! But you’ve got to prioritise your team – a happy practice is a successful practice. Does it affect staff retention? Well, I’ve had 1 vet leave in over 5 years just wanting to do something different, so I’d say our retention rate is pretty good. Overall I’d say that regular meetings work well for us, but as with anything they shouldn’t be rigid – the demands of veterinary practice means that some flexibility must be built in. www.wheelhousevets.co.uk

Leadership Tips by Mark Hedberg, College of Animal Welfare

Your Team is like Soup: What’s your recipe? Grandmas through the ages have always sworn that soup gets better as time goes by. Flavors mellow, blend, and mix in the refrigerator, adding a magical ‘something’ to the soup that was already pretty wonderful to start with. What’s Grandma’s secret? More importantly, what does that have to do with your team? Making a really good team is just like making a really good soup. Grandma would go down to the local market, or the shop, and pick through the veggies, the meat, the herbs, the spices, looking for just the right ones. Overripe or too green? No good, and of course every dish had its own secret sauce. Teams are like that too. The best teams have a little bit of everything; the meat and potatoes balanced out with the dash www.practicelife.biz z March/April 2015 z Practice Life

of garlic or pepper. Just like food, you’ll have productive ‘meat and potatoes’ team members, and you’ll have creative ‘spice’ members that can give your workplace a little extra spark. One isn’t better than the other – an ‘all spice’ team will give you heartburn, and an ‘all potato’ team won’t take you anywhere. As a manager, if you don’t know where you’re going in business, that’s like not having a recipe. All you’ll get is a bad taste in your mouth. This is often why teams stumble when a new manager comes in to lead an existing team; what was just to one manager’s taste may not be what the new boss likes to eat. That’s not a crime, that’s just different tastes. That said, as a manager, it’s your job to learn about other flavors and tastes – the world would be a boring place if the only food was frozen pizza! Bon Appetit!

CLIENT CARE & MARKETING

THE ZOO IN YOUR COMPUTER: An Introduction to the Animals in SEO and Quick Fixes To Keep Them At Bay Laura Holmes is E-marketing Coordinator for Norbrook Laboratories and has worked as an SEO Executive for a leading digital marketing agency.

So, you’ve launched your website. Now you can leave it to tick over – right? I’m afraid the answer is most definitely NO.

ou may think that by investing time and money on a website for your practice you‘ve done enough to reach out to clients and pet owners online. And with one final click you can leave it all behind and get back to treating animals safe in the knowledge that your website is being found. Unfortunately this is not the case. Your website will continue to need some nursing along the way to make it more visible to existing and potential clients. This is known as Search Engine Optimisation (SEO). SEO can seem a daunting task, however, there are a few simple tricks that can help you to compete in Google and be found, as well as a few things to avoid at all costs! Google is the largest and most important search engine. If you’re doing well in Google’s Search Engine Results Pages (SERPs) then you will invariably be ranking well across other well known, and not so well known, search engines such as Yahoo, Yandex and DuckDuckGo. So, what has SEO got to do with animals you might ask? You may be surprised to learn that Spiders, Hummingbird, Panda, Penguin and Pigeon can all be found in SEO. When a client searches for “veterinary practice near…” there are hundreds of things that Google considers before it offers your, or your competitor’s website to the potential client. Every year Google looks at different combinations and changes them; these are called algorithm changes and bigger, more impactful algorithm changes gain names such as Panda and Penguin. Panda and Penguin are two of the biggest algorithm changes to have affected SEO in recent years. Panda focuses on websites with ‘thin’ content such as low word counts and uninformative copy, whilst Penguin concentrates on link acquisition. So, who is linking to your practice website? How did this link acquisition come about? Did you pay for the links? If your website is flagged up under either of these algorithm changes, then Google can ‘smack’ your website with a penalty which can see your website drop right down in the SERPs. Or, as famously happened with flower chain Interflora, it can be completely removed from the search engine altogether. In this case, Google had picked up on links being given by Interflora customers in exchange for free bouquets. Although this sounds scary, if you have your website set up with the free Google Webmaster Tools, you will be warned of any violations that might be detected on your website. Interflora is back in the good books, so if you search for them or any terms such as “flower delivery”, you can now find them.

Avoiding Panda To avoid being in the clutches of a Panda penalty you should ensure that the content on your website is well-written for your customer and contains relevant information. Many years ago it was acceptable in SEO circles to stuff text with keywords and so you would unfortunately see terms such as “veterinary practice” inserted into copy to try and rank for that phrase – this is a definite no-no. It’s important to write copy which is natural and not try to deliberately rank for any words in particular. Google is getting smarter thanks to the use of Spiders which ‘crawl’ across your website and then send information back to Google such as whether your website uses videos or which words are used. The information collected will determine where your website should be placed when a customer searches for a term such as “veterinary practices near…” and will compare your website’s offering against others in deciding who best meets the searcher’s query. By ensuring that your website has interesting, non-plagiarised and informative content, of a moderate length, without repetition, on all of your site’s pages, you can avoid Google’s Panda.

Keeping Penguin at Bay Penguin focuses on how you’ve acquired links to your website. Google considers a link almost akin to a vote, so when your website gains a link from another website, it’s somebody vouching for your website and telling Google that the content is informative. By gaining links you are ‘telling’ Google that people think you should be ranking higher in the SERPs. So how can you gain links? A historical, and now should-be redundant SEO tactic was to actively go out and request any and every link, even if this meant buying a lot of low value, irrelevant links. This is no longer advisable and relevancy is important. Not all links are created equal; if your practice was to say, gain a link from a website such as Norbrook (veterinaryrelevant), this is deemed of higher ‘value’ than one from a florists in Paris. And because some websites hold more link value than others, (this used to be measured by PageRank, a link analysis algorithm used by Google to determine the relative importance of a website – no longer the case as Google doesn’t update PageRank anymore) getting a link from a website which has a higher PageRank is worth more than getting several links from lower PageRank websites. The best way for you to gain links for your website is to ensure that the content is something that people want to share. Could one of your vets write a regular vet’s advice column on different health care issues, for example, how to deal with mud fever in horses? People such as horse riders and livery business Practice Life z March/April 2015 z www.practicelife.biz

CLIENT CARE & MARKETING

may find this information useful and want to link to it from their own website. If one of your clients has a small animal rehoming centre then there’s nothing wrong with asking them if they could offer your website a link. Be careful though, if you were to get an influx of new links in a short period such as four weeks, this can raise a red flag to Google as to how you’re gaining those links, which may lead them to investigate your website.

Let the Pigeon Loose! Google’s latest named algorithm change is Pigeon; the intent of Pigeon is to localise search. This means improving recognition of where a user is located, and identifying where the vet practices are in relation to them. Preference is then given to local search results. So, if you search for a vet practice in your hometown, you will be presented the most geographically relevant practice to you. A quick and easy way to get on the good side of Pigeon is to create your free business listing on Google Maps – this should take no longer than five minutes and will help Google to find your practice’s website.

Hummingbird – Google gets Conversational Hummingbird is another animal-themed algorithm change which affects how Google works and how your website is presented against competitors. Hummingbird shows how smart Google is getting. The search engine can now differentiate what you’re searching for and looks at conversationalist searches with more emphasis on the actual search phrase. For example, if you were to type into Google, “where’s the closest place I can buy an iPhone 6?”, instead of sending you to an online result such as Amazon (which would have historically happened, by picking up on a few words such as “where” and “buy”) it will now understand that you most likely want to go and physically buy an iPhone 6, so will find you the best local result. If you search for “Orange”, Google is now looking to understand whether you mean the colour, the fruit or the store and will refine the results it presents you with. You don’t really need to worry about doing anything with your practice website for Hummingbird; it’s really more of a change to the way that Google functions. Additional quick fixes: Get Social Having social media can help to improve your website’s online presence and can also have an added benefit of boosting customer relations. As social media continues to be more important, so does having your vet practice on these channels, for example on Facebook, Twitter or Google+. Obviously, having a social profile means more work for you, as it’s important to ensure that it is regularly updated. There is always the chance for negative comments from disgruntled customers on whichever platform you use, so you need to weigh up the pros and cons for your business. It’s important to note that by adding lots of links on to your social media accounts, you won’t gain links that Google counts (not all links are counted). If you have an active following, Google will consider this akin to people voting for your website, so it’s likely that Google will look at listing your practice website higher in the SERPs. Hint: It’s better to focus on having one social media profile on one channel (for example just having a Facebook profile) and use that really well, than trying www.practicelife.biz z March/April 2015 z Practice Life

to cover all bases by having a presence on all social media sites and not to update these very well – especially if you’re pressed for time. If you do use more than one social media site ensure that you’re offering unique content and don’t just post the same content on each – videos and photos work well on Facebook for example, whilst a written update can work better on Twitter. ‘Fresh’ Content Google puts more prominence on websites that are being regularly updated. If you’ve visited a website and the news feed hasn’t been updated for three years, how do you know if that business is still active? If you don’t know, then Google doesn’t know either and Google doesn’t want to promote a potentially inactive website over one that it knows is still active. You don’t need to rewrite your whole website but adding regular news items, even if it’s one a month, lets Google know that your website is still active and in turn, also your business. Are you having puppy parties? Do you have a new vet in your team? Have you started to stock a new range of cat food? Then these are things you should be writing about! Just ensure you avoid ‘thin’ content as aforementioned – aim to write about 200 words per news item. This has an extra bonus in that other websites may want to share your news and will in turn link to you! Keyword Optimization What is it about your practice that stands out from competitors? Are you equine-specific? Do you offer a free callout? Do you offer alternative therapies alongside conventional medicine such as acupuncture? If so, you should optimize the keywords that you’re using on your website. Keywords act like triggers telling Google what your website is about, so by including words such as “Free call out vets in Derby” you let Google know that you want your website to be offered to clients when they search for similar phrases. By just listing yourself as a “vet practice in Derby”, you’re instantly competing against small and mixed animal practices which is not good if you’re an equine-only practice. By adding the keywords “equine vet practice in Derby”, you’re instantly making your website stand out from others and potential clients who are searching for a vet for their horse are more likely to find your website and convert into a customer. Remember not to overuse keywords; if on reading your copy out loud it sounds unnatural and forced, then it probably is. It’s always important to write for your clients and not to try to deliberately write for the search engines or the spiders that crawl your practice’s website. An important message to take away is that SEO is everchanging, in the same way the veterinary field is ever-changing with the launch of new products into the market. SEO tactics that used to work several years ago (such as keyword stuffing) can be abused by websites and so in turn Google changes its search algorithm. Every year it alters it in the region of 500-600 times so it’s important to keep updating and investing time and resources in your website even if you can only dedicate an hour a week to it. If you don’t work on your website, your competitor will be working on theirs, and Google might just rank their website higher in the SERPs than yours, which could mean a loss of clients to your practice and in turn profits. www.norbrook.com

BUSINESS HEALTH & FINANCE

An Owners Guide to Succession Planning Amira Norris started her career in Financial Services in 1999 and qualified as a Chartered Financial Planner in April 2009 with specialism in Retirement Planning. She joined PPS as Business Development Manager in 2010 and became a Partner in 2013. • You haven’t started to think about it • You have no idea how to develop a succession plan • You simply don’t want to think about the future Running a business is hard work. Most vets find themselves too absorbed in the day-to-day running of their practice and the provision of animal care to focus on the longer term problems, like planning for succession. It may be that you think it will be too complicated. But in truth not preparing beforehand will actually make the process more difficult in the long run. It is much easier to start early and go through the process one step at a time. When planning for succession, a number of tough personal issues will also surface such as ‘What will I do when I retire?’

oyal College of Veterinary Surgeons (RCVS) figures indicate that around 20% of practitioners in the UK are over the age of 50 and hundreds of the privatelyowned veterinary practices across the country are owned and operated by ‘baby-boomer’ veterinarians on the cusp of retirement. Many don’t have a firm transition plan in place – or any plan at all. These owners aren’t grooming an associate to take over, nor do they have partners ready to buy them out. Their endgame is simple: put the practice on the market, sell it in a bidding war, and then walk away with the cash to fulfil their retirement dreams. This plan may work for a few, but probably not for the majority. The question will be in the timing – and in the planning.

Assemble a team of trusted advisers

Make the process as simple as possible and start by planning it out with professionals that can help you, such as your accountant, financial adviser and solicitor. Taking advice from the right professionals will give you peace of mind and making a complex process much easier, allowing you to focus on more important things – like your practice. You should also consider investing in the services of a business consultant who specialises in this area. Their skills set can help boost your credibility and approach a wider group of potential buyers on your behalf whilst protecting your identity, especially in the early stages of the process. Having someone to discuss your plans with in confidence and who supports you throughout the process can often be worth much more than their fee.

The Importance of Planning

Develop an exit strategy

There are three main reasons why you may not have a succession plan:

On the proviso that you don’t have to leave your business imminently, it’s crucial

that you draw up a three-year exit strategy. This will give you the time that you need to find the right buyer; in addition, it will mean that you will not have to make a kneejerk decision about the future. You should be clear on your objectives and who the right buyer might be. These might include: • setting the date you want to retire, • preference for internal succession or maximising your target price on the open market; • whether you are prepared to continue to be involved in the business, and • securing jobs for your employees. Good tax planning can also help to minimise your personal tax liabilities, and advice with forward planning is essential.

Make sure you have the right people in place to make a sale more attractive The obvious starting point for any succession plan is to look within your own practice and assess the potential for an existing assistant or assistants to take over the reins. Starting the process early will allow both/all of you to explore the viability of true business succession and continuity for the practice. However, key areas need to be addressed including the willingness of an assistant to take on the risk – and reward – of business ownership. Other issues include the viability of raising finance to support a buyout and any skills gaps which would need tobe filled. Many of the concerns surrounding an effective sale are often more complex when there are no clear successors who can take over the practice. A business that is 100% reliant on its owner will have a significantly reduced value. If you decide to sell your practice on the open market, then the key is to make sure it can stand on its own two feet; that includes having a team in place

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BUSINESS HEALTH & FINANCE

that could provide continuity for your customers if you were either to step away entirely, or to greatly reduce your role.

Be realistic about the value of your business After all the hard years of building up your business, you quite rightly want to be rewarded. But do be realistic about the potential value of your practice. It is not solely based on the goodwill and it will be affected by a number of factors including the area of specialism, for example small animal or equine, your pricing strategy, where you are located, any local competition, staffing efficiency, profitability and of course the dependence on you as the owner. The best step you can take is to obtain an independent valuation of your business from a reputable valuer. In the early stages of the succession planning process, getting a formal valuation can also help direct and modify your business strategy leading up to any sale. Focus will generally shift to short-term results, rather than long term investment plans and in minimising any provisions for bad debts and old stock. What you can be sure of, is that the type of buyer who will be interested in your practice will have learnt much about the profession’s development in recent years. They will be picky and

you should expect them to be – after all this is not just a monetary transaction. Expect them to analyse growth potential, client visit data, and be able to identify areas of stagnation. You have invested much in building your business, but there is nothing to be gained by taking these things personally and you should approach the sale with as much objectivity as you can.

Prepare your Practice for sale The aim of a well thought out succession plan over a number of years, is to present potential purchasers with as ‘tidy’ a business as possible. This includes effective management information systems, well-maintained premises and equipment, and well written documentation for all key contractual relationships, especially for your employees.

Ensure you stay focused on your practice right up to the sale It’s easy to become distracted if you know that you will be exiting in a couple of years’ time. However, it is vital not to lose the passion and vision that you had when you yourself became an owner. Taking your eye of the ball could affect staff morale, business growth and ultimately the value of the company.

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Don’t look at the exit as the end Many veterinary owners delay retirement because they don’t know how to continue to support themselves financially or if they will have ‘enough money’. Part of a good exit strategy is to come up with a sound financial plan of how to maintain your standard of living after selling your practice. As a business owner, you may have a more complex retirement strategy, with your income potentially being provided from different sources. These could include rental income from retained ownership of the practice premises, the proceeds from the sale of your business, previous pension arrangements and other investments. An experienced financial planner will be able to work closely with you to understand your life goals and ambitions, use comprehensive tax planning to minimise potential income and capital gains tax liabilities, and provide detailed cash flow analysis to ensure you can enjoy your retirement to its full potential. The old adage of ‘fail to plan – plan to fail’ has never been as relevant as it is today. Good planning now will mean a happier outcome for you and your retirement. www.pps-vet.co.uk

PRACTICE DEVELOPMENT

Improving the customer experience is good for business.

Here’s the evidence to prove it. Kristie Faulkner RVN, Business Development Director at Onswitch, discusses an evidence-based approach to customer experience measurement

his aim of this article is to present you with facts, data and evidence to demonstrate the real and significant effect that great customer care has on your practice bottom line. In our day jobs as vets and nurses we need test results, measurements and readings to guide us in our clinical decisions and determine what success will look like, as well as allowing us to judge when we have achieved it. However, in the management and commercial side of our practice, whilst these things are no less important, historically many practices have been less thorough in the collection and analysis of such data. Yet this data does exist – increasing numbers of practices are measuring their performance in all aspects of their business and it’s no coincidence that these are the practices reporting strong growth and healthy increases in new client registrations. We’ll look at data from independent practices in the UK and a case study from Independent Vet Care, each of which demonstrates that delivering an excellent customer experience brings real results. Despite the fact that you probably know clients will leave if they are not being treated as they expect, you’re almost certainly not monitoring where your service levels are and taking steps to stop any slow but steady attrition of active client numbers and therefore revenue. Perhaps it’s just that you need proof? Data? Evidence to show that by taking active steps to improve your customer experience, your business will grow?

won’t sell you things you don’t need. Or the dealership in town - guaranteed parts and use of a courtesy car are great, but there’s always an unexpected ‘extra’ on the bill. Both have their advantages, and disadvantages, so what swings it for you is how you feel about the whole experience. And if you are thinking, that’s all very well, but I can’t measure how my customers feel about my practice, think again. Here’s that data we mentioned. UK independent practices – what gets measured gets better Every month, as part of a national Index reporting programme, telephone calls are made to around 1,500 small animal and equine practices in the UK and Ireland. This means that at least four times a year every practice (including yours) receives a call. Some of these practices pay for detailed monthly reports charting their performance over time, and comparing against local competitors, whilst other practices simply contribute their data to the huge database. Either way, each practice is awarded an overall score and rated on the same key criteria. Presented at the Inaugural EVBM Congress in October 2014, average data from 2014 compares those practices receiving monthly reports and using their insight to improve the customer experience, with those who do not. The two monthly indexes (Small Animal and Equine) are compiled from calls to around 1500 practices, so each quarter every practice across the UK and Ireland receive a mystery shopping call asking for advice and information as a potential client. Individual practices are awarded an overall Index score.

Here it is. What is the customer experience? The basic principles of customer service are simple and clear, and apply in every profession – where they have a choice, consumers will place their business with people who they like and trust, and who offer good value. The phrase ‘good value’ is significant here, you’ll note that it’s not ‘low prices’ or ‘cheap’ – most of us are savvy enough to know that you do get what you pay for, and if something seems too good to be true then it probably is. Pet and horse owners are no different. Nor are you. Where do you choose to service or mend your car? The local garage, where the staff know you and you can drop the car off at your convenience? Sure it’s bit more expensive, but you trust that they

Take a look at the results. It’s clear that what gets measured gets better Customer care training delivers uplifts in performance The telephone is a key touch point on your customer’s journey through your practice. Research shows that around 80% of initial contact occurs in this way – what your team say, and crucially, how they say it, will determine whether the pet or horse owner on the other end chooses to place her business with you. The data Practice Life z March/April 2015 z www.practicelife.biz

PRACTICE DEVELOPMENT

Independent Vet Care’s strategy is to develop each site to be the most successful it can be, and customer experience plays a key role in this success. Each practice joining the group receives a suite of training and investment to ensure that the customer experience is always placed firmly at the heart of the practice: • Monthly Index reporting to measure current performance and set benchmarks and targets • Customer care training, both for the front of house team (covering telephone and face-to-face skills) and the clinical staff (consultation skills) •R egular client surveys to collect feedback and measure likelihood of recommendation (Net Promoter Scores) Data for Blackness Veterinary Centre showed a real step change in performance achieved through this consistent focus on the customer experience: above shows that it is not common practice to ask the animal’s name when speaking with owners on the phone, yet this is a simple way to prove to a potential client that her pet or horse would be treated as an individual at your practice, not just as a case, a number, a cash cow. Delivering excellent customer care in a busy practice is not difficult or expensive, but for many it does not come naturally. The good news is that it can be learned, and putting a simple but effective process in place will ensure that your team give the same great care to every client, every time. Callers are potential new clients, but very few are offered appointments Successful small animal practices convert 40% of their telephone calls into paid-for appointments, equine practices more so, at 80%. Fees are, after all, the lifeblood of your practice. Giving the lowest rate to a price checker does not earn your practice any money if it puts the caller off coming in to see you because the receptionist was curt and disinterested. The caller is far more likely to take her pet in to see the practice who asked her pet’s name, explained what is included in the higher, but still reasonable, price quoted and offered an appointment so that the vet could recommend the most suitable options. ‘Good value’, remember? If an owner has gone to the trouble of finding out about you and ringing your practice, she has money to spend and an animal that needs a whole lifetime of care and she may well have a whole lifetime of care for future pets and horses too. Why wouldn’t you offer to see her? Because those price checkers ringing you will also be calling other practices – the telephone is your golden opportunity to demonstrate just how great your practice is at this key point on your customer’s journey. Case study – Blackness Veterinary Centre, Dundee, part of the Independent Vet Care group All the same challenges apply when you run a chain of practices as when you manage your own one site, they are just magnified accordingly. Veterinary practices state they understand that without an excellent customer experience, their client base will dwindle. Conversely, when customer care is wonderful, owners can’t help but tell their friends, which attracts more new clients at no cost. www.practicelife.biz z March/April 2015 z Practice Life

June-September 2013 (independent practice) vs. June-September 2014 (part of IVC) Consults New clients Active clients Turnover

30% increase 58% increase 5% increase 9% increase

Barbara Barbard, Clinical Manager at Blackness Veterinary Centre is passionate about maintaining this commitment to the customer experience. “IVC helped us implement training and reporting that show us exactly where further improvements can be made, and with ongoing measurement we’ll ensure that we don’t take our eyes off the ball. In the seven months since we began mapping our customer journey and collecting data, our customer service has demonstrably improved, with Index scores now around the 80% mark.” What would your data show? The evidence finds that improving the customer experience is good for business, but do you have data for your own business? The first step to getting better is to measure where you are now – this is as easy to do as setting up a client survey on your practice website, or emailing out a link to your clients. There are several free tools online, SurveyMonkey.com is a good place to start. Once you know how happy your clients are now, you can set targets for improvement. Ask for their suggestions, you might be surprised how easily you could implement changes that will make a big difference. Just please do something, no matter how small. There are no downsides to improving your customer service and any money you spend on training or reporting will prove to be a wise investment when client numbers and average transaction values increase. We’ve long been told that you have to speculate to accumulate. The evidence shows that there can no longer be any speculation about the importance of the customer experience on your bottom line. So if you’re really serious about growing your business, it’s time to spend a little time and money getting it spot on at your practice. Because if you don’t, you can bet that there are others in your town who will. www.onswitch.co.uk

CPD SHARED

VPMA/SPVS Congress 2015

the best yet!

Over 470 delegates, of which most were either Practice Managers or Practice Owners attended the 3rd combined VPMA/SPVS Congress on 23 and 24 January at the Celtic Manor Resort in Newport, South Wales. Many practices brought several members of their teams and in total over 200 different practices were represented. Over two days, an impressive line-up of speakers from the UK and overseas and from inside and outside the veterinary profession offered insights into management, marketing and business for veterinary practice. Speakers from outside the industry included TV Presenter, Expedition Leader, Leadership Trainer and ex-Royal Marine, Monty Halls who opened Congress with an inspirational talk on the importance of pushing your own personal boundaries. Psychiatrist, broadcaster and journalist, Dr Max Pemberton presented a comprehensive and accessible guide to mental health problems for vets and managers. Celtic Manor’s own head of 5 Star Service Delivery, Michael Pagnotta, explained how they ensure all their staff operate to the same consistently high level of service provision and Ian McKelvie, CEO of top US Consultancy, Becauz, presented a number of high energy, interactive, leadership and management sessions. A debate on Friday evening, run along the lines of BBC’s Question Time, included Nick Stace, CEO of the RCVS and Mark Welch, Main Board Director and Operations Manager of Vets4Pets/Companion Care on the panel. Questions ranged from Out of Hours service provision to work life balance and how the profession might change as more woman move into ownership.

Congress sold out this year with a waiting list of both delegates and exhibitors. The following quotes from delighted delegates and exhibitors suggest that this event, where the practice team comes together, is now firmly positioned as one of the most popular in the UK veterinary calendar:

‘Great Lectures, lovely venue, opportunity to meet with business reps’ ‘The biggest problem was choosing between lecture streams with so much excellent and relevant content’ ‘Banquet on Friday night was absolutely brilliant!’ ‘For an exhibitor, there were high quality leads and a well targeted audience of decision makers’’ ‘No other Congress delivers this quality of delegates and intimacy all under one roof’ If you missed out this time, make sure you book early for next year as we expect to sell out again!

CPD SHARED

Review of (some of) the Client Journey stream VPMA/SPVS Congress 2015 Ian Wolstenholme If you were there, you will be very much aware of the great CPD programme at Congress in January. So much choice between client experiences, equine, leadership and management and health and wellbeing. I wish at times like these I was able to clone myself! I was asked to review the Client Journey sessions but did take one diversion – more of that later. It was my great delight to finally meet Paul Green from Vets Practice Growth UK who started the stream on the Friday morning and to chair his opening gambit relating to the very latest thinking in marketing. There were some shocks for the audience. Gone are the old “comfort blankets” of being safe if you provide clinical excellence, have an intact local reputation and delivered great service last year! New marketing is the here and now and the tactics you employ as a practice owner or manager have to be updated quickly and regularly. With a dramatic countdown Paul revealed the least efficient strategy around which many, if not most practices, base their marketing – hope! Given that there are predictions of there being a single dominant “national vet” by 2020, the question about what independent practices need to do to achieve growth to survive was asked: answer, get more clients, ethically get them to buy more often and get them to spend more. Some facts from this presentation: 89% of the population use the internet regularly. There are 1.1 billion websites active. There are 250,000 searches for vets in the UK per month with Google and Facebook being the most popular routes to search. Mass marketing is dead and Paul’s advice is to stop spending money on local print media adverts (except for this this publication! –Ed.) and radio campaigns right now. Alison Lambert is always a popular contributor of current data, vox pops and mystery shopping outcomes, but following Paul Green, her lecture was a chance to find out what key opinion leaders are, how they think and what they can do to boost (or damage) your practice. KOL’s include groomers, pet-sitters, kennels and catteries and many more and are often trusted by pet owners far more than vets! They rely on emotional bonds, and having just returned from another conference in the U.S., Alison played a video advertising a drink-drive campaign that used the human/animal bond. If you go to #friendsarewaiting, you’ll see that the vet profession has missed a golden opportunity! Pet health schemes continue to grow and sadly, I had to forsake Denplan’s Janet Hughes’ talk about their experiences in favour of dipping into the Leadership stream to listen to Michael Pagnotta who is the Head of Learning and Development for our hosts, the Celtic Manor Resort. This was a packed house and was almost like sitting in on a West End theatre show without music! The animated and dynamic Mr Pagnotta is a trained actor and one feels that there isn’t a customer-staff confrontation scenario that he hasn’t come across and dealt with. During his “show” he drew many parallels www.practicelife.biz z March/April 2015 z Practice Life

between the hospitality and veterinary arenas and planted many seeds in the minds of delegates about how to deliver superior service to clients, rather than what Michael describes as ‘airhead’, ‘by-thebook’ or indifferent service. With his acting skills, words became actions and he left his audience wanting more. Methinks if our congress returns to Celtic Manor next year, Michael will have to do an encore. Following his presentation, I chatted to him for Practice Life and you can hear our five minute feature by typing the link on page 43 into your browser. The final session of Friday’s schedule was a platform for Jacky Tidy with hints on winning the pet owners’ pound. Being unable to attend this (because I was recording with Michael Pagnotta) it was only whilst waiting for a colleague in the hotel corridor that I learned that Jacky was actually unable to attend and Alison Lambert was asked to deputise. Apparently, a clever combination of Jacky’s slides, Alison’s phone and a microphone, meant that, whilst not there in person, this double-act easily managed to ensure that no-one was disappointed. Technology wins again! Like many, an 8.50am start on Saturday “after the night before” is always a challenge! For Client Journey openers, it was difficult to see Brian Faulkner in any other light than jumping up and down to The Bogus Brothers! Fortunately he was “static” enough to present a great session entitled “Navigating the Bermuda Triangle”. This was all about that area of practice between the consult room door and reception and how often charging and opportunities are missed or lost. A lot of common sense information was relayed including getting your receptionist to help the vet by being as specific as possible on the diary with symptoms/reasons for the visit, rather than just writing “off form”! As I predicted a couple of years ago when I attended the SEVC in Spain, “recommendations” have not turned into “needs” in UK practices. I particularly liked Brian’s very useful phrase “This is what I would love to do, but I appreciate I’m asking you to pay for it”…..then shut up! Ever since I heard Joy Howell from Bayer talk about worms with so much passion several years ago, I have admired her wealth of nurse experience. Joy is a real advocate of vet nurse empowerment and in two lectures teamed up with Liz Panter and Bizzy Allen-McClure to discuss winning in the waiting room and making good use of your nurse team. 2015 is going to be a big year as via the Royal Charter, the recognition of VN’s as a profession and associates of the RCVS comes to fruition. It’s also the 50th Anniversary of the British Veterinary Nursing Association’s formation and Joy et al had tons of ideas to capitalise on nurse-led clinics, what they can do to take some pressure off vets and to really raise the face of the modern RVN and student team. Too often, ignorance of nurse skills by other practice members is a barrier and as a start, Joy suggested a job-swap day so that a receptionist or a vet follows a nurse around the practice to become familiar with their duties. This has had a positive effect in many practices and resulted in reception booking appointments for nurses with a far better perspective and even vets referring clients to their nurses.

CPD SHARED

My own practice has recently moved into new premises and during the planning stage, we were fortunate to work to an almost blank canvas. This meant that, amongst many other considerations, we could implement several of the suggestions and recommendations of the International Society of Feline Medicine (ISFM) when thinking about cats and their owners. That said, in our old practice, we did what we could to make it as comfortable and stress-free for felines. This was the point of a presentation by Martha Cannon from the Oxford Cat Clinic, backed up with videos of needs and demands from some cat owners from Onswitch. If you have a spare moment, Martha suggested a look at the Bayer Veterinary Usage Study of 2011. Key take home points from the

lecture: no scruff, no stress, respect me and my cat, give me some space and take time, be patient and handle cats gently. Even the most compact of reception areas can be divided in such a way as to separate dogs and cats or if all else fails, sensible diary booking by reception. So that is a whistle-stop tour of just one stream from Congress this year. Due to travel arrangements I was unable to stay until the bitter end and lectures sadly overlooked included Facebook and the Client, Driving compliance digitally, Geriatric Pets and Client Care at End of Life. I do know that several of the speakers from across the two days have made their presentations available on the VPMA-SPVS Events websites and certainly are worth reviewing if you have the chance.

Early Birds Catch Breakfast and So Much More! VPMA-SPVS Congress delegates really made the most of every valuable minute of CPD, attending early morning breakfast seminars held by Platinum sponsors Norbrook and Citation. A buffet style hot breakfast and lots of coffee certainly helped fuel Catherine Smith the discussions! On Friday the Norbrook Business Breakfast was facilitated by Alan Robinson of Vet Dynamics and made use of “the intelligence in the room” by debating common issues faced by the profession. The 40 delegates agreed on the top 3 issues for discussion with Alan handing “the sausage of cynicism” (a sausage on a fork) to the participant designated to challenge the group’s beliefs. This led to a lively and interactive debate considering the time of day! Covering topics such as recruitment, leadership and management in the workplace and work-life balance, the recurring theme was that what we know about and what we do in veterinary business is no longer aligned with

the modern world in which we practise. Many accepted that conventional business practices fail to provide clear solutions in a changing business and competitive environment. This no doubt adds significantly to the frustration and confusion of busy practice managers and owners. New ways of working are needed and this relies on significant changes in the way we think about business and engage and train our staff. On Saturday morning, the Citation Breakfast Seminar gave delegates the opportunity to learn more about the new Department of Work & Pensions (DWP) “Fit to Work” scheme that will start regional roll out in the spring and should be completed by May 2015. The general consensus of the early risers was that this would be a helpful scheme, as those employees who have reached or are expected to reach four weeks of sickness absence, will be referred for an occupational health assessment. This expert advice from Nigel Lea and Catherine Smith from Citation led to discussions about issues surrounding sickness absence in practice. The take home message was to ensure that all absence is documented and that all practice systems and policies are up to date and fit for purpose – we were told on average that Citation find 28 issues in every practice policy when they look into them!

Geriatric Pets

Doing the best for the patient, the owner and your business... Mike Davies BVetMed CertVR CertSAO FRCVS, sponsored by Norbrook, spoke on geriatric pet care during this year’s VPMA/ SPVS congress. The 50 minute lecture covered not only why you should offer a geriatric clinic but also gave tips on how a clinic should be run. While there is no standard terminology or defined age at which pets become senior, based on tissue changes, 7 + seems to be the norm. Some of these tissue changes may be visible, with impaired physical activity and altered behaviour but what about the invisible internal changes? Although ageing is inevitable, this doesn’t mean it should be treated any less seriously than any other illness or disease. The clinical objectives of a geriatric clinic are for early detection (therefore allowing early intervention) of diseases or disease processes aimed at increasing quality and longevity of life. With

that in mind, geriatric clinics are not only best-practice in the management of elderly patients but they give added-value service for clients, reinforcing the client-practice bond. What is the demand for these types of clinics? In a Provet On-line survey asking “How often should old dogs be screened to detect diseases early?”, 41% answered every 6 months and 46% answering annually. What was most interesting was that only 3% answered never, so “the clients wouldn’t want it” opinion of a lot of vets seems to be unfounded. Tips on running geriatric clinics included starting with sending out mailings to eligible pets on the practice database offering specific geriatric appointments. During the examination, it was advised to start with a clean sheet of paper so as not to let prior notes cloud your judgement. Ask the client open questions Practice Life z March/April 2015 z www.practicelife.biz

CPD SHARED

FIVE MINUTES... With Michael Pagnotta, Head of Learning and Development at Celtic Manor Resort talking to Ian Wolstenholme IW: What parallels can be drawn between providing great customer service in hotels and veterinary practice? MP: I think the first thing to be aware of is whether you’re in a hotel, a restaurant or a veterinary practice, the desired outcome is always the same: you’re trying to achieve a very content and satisfied customer journey. Whether you are signing in a client or checking in a hotel guest, at the end of the day, the way you greet that customer and the rapport you build doesn’t change regardless of the profession you are in. IW: How do you train your staff to achieve five star customer service here at Celtic Manor? MP: It’s a combination of things. As I mentioned in one of the slides I use the ACTORS acronym. Staff have got to be approachable, make eye contact and be confident. You cannot be in a customer facing role if you don’t love serving people. They have to be trained and take ownership of a problem or complaint. No customer wants the buck passed – they want someone who will deal with it. Respect. People are people and should be treated with respect and dignity and lastly, of course, have a self awareness of yourself. IW: It’s not what you say but how you say it. Should veterinarians have acting lessons? I only ask because someone once said that a clinical consultation is like a small piece of theatre. What are your thoughts Michael? MP: Acting lessons? Yes definitely! You’ve got to remember that you are dealing with clients who are emotionally attached to pets so it’s not just a case of solving the problem. It’s about keeping

Mike Davies

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that customer happy and that means engagement and building rapport and you can only do that well when you yourself know how you come across to people. I think acting does that because it makes you face your demons! IW: You are responsible for a fairly heady team of employees here at Celtic Manor. Again I suspect that there may be some similarities between hospitality and clinical practice. You employ staff from different backgrounds and cultures with a range of language abilities and capabilities. How do you ensure that everyone delivers constant and equal styles of customer service? MP: It is difficult and we discussed this at several management meetings when I came here. True we are dealing with clientele from all walks of life and we respect that. But when you’re the employee and you’re working within our business, you have to adopt our internal culture. That means what you do outside in your time is fine, how you speak to people, what you believe in etc. In the resort it is important that you adhere to the superior service rules of respecting the customer, keeping your own opinions outside if you really want to succeed in this customer-facing role.

If you wish to hear the full interview with Michael Pagnotta, just type the link http://1drv.ms/1wy9TBV into your browser.

(not yes or no answers) to find out as much of what is happening in the pet’s life and routine as possible. Even a cursory history and clinical examination cannot be achieved in less than 30 minutes and certainly this type of consult cannot be adequately completed at the time of a typical booster vaccination. Allow plenty of time. The objective for geriatric screening is to identify evidence of likely age-related problems and gather base-line information that may be useful to the patient later on in life and this cannot be rushed. It will be a practice decision as to how to implement the clinics but they generally work best when they include Veterinary Nurse involvement in some way. Diagnostic screenings can include a variety of tests most commonly urine and blood tests and blood pressure monitoring (especially for cats). However you decide to run your geriatric clinic, it will not only be beneficial for your patients but will also will bring in extra revenue to the practice. Are you running geriatric clinics? Would you like to contribute to a future special feature on the topic? Contact us at editorial@practicelife.biz

CPD DIARY

Focus on Technology for Profitable Practice Wednesday 17 June 2015, Staverton Park, Daventry Whether you are a dinosaur or a technology whiz, you won’t want to miss our 2015 Focus on Technology for Profitable Practice. Think of it as your annual booster... the day you recharge your thinking on all things digital or technology-related. We know that you don’t want to spend too much time out of the practice, so this year we are widening our remit to include why, when and how to invest in diagnostic technology.

WORKSHOP HIGHLIGHTS USING TECHNOLOGY TO IMPROVE PROFITABILITY

COMMUNICATING WITH CLIENTS IN THE 21ST CENTURY

Making big toys pay! James Weston, Northwest MRI Find out how James on inheriting an MRI machine with his father’s practice, managed to take it from an occasionally-used expensive toy to a tool for a mini-referral service, sharing it with neighbouring practices, and having the results read overnight by an expert in Illinois. He describes the model and the marketing and considers how it might work for other top end diagnostic equipment.

Developing a Digital Marketing Plan Laurie May, Zoetis Take a walk through the digital landscape as your clients do. We will take a look at the customer journey online and how your website and social media delivers value and converts browsers into clients. From analysing data to assess how you perform online against your business objectives to looking at ways in which to improve conversions. Laurie from Zoetis, a qualified marketer, and head of digital marketing at TMLA will share with us some best practices.

Regenerative Medicine Stephen Barabas, VBS Direct Stem cells and Platelet Rich Plasma has opened a new field of medical science for treating patients in the 21st Century by medical and veterinary practitioners. This lecture aims at giving an overview for the veterinary practice of existing human and veterinary clinical studies surrounding regenerative medicine, the practical aspects of using these technologies for vets, and the financial cost to the pet owning client and rewards for the veterinary practice. DIY Benchmarking and Dashboards Alexander Arpino, Veterinary Insights plus case study vet Profitable practice needs proper benchmarking. If you are investing in equipment and training, you need to ensure we have a simple means of tracking the return on investment. Alexander Arpino describes Vet Viewer and how participating practices can compare themselves with others on a range of metrics and profitability. A practice owner will share his experience of using benchmarking to create dashboards as a means of monitoring a practice or individual vet’s financial performance.

Good Old Fashioned Email Susie Samuel, Vethelpdirect Sometimes in the rush to embrace the new, the ‘old’ gets ignored. Email marketing is widely accepted to have the highest return on investment of any marketing activity, but is often overlooked these days with new technologies grabbing all the attention. This session will cover technical aspects of email marketing such as building and curating your database, A-B testing, and a discussion of which platforms to use alongside case study examples of good and bad practice in email communication with clients. Smart phones and text messaging: are you hitting your targets? Johnnie Ingram, Vet Solutions When are pet owners most likely to use their mobile device? How often do they check them during the day? What’s the best way to reach older pet owners? Join Vet Solutions to test your knowledge about effective client communications, share your experiences with your peers and colleagues and learn about communications that will enhance the flow of clients through your door. Plus evidence-based tips on how best to use text to drive compliance and other promotions.

Practice Life z March/April 2015 z www.practicelife.biz

CPD DIARY