Practice Life Magazine 0913 by The Magazine Production Company

Sept/Oct 2013 www.practicelife.biz

the magazine of spvs and vpma

Vet

spvs

Veterinary Is your business in good financial health? What to check & tips for turnaround

Getting Client Feedback

In the Spotlight:

Best Practice

A practice shares its insights Diagnostics Day and 2014 Congress updates

When the Atmosphere Turns Toxic Dealing with difficult team members

The Long Game Strategic business planning for vets

We believe healthy finances are just as important as healthy patients

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The PPS Group relates to Professional Practice Services, our Business Consultancy and Independent Financial Advisory arm, and PPS GI, our specialist insurance brokerage. PPS Group is a trading name of Professional Practice Services which is authorised and regulated by The Financial Services Authority. PPS GI is an appointed representative of Professional Practice Services which is authorised and regulated by the Financial Services Authority. The Financial Services Authority does not regulate finance.

Editors’ Letters

elcome to the first edition of Practice Life Magazine, the new joint publication for SPVS and VPMA. I am extremely proud to have been involved in the development and production of this magazine. The SPVS Journal has been a source of useful articles as well as news items for many years and in our recent survey it was considered an important benefit by a fair proportion of the society’s members. However it was felt by Council that something more substantial, with an accessible archive of articles, would be even more valuable for practices. Having collaborated successfully with VPMA on CPD courses and congress it seemed a good idea to build on that relationship and create a joint magazine that would hopefully appeal to a wider audience. Knowing that this was my remit I took over as SPVS Editor in January with a degree

ello and welcome to this first issue of Practice Life. It’s great to be involved in this conjoining of our two longstanding publications. So why me as the VPMA editor? They do say that one willing volunteer is worth twenty pressed men! Back in the day I was a feature writer for some of the long-vanished keyboard music magazines titles. The mistake was mentioning this at a VPMA council meeting... and thus out came the short straw! In all seriousness though, this magazine will only work with a great team to oversee content and collaboration. You will see and immediately recognise some of the leading luminaries in practice management writing and their time and talents are valuable, but the one great change (and long overdue in my opinion) comes from you... yes

of trepidation but I needn’t have worried because the enthusiasm and motivation of the team involved in the project have made it an exciting experience and I hope that both SPVS and VPMA members will be as pleased with the result as we are. We wanted the publication genuinely to reflect life in veterinary practice and to appeal to the whole practice team. Hence a proportion of the contributions are from real people, working in real practices, prepared to share their experiences; I always find such articles interesting and am reassured that other people face similar day to day challenges. Hopefully you’ll feel the same and see Practice Life a helpful, supportive resource that you look forward to receiving and reading each quarter. Please let us know what you think of it. If you have any suggestions or requests for subjects that you’d like to see covered, do get in touch on steph@practicelife.biz.

Stephanie Writer-Davies, SPVS editor

YOU. If you play any part in trying to make your practice stand out from the crowd, Practice Life wants to draw on your knowledge, hints and tips on how you make it work. There is a wealth of experience amongst our readers and the challenges that practice managers, veterinary nurses and client care/reception staff face daily would make intriguing reading, yes, but more importantly, if shared, could provide reassurance that “you are not alone” in what can sometimes be an insular, solitary part of the profession. Don’t forget that you can digest PL on the go, via our digital version (www.practicelife.biz) and hope you will get in touch on ian@practicelife.biz to offer feedback so that we can start to shape Practice Life to maximum effect. In the words of that Steve Allen song “This could be the start of something big”...

Ian Wolstenholme, VPMA editor

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

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Contents g

UPDATE: News & Views 5

Stephanie Writer-Davies BVSc MRCVS steph@practicelife.biz

SPVS news

VPMA

Snowscene and salary survey news

Ian Wolstenholme, Practice Manager ian@practicelife.biz

Publisher

Meet your new regional organisers

Editors SPVS

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.

VPMA news

IN THE SPOTLIGHT

Liz Watkins from Watkins and Tasker shares her practice journey and insights g

college corner

Practice Standards Scheme update g

vds news

Bun in the oven g

well-being

How to be a happier vet – backed up by science g

managing people

When the atmosphere turns toxic g

client care and marketing

Getting client feedback: Best Practice g

business health and finance

Special feature: Is your business in good financial health? What to check & tips for turnaround g

practice development

Strategic business planning for vets g

cpd diary

SPVS/VPMA Congress 2014, Diagnostics Day © 2013 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.

and BVNA Management Stream g

what’s coming up

Events listing and a peek at what’s in the next issue

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

Practice Life z September 2013 z www.practicelife.biz

News & Views SPVS-VPMA Congress 2014 Early Bird Discount

Highly Qualified Overseas Graduates Want to Work in the UK

Don’t neglect to grab your congress registration at the early bird rate before 31st October! For an overview of congress see our write-up in this edition. You can book online now at www.vpma-spvs-events.co.uk/congress

Are Your Clients Using Accredited Retailers for Their Prescriptions?

All clients are entitled to request veterinary prescriptions, rather than purchase medicines from their pet’s veterinary practice, but how many of them know whether the online pharmacy they plan to use offers quality and value for money? The Veterinary Medicines Directorate (VMD) has been running an Accreditation Scheme for internet retailers of veterinary medicines since May 2012 and around 30 websites are now included in the scheme. VMD accreditation provides assurance that a website follows the correct procedures and protocols for selling veterinary

medicines via the internet, and that a fully qualified and registered Responsible Qualified Person (RQP) oversees the dispensing of all veterinary medicines. Just like registered Veterinary Practice Premises, Accredited Internet Retailers must undergo regular inspections by the VMD, to ensure that the veterinary medicines sold are sourced, stored and supplied correctly, thus reducing the risk of owners buying inappropriate or ineffective medicines for their pets. The VMD website includes an up-to-date list of Accredited websites [http://www. vmd.defra.gov.uk/InternetRetailers/ accredited-retailers.aspx] and a leaflet aimed at explaining the scheme to pet owners can also be downloaded from the site [http://www.vmd.defra.gov.uk/ pdf/leaflet_internetretailers.pdf], as can one entitled ‘Is this medicine safe for my pet?’ [http://www.vmd.defra.gov. uk/pdf/leaflet_pet.pdf], which further demystifies veterinary medicines.

A survey of this year’s Royal College of Veterinary Surgeon special registration ceremony for eight veterinary graduates from outside the UK, who passed the RCVS Statutory Examination for Membership, revealed that six already held postgraduate qualifications and seven had already practiced elsewhere since their initial graduation. Reasons given for wanting to become MsRCVS included: a love for London combined with a desire to work in the city; and optimism that having the prestigious letters MRCVS after one’s name would open up career opportunities worldwide. Perhaps that’s the real reason for the statistics showing overseas veterinary surgeons leaving the UK after gaining their membership of the Royal College – a desire to spread their wings still further, with a UK qualification that implies true expertise. These graduates, some of them highly specialised in one field in their home countries, have had to become omnicompetent all over again in order to join the Royal College of Veterinary Surgeons. At least one has already started working in the UK, and the confident smiles in the RCVS photograph [http:// www.rcvs.org.uk/news-and-events/news/presidentwelcomes-successful-membership-exam-candidates/] imply the others won’t be unemployed for long.

Online Animal Welfare CPD for the Whole Practice Team Back in May, the British Veterinary Association Animal Welfare Foundation held a highly informative Discussion Forum in London. Videos of all the sessions are now available online and are well worth watching. Of particular interest, not just to vets but to all who deal with the public and their pets, are the session on the links between animal and human abuse, as well as the series of role-plays relating to the welfare of ‘unowned’ animals. The former session was presented by former BVA president Dr Freda Scott-Park, who now chairs the Links Group, and explored ways in which veterinary practices, welfare organisations and the police can work together to help prevent related abuse cases from going undetected. The latter session looked at various scenarios veterinary surgeons might find themselves in when an animal is presented to them, but the owner either cannot be located, or is unable to cover the cost of prospective treatment. CPD to enjoy in your own time, in your own home, or during a practice CPD meeting: http://www.bva-awf.org.uk/videos/awf-discussion-forum

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news & Views

There’s still time to enter the PetSavers Annual Photography Competition

Free to enter, and with a theme of ‘Mischievous Pets’, the PetSavers Annual Photography Competition runs until 31 January 2014. Get a poster to promote the competition in your waiting room from www.petsavers.org.uk or by emailing e.sansom@bsava.com. Members of the practice team as well as clients can enter and the prizes consist of photography vouchers for the top three entries in the adult and junior categories as well as a photography book and DVD for the two overall winners.

Calling all BVNA Congress attendees! Look out for VPMA President Helen Sanderson and Regional Co-Ordinator Renay Rickard speaking on Friday 11th October at 10AM in the Management Stream

Managing appraisals and performance reviews Our lecture at BVNA Congress discusses the application of a simple and effective review programme that involves the whole practice team. We’ll look at ways to amend your current appraisal system and how to start one from scratch. We’ll also look at the use of solid induction processes, the use of job descriptions and team development. You’ll find out how to write your own “key performance criteria” for your team that will help to ensure you’re all working to a common goal. The aim is to identify not just where you would like to be as a practice – but how you are going to get there! Reviews are often dreaded, but this needn’t be the case. We show you how to engage your team into the process so that staff will look forward to the opportunity for a discussion. Training and development needs will be identified mutually with a clear action plan developed and regularly re-visited. We will be looking at how often the performance and development of a team member should be reassessed and the best person in the practice to do this.

Ever Reported a Suspected Adverse Reaction? How Easy Was It? Throughout August and September the Veterinary Medicines Directorate (VMD) are conducting an online survey of how quick and straightforward people find their systems when submitting a report. So, if any member of the practice team has ever reported a suspected adverse reaction to a veterinary medicine, now’s the time to give the VMD some feedback. The survey is at http://www. vmd.defra.gov.uk/limesurvey/index. php?sid=28316&lang=en with five easy-to-answer questions designed to improve the service in the future.

RCVS Regional Question Time to Visit Salisbury in October The next stop on the regular RCVS Regional Question Time tour of the UK is to be Salisbury in October, with the venue and date to be confirmed nearer the time. The meetings usually start with a buffet supper from 6.30pm, then proceed to the meeting itself at 7.15pm, during which veterinary surgeons, veterinary nurses, and other members of the practice team can question the RCVS panellists on a wide range of topics. Previous subjects have included Equine Passports, canine tail-docking, the Practice Standards Scheme and the role and status of veterinary nurses, with meetings generally finishing around 10pm. This is a valuable opportunity for all those within easy driving distance of the host town to quiz their regulators, so readers are advised to keep an eye out for further announcements by the RCVS.

Practice Life z September 2013 z www.practicelife.biz

SPVS News A few words from

SPVS President, Adi Nell

IMPORTANT NOTICE Society of Practising Veterinary Surgeons Annual General Meeting 2014 The SPVS AGM 2014 will be held on Saturday 1st February, at the Celtic Manor Resort, Nr Newport, Wales, immediately after the end of lectures, approx 5pm The election of Officers and Councillors will take place at the AGM and all SPVS members are invited to take part in these elections.

It’s been a very busy time for SPVS, working not just to enhance our membership benefits but also on behalf of the whole profession. Our Salary Survey has had a fantastic response and will provide a real benchmark for employers and employees, alike. The CPD sessions have been very well attended and our first Diagnostics Day, scheduled for October 15th in Daventry, is selling out fast. And that’s not to mention SPVS Congress 2014, to be held at Celtic Manor in partnership with VPMA, which will provide excellent CPD and also the really valuable networking and support opportunities that our members prize so highly. Where else can you go to interact with a few hundred practice owners and managers who share your joys and frustrations and all want to help each other? The debate with the RCVS on their proposed new Learned Society of Fellows generated great interest on the SPVS discussion list. Thanks must go to Jacqui Molyneux at the RCVS who responded to our concerns, but there are still a number of questions to be answered. SPVS will not give its support to this proposal unless it is satisfied that it does not represent mission creep by the College and that it is fit for purpose. The ideal solution might be to have a Learned Society wholly separate from the College, but many of the divisions (BSAVA, BCVA, BEVA, pig and poultry societies, zoo vet group, etc.) might feel that such a society encroaches on their own spheres of expertise. The RCVS Practice Standards scheme is under review and the new proposals are very close to the heart of all those who own and run practices. The College has put forward some very interesting ideas, but there is a concern that the process is being rushed. Once again, SPVS will only endorse any new scheme if it feels it will genuinely be a step forward for the profession and workable for practices. That might mean it takes a little longer to finalise, but I’m sure that’s what our members would expect us to do and the SPVS representative on the Practice Standards Group, Anna Judson, is making sure that the views of the society’s members are heard and taken into account. Finally, congratulations to Steph, Ian, Libby and the team for putting this journal together. I’m sure it’ll be a valuable resource to practice owners and managers everywhere.

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Nominations for Councillors and Officers need to be received in writing, duly proposed and seconded 15 days before the AGM, Friday 17th January. Such nominations should contain the signature of the nominees and their proposers and seconders. All proposers and seconders must be members of the Society.

SPVS Dates For Your Diary

2013

October 9th – ‘Preparing for Business Partnership’ – day course in Gatwick October 15th – ‘Focus on Diagnostics’ – day course in Solihull October 24th – ‘Reception Training’ – day course in Birmingham November 20th & 21st – London Vet Show – SPVS and VPMA will have a stand – come and visit for details about Congress as well as other CPD courses and membership enquiries December 9th & 10th – Officers’ and Council Meetings – if members would like to raise any points please get in touch with the Hon Secretary, Tom Flynn via the SPVS Office December 10th – Christmas Dinner Royal Thames Yacht Club, Knightsbridge Tuesday 10th December. To book a place please contact the SPVS Office

2014 Jan 30th – Feb 1st – SPVS & VPMA Joint Congress Celtic Manor Resort, Newport, Wales Mar 15th – 22nd – Snowscene in Lech, Austria May 30th – June 6th – Scubascene in the Red Sea

spvs news

Snowscene 2013 Stephanie Writer-Davies reports on a week of Spring skiing, Neurology and Psychology in Italy SPVS Snowscene 2013 took place in Sestriere at the Hotel Roseo and was the usual mix of good accommodation, great food, wonderful skiing, excellent CPD and friendly sociable atmosphere that regular delegates on these trips have come to expect.

he early Sunday morning flights from the UK felt somewhat antisocial and some of us were rather bleary eyed as we checked in at Gatwick and Manchester. However the advantage was that we arrived at the hotel about lunchtime which allowed plenty of time for everyone to settle in and make use of the leisure facilities or arrange ski and boot hire during the afternoon before a welcome drink in the bar and our first experience of the extensive buffet supper that we were treated to each night. The following day the keen skiers in the party were in the dining room early, enjoying the huge breakfast available before lectures which meant we could get out on the slopes as soon as the morning talk finished. There were 15 hours of CPD in all and the sessions started on Monday; 1 hour from 8-9am and then 2 hours from 5.30-7.30pm with the same schedule being followed all week. The presentations by Brian Faulkner, BSc (Hons), BVM&S, MBA, MSc (Psych), GPCert(SAM), GP Cert(B&PS), MRCVS and Rita Gonclaves, DVM, Dip ECVN, MVM, FHEA, MRCVS, European Recognised Specialist in Veterinary Neurology were excellent and both speakers were entertaining and engaging. Brian explained how psychology is relevant to veterinary practice, covering subjects such as the Psychology of

Persuasion, Personality Types, Emotional Intelligence and the Psychology of Confidence and it was apparent that this particular aspect of Psychology could easily be applied to skiing! He also introduced us to his idea of the Colourful Consultation which showed us the skills needed to make all our consulting sessions go smoothly with positive clinical, personal and financial outcomes resulting in happy clients and a happy practice team – the ‘Triple Bottom Line’ idea of Patients, People and Profit. In the same way that ski instructors make skiing look and sound so easy to master, Rita persuaded the delegates how easy neurology can be! She reminded us how to perform a full neurological examination without needing any specialist equipment, talked about Neurological Malformations, Spinal Disease, Vestibular Disease and Neurological emergencies, giving plenty of practical hints and tips and explaining how a logical approach results in lesion localisation making treatment decisions easier. At the end of her sessions we had all been inspired to go out and buy MRI scanners and to consider gabapentin a wonderful drug. On Thursday evening we had an unexpected additional session when Brian’s son, Seth, celebrated his 7th birthday by challenging us all to ‘Name that Flag’. It seems that he developed an interest in flags during the Olympics and

Clear skies made for a happy group setting off

A well earned rest in a mountain cafe

“Snowscene is a really good way to combine quality CPD with the opportunity to ski, and talk about issues with like-minded colleagues.”

Practice Life z September 2013 z www.practicelife.biz

SPVS News

now knows the flags of the majority of the world’s countries, even obscure ones. Apparently not at all intimidated by standing at the front of a room of about 50 people, Seth got 20/20 flags randomly selected from a bank of 200 correct and won convincingly. The audience, getting only 2/20 correct, was suitably impressed by his skill though several of us wondered if there was a living in it! The skiing was wonderful; as is usually the case on any ski holiday, there were varying weather reports and going to bed on the first night, with the snow still falling, we were expecting to wake to the same conditions. However Monday morning broke with glorious sunshine which continued for the first three days. We were able to make the most of the extensive ski area that Sestriere is connected to, including skiing to France and back (a great day only marred by the dearth of mountain restaurants on the French side which saw the group I skied with missing lunch and arriving back at the hotel starving – a good excuse to indulge in the cakes and hot chocolate provided as apres ski refreshment though!) On Thursday it snowed again covering the skied-off areas ready for clear skies which returned on Friday. Saturday began with snow falling, low cloud and poor light but, being our last day on the slopes it just wouldn’t have been right not to try to ski so we set off again and were rewarded for our efforts; the light and cloud conditions improved and the snow was perfect. It was a great day and a fitting end to the week which was rounded off with an impromptu closing ceremony in the hotel bar just before supper, when both speakers were presented with small tokens of everyone’s appreciation for their lectures and in Brian’s case, www.practicelife.biz z September 2013 z Practice Life

The author Steph with Jim Cumming and Kevin and Jenny Walton

acting as the group leader and making sure everything had run smoothly. SPVS Snowscene is a really good way to combine quality CPD with the opportunity to ski as well as talk about issues of veterinary life with like-minded colleagues. It is a friendly week and regular attendees make sure that newcomers are made welcome. 2014 Snowscene is taking place in the Hotel Kirstberg, Lech, Austria from March 15th to 22nd. Contact SPVS Secretariat on 01926 410454 or e-mail office@spvs.org.uk for more details or to book.

spvs news

Antimicrobial resistance and European Antibiotic Awareness Day The European Antibiotic Awareness Day (EAAD) is an annual European public health initiative that takes place on the 18th November to raise awareness about the threat to public health of antibiotic resistance and prudent antibiotic use.

SPVS Surveys Valuable Tools, Not Just For Our Members

There is no doubt that the use and misuse of antibiotics in human and veterinary medicine has led to a relentless rise in the number and type of resistant microorganisms we face. The first EAAD was held in 2008 and since then has primarily focussed on human health and has developed a website (http://ecdc.europa.eu/en/eaad/Pages/Home.aspx) dedicated to providing information for public health authorities, health care professionals and the general public. Attention is now moving to the animal health sector and all of the veterinary organisations have been asked to contribute to the work of spreading awareness of the issues. It is important for the veterinary profession to be proactive and play our part in this. We can promote best practice and better animal health management in reducing the need for antimicrobials by further educating ourselves, our staff and our clients about the crucial importance of the responsible use of antibiotics. The number of information resources available to veterinary practitioners is steadily increasing: BVA have produced guidelines on responsible use of antimicrobials (www.bva.co.uk/public/documents/BVA_ Antimicrobials_Poster.PDF) BSAVA have introduced their Protect initiative on the small animal side (www.bsava.com/Advice/PROTECT/tabid/1665/ Default.aspx) BEVA have also developed detailed equine based guidance (www.beva.org.uk/useful-info/Vets/Guidance/AMR) Many other divisions are working to update and expand existing guidelines and to introduce new ones. The overriding message is that antimicrobial resistance is a shared problem and owners, individual vets, nurses, practices, representative organisations, industry and governments will need to work together to find the solutions.

is its active enthusiastic The life blood of SPVS Council stand for Council or members. Would you like to February 2014 election? nominate a colleague for the terms of three years Council members are elected for and are expected to: cil whole day meetings ttend each of the three main coun •A which are usually held in London develop SPVS policy ontribute to the discussions and help •C • Participate in SPVS projects een meetings to • Contribute to e-mail discussion betw projects help in the development of ideas and and other documents • Provide comment on consultations interested in joining Council If you are an SPVS member and y Tom Flynn via the etar please contact Honorary Secr pvs.org.uk) for a job e@s offic SPVS office (01926 410454, t is involved. wha of ils description and further deta

As the honorary PRO for SPVS, Peter Brown’s role includes having an overview of all the marketing and publicity as well as dealing with requests for information, both from within and outside the profession. SPVS works closely with the BVA and often co-ordinates its response to major issues alongside them; however the society is also approached in its own right, not least because of the information contained in the association’s annual surveys. Peter works hard alongside the secretariat, to circulate and encourage response for the survey questionnaires, before finally analysing and publishing the results. As an example, the society was recently approached by a journalist at the Daily Mail who was running a story on a pet owner whose insurer had refused to pay out for her pet’s treatment. According to the paper, insurers had claimed that vets fees were rising at 12% per annum, but Peter was able to quote figures from the SPVS Fees Survey to give a more balanced view. A similar theme was taken up by the BBC’s Rip Off Britain, who approached both SPVS and the BVA. This time Peter was able to work with the BVA, sharing the data from the SPVS Fees and Salaries Surveys to help them deal with the query. Peter commented that as PRO he finds it exciting to see that SPVS is continuing to evolve to meet the needs of practitioners and reflect, through its Council and activities, the changing demographics of the veterinary profession. He said ‘We are a smaller society, but whilst we may lack the clout of some of our sister organisations, I think it gives us a unique position where anyone who is interested in the workings of a veterinary practice, be it as an owner/manager, a director or an interested employee, can come and find something useful in a friendly and supportive environment, and I hope I can help to communicate that’. Practice Life z September 2013 z www.practicelife.biz

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A few words from

VPMA President,

Helen Sanderson

Dear Members, I am so delighted to be welcoming you to the first issue of our new magazine “Practice Life”. We had our first discussion with SPVS regarding running a joint magazine at our Congress back in January so I am delighted that it has come to fruition. I would like to thank everyone who worked so hard to make it happen, especially the editors Ian Wolstenholme for VPMA and Steph Writer-Davies for SPVS. We are aware that there are lots of management magazines out there but we hope you find “Practice Life” a little bit different with articles of interest for all the members of your team and lots of real life scenarios and advice for you. Do let us know what you think of it. As president this is a busy time of the year with lots of congresses to attend including BEVA, SEVC, BCVA, BVNA and of course the London Vet Show with BVA Congress, and you’ll find my reports on these in the next few issues. Don’t forget to keep the last weekend in January free to attend our own congress at the exclusive Celtic Manor Resort in Newport. We have secured some exciting speakers and I am especially delighted to be running our first ever Equine Management Stream (more details can be found inside) so book early to avoid disappointment!

VPMA News Are you interested In becoming a VPMA Council Member? We’d love to welcome you onto council to help drive the association forward with us. We’re particularly looking for people with financial and administrative skills. If you’d like to help out, please contact the Secretariat on 07000 782324.

BVA News for Practice Managers Sarah Hibbert is the VPMA representative on BVA Council Our BVA affiliation is a great way for members to keep up to date with key issues affecting the veterinary profession today. Some interesting information from the recent meetings includes the launch of the Free Range Poultry Poster from the Animal Welfare Foundation. This newly updated popular poster is designed to assist vets in identifying diseases in freerange birds such as exhibition chickens, hens, ducks, geese, turkeys, ornamental waterfowl, quail, ornamental pheasants, guinea fowl and peacocks. Intended for use as a quick reference guide, the easy to follow format lists the common problems and diseases by species and age. It lists details of disease signs, symptoms and causes and offers advice on prevention. This new edition also contains brief bio-security guidelines. It can be downloaded from the following link or printed direct onto A3 paper and displayed as a poster in your practice. www.bva-awf.org.uk/advice-vets/free-range-poultrydiseases-0 At the last meeting the issue of posting samples through Royal Mail was also raised and it is worth practices being aware that the regulations on this have been revised. It is now only permissible to send blood or urine samples of a maximum volume of 50ml or mass of 50g. In addition the sample must be safely packaged in accordance with Royal Mail packing instruction 650 or by using their Safebox. Further details can be found on the following link under biological substances: www.royalmail.com/business/help-and-support/tell-meabout-restricted-goods

Best wishes Helen Sanderson VPMA President

Practice Life z September 2013 z www.practicelife.biz

vpma news

meet Your regional organisers

Update from

Regional Co-ordinator,

Renay Rickard

If you are not in touch with your local regional group and would like to get more involved, please contact the VPMA Secretariat. Yvonne Shaw Central Scotland Tel: 0787 925 4399 ro1@vpma.co.uk Gillian Kidd Scotland Tel: 01408 622217 ro2@vpma.co.uk

Welcome to the first Regional News bulletin in your new magazine. For those that don’t know me, I am the practice manager of a 13 vet mixed practice in mid Cornwall. I also work for Duchy College in Cornwall as part of the Veterinary Nursing team as a course moderator and clinical coach trainer. I feel passionate about my role as Regional Co-ordinator for the VPMA. The VPMA regions are an important part of association’s development. They help ensure that the membership is represented and grown at a local level. We want to bring networking opportunities and CPD to all members (and non-members) across the whole of the UK. We try to promote VPMA and organise meetings at least twice a year, the size of which range from small informal gatherings for networking and supporting each other, to larger CPD events. Please feel free to contact me about issues you’d like to discuss at regional level. If you want to get involved in organising and cohosting regional meetings, we’d love to hear from you too. We particularly need help in Yorkshire and London. You can meet a few of our new regional organisers in this issue. Our thanks to all the RO’s for their continuing help and support!

Pauline Graham Cumbria Tel: 07803 228720 ro3@vpma.co.uk Denise Whitham Herts/Beds/Northants Tel: 07837 058155 ro4@vpma.co.uk

Yvonne Shaw I began my career in the veterinary industry in 1997, becoming a Registered Veterinary Nurse in 2003. In 2009 I had the opportunity and support to combine my veterinary skills with the role of Practice Manager within a busy small animal veterinary practice based in Glasgow. I thrive on teamwork, motivating and supporting others and I feel privileged to have worked with some incredible veterinary surgeons and inspirational veterinary nurses. I am very keen to broaden my links with other practice managers, highlighting the advantages of networking to help us develop our practices and share our insights.

Cath Grimsey East Anglia ro6@vpma.co.uk

Denise Whitham My career in veterinary practice started as a part time receptionist with the Icknield Veterinary Group in 1994, working my way up to become Practice Manager of our multi-branch practice 4 years ago. I joined the VPMA when I first became Practice Manager, as it offered a support network and much needed guidance.

Rita Dingwall East Sussex Tel: 01435 866058 ro9@vpma.co.uk

As Regional Organiser, I’m looking forward to being able to host meetings for other managers, with the aim of discussing and sharing solutions to the challenges we all face in our day-to-day roles.

Melvyn Wilkins Gloucestershire/South Wales Tel: 07887 895274 ro5@vpma.co.uk

Helen Sanderson Oxfordshire/Wiltshire/Berkshire Tel: 07765 338607 ro13@vpma.co.uk Claire Bake Co. Durham Tel: 01388 602707 ro16@vpma.co.uk Susan Lunn Stoke on Trent/South Staffordshire Tel: 01543 424100 ro17@vpma.co.uk Julie Beacham Buckinghamshire Tel: 07710 317310 ro18@vpma.co.uk Suzanne Headington South West Tel: 01242 680000 ro20@vpma.co.uk Renay Rickard Cornwall/Devon Tel: 01208 872254 ro21@vpma.co.uk

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Cath Grimsey I’m the Practice Manager at newly opened Johnson and Scott Veterinary Practice near Ely, Cambridgeshire. The industry has evolved since my last practice management role and l see the opportunity to become Regional Organiser as immensely positive both in terms of injecting new enthusiasm into VPMA participation with some engaging and informative meetings, and of widening my own knowledge and experiences through some friendly networking events. Suzanne Headington I have been working with veterinary practices since 2005 and have experience in dealing with a wide range of business advisory, tax and accounts matters through my role as Senior Manager at Hazlewoods as well as being a VPMA member. My aim as a regional organiser is to provide the opportunity for members and nonmembers to get together and to look at exciting and informative topics which will help veterinary practices on a day to day basis. and I also ride and play water polo!

vpma news

Upcoming Regional Meetings Central Scotland Tuesday 1st October 2013 at Airdrie Golf Club ‘Leadership & Management’ Speaker: Nick Steele National Consulting Manager Zoetis’ Vet Support+. Sponsor: Vetshare Attendees are invited to take part in a round of Golf in the morning! For more information speak to Yvonne on ro1@vpma.co.uk

Oxfordshire, Wiltshire & Berkshire Tuesday 1st October 2013 in Hungerford, hosted by VPMA President, Helen Sanderson ‘Equine Management: Coping with change’ (Dr Batson); ‘Are you missing out on cash in your practice?’ (Hazlewoods) Followed by networking session.

Notices CVPM Information and Exam Preparation Workshop Saturday 19th October 2013 in Aylesbury In light of the changes to this year’s Certificate in Veterinary Practice Management (CVPM) entry criteria and examination process, the VPMA’s Certification & Training Committee are holding a free information and examination preparation workshop at Wendover Heights Veterinary Centre in Tring Aylesbury. 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 presentations 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 on the 29th 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 and join us for a couple of hours starting at 10am. Please register your attendance before: Friday 11th October 2013 by email to secretariat@vpma.co.uk

Speaker: Hazlewoods LLP and Dr Emma Batson, Merial Animal Health For more details see www.vpma.co.uk/education/cpd-events

VPMA AGM Thursday 30th January 2014 5pm Celtic Manor Resort More details in the December issue

Practice Standards Scheme: Call for Managers’ Input Carole Clarke (Past President) is currently the VPMA representative on Practice Standards Group The RCVS Practice Scheme is currently under review with a new format to the scheme proposed for 2015. The Practice Standards Group (PSG) agrees the changes before they are approved by RCVS, and it is made up of representative of a number of veterinary associations including the VPMA. The new scheme is being broadened to include ambulatory and referral practices and will concentrate much more on behaviours, using the Plan – act – do – review (Deming) model used by other awarding organisations such as Investors in People. This will be in addition to checking facilities, services and legal and professional compliance. An improved IT system with uploading of relevant documents prior to inspection is also proposed. A modular structure is envisaged with the opportunity for general practices to opt for additional accreditation to bronze, silver and gold levels via optional standards. Setting these will be a challenging task which is under way now. The RCVS has appointed a project manager to drive the development and consultation.

It is hoped that the new draft modules will be written by the end of October 2013, discussed by PSG and put out for consultation between November and March 2014. Following review, the full consultation will be opened in the autumn of 2014. Assuming the new scheme is approved and adopted, inspectors will need to be retrained in the changed assessment criteria and a pilot of the new scheme will be run. This is a very tight schedule, and the level of change is ambitious, particularly with so many people involved, but your views and input are paramount if we are to obtain a set of standards that practices and their clients want. I represent VPMA on the PSG group and will be working hard to ensure that any changes are kept simple, achievable and relevant to practice. As managers, we often have to do the preparation and support work for practice standards, and it is vital that it is a useful management tool, rather than a burden. We will be involving several members of VPMA in the process and your comments are welcome at any time. If you want to be more involved you can contact me by email or by phone through the secretariat. carole@millhousevets.co.uk

Practice Life z September 2013 z www.practicelife.biz

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in the spotlight

‘In the spotlight’ takes an in-depth look a particular practice, discussing what, in the eyes of its key staff helps it to excel. This issue Liz Watkins, partner at Watkins and Tasker Vets in Bristol, and founder of Chunk Training shares her practice journey and insights with us.

in the Liz, you took over the practice in 1990 and have grown it to a 3 branch group. Tell us a little about that journey. I’d worked for several years in the practice before I bought it. It was fairly low tech – as an assistant I bought our first anaesthetic machine as I was fed up with our bitch spays going home still asleep (who remembers the days of Sagatal anaesthesia?) The farm work gradually declined, and we became entirely small animal in 1997. Welcoming Steve Tasker as a partner to the practice was a turning point too. With the enthusiasm of a new face, we gradually improved the whole practice’s equipment, systems and reputation, growing to 5 vets – no mean feat in a rural practice. Several years ago, we started working with a business advisor, Gregory Haddock, who finalised the transition of the practice to a proper business footing. What has been your biggest success and what would you do differently if you started anew? Our biggest success undoubtedly came from examining everything from the client’s viewpoint, and changing our systems, marketing and staff training accordingly. This happened after I was invited to a meeting billed as a ‘marketing boot camp’, run by Gregory (above). I went out of curiosity, and it was my first step on a long journey of discovery of the whole new discipline of business studies,

a world which was never touched upon in my days at Vet School. My one regret is that I came to this discovery late. The practice was stable, it gave me a lifestyle I considered reasonable, and I never gave much thought to business matters. For 20 years, I considered myself a vet, not a business woman. As the market became more competitive, my relaxed attitude was no longer enough keep up with the game. I now take the role of business manager in the practice, and still read widely and study regularly to keep myself energised and enthusiastic, while doing at least 3 clinical days a week. As a woman, do you think it’s been harder to build your build your business alongside your family commitments? What advice would you give to a female vet on the threshold of practice ownership worried about juggling family and career? Gosh, that’s a difficult one. I was lucky – school was opposite the surgery, home was half a mile away, and my children grew up very self-sufficient. I had a staff member who was both vet nurse and nanny, and still works for me 20 years on – though she no longer comes to work in her motorbike leathers! I wouldn’t presume to advise others in my situation – it’s no longer acceptable to set up a cot in the office, or bundle children and duvets into the back of the car to

go and do a cow caesarean at night! By current standards we were so informal, but it was great fun, and we accepted it as normal. I think it must be much more difficult now. The practice has RCVS Accreditation. Has this benefitted you and how? I’m not sure how much effect it has on the public directly. But it forces you to run a tight ship and has many indirect benefits. We run all 3 branches to GP (General Practice) standard. You place a big emphasis on having a large part of your team as Qualified VNs. What does this bring to your practice? The public now expect such a high standard of advice, and expect to get it from the staff member who answers the phone, or sees them at reception. And our nurses ease the workload of the vets. Nurse clinics are a successful and fast growing part of our practice. You do your own out of hours (OOH) service with a 5-vet team. What are the advantages and the challenges of this? We used to be a part of a co-operative OOH service, but found it frustrating: we know our own clients and their needs, and they know us. We can all get into the PMS (Practice Management System) from home, so we can give clear and informed phone advice. Many OOH

Practice Life z September 2013 z www.practicelife.biz

in the spotlight

calls are highly emotive and the last thing clients want is to be dealing with a stranger. If you ask our staff, they are united in their opinion: they all find it a hassle to have to be part of the OOH rota, but they are all proud to be part of a practice that preaches personal care for our clients, and practises what it preaches. Tell us a little about your staff selection process. Do you look for skills or personality? Of course we look at both. We take a lot of work experience students, and we often select from this group as we’ve worked with them and know them well. For more qualified staff, my philosophy is that they need the basic skills for the job, but beyond that, a positive and mature attitude, a smiley face, and a flexible, helpful outlook is paramount. The success of a staff member is one third knowledge and two thirds personality. We always invite staff to work for us for a day or two before starting employment so that we can test each other out.

Liz is still hands on with clinical work as well as management

How important is team communication? Any tips you’d like to share? Don’t start me on that one! You can never get communication to be perfect, but we constantly strive to improve. We have one-to-one meetings for each staff member every 8 weeks to allow everyone to have a voice, and whole practice meetings every 4 months, when we close the practice for an afternoon (except for emergencies of course). We also have a series of online presentations to disseminate our basic policies and information – but more of that later.

sure that all staff have access to the same information, and are able both to inform and to wow our clients.

Effective client communication is a key part of your practice ethos. How do you achieve this? In several ways – we have policies covering our non-verbal client communication, including monthly e-mail newsletters, information screens in our waiting rooms, new client packs, and Facebook. We discuss communication at practice meetings – Steve and I have been known to give demonstrations by playing at being ‘client’ and ‘receptionist’. The staff seem to enjoy watching us make fools of ourselves! More recently, I’ve created training modules to make

You’ve recently set up Chunk Training to help other practices with their client skills. What was the driver with this? This grew out of the need to train our staff. Now that we have about 25 employees, training each and every one of them to the same standards becomes very difficult, especially for part timers. While we still value face to face training, we now have a library of on-line training modules. This really comes into its own when we have a new staff member. It seemed such a valuable resource, and so easily distributed, that I created Chunk Training to introduce the

Liz volunteering at the Olympics last year with one of the modern pentathlon horses

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system to other practices. Short training modules (15-20 mins) are distributed on-line at fortnightly intervals, and managers can be kept in touch with the trainee’s attendance, assessment scores and comments. It helps those who rarely do CPD, such as animal care assistants, kennel staff etc., to get in the swing of regular training. I make the modules as fun as possible. In my practice, all the staff undertake them, even the vets. We cover everything from worming protocols to new client policies, to how to collect payment successfully. This way, all the staff give the same advice in the same situation – something clients find reassuring. Chunk Training can be found on www.chunktraining.co.uk

In the spotlight

in the

From scary to sublime!

How Watkins & Tasker help dogs overcome their fear of visiting the vets Michelle Cox RVN NCert(AnBeh)

Michelle has been nursing for 8 years, gaining a nurse certificate in animal behaviour in 2010. She is also currently studying with the Cambridge Institute of Dog Training and Behaviour towards a BA Hons degree. In her little bit of spare time she breeds working Labradors and gundog trains them, and tries to find time to walk her 6 labradors and collie!

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’ve been at Watkins and Tasker nearly a year now and have loved every minute. One of my first remits was to get the nursing clinics up and running, so I’ve dedicated most of my ‘free time’– if there is such a thing in practice! – to planning these out and getting them going. We’ve got 5 nurse clinics on the go now and they’re all doing very well. One of our most successful and my personal favourite is the socialising clinic. This is for those dogs that are particularly afraid of coming to the vets, and are aggressive or petrified in the clinic. We have a programme where they are introduced to the clinic, its staff and the surroundings in a gradual phased manner so that they slowly acclimatise to the experience and gain confidence. It’s a bit like CBT (Cognitive Behavioural Therapy) for dogs! During these visits we work up from just spending a minute or two in the reception area, to a short stay in the waiting room, and eventually to a visit of about half an hour. They get lots of fussing or gentle coaxing during these visits, but they’re kept to a limited period of time so they don’t feel overwhelmed. From there they’ll build up to a short peek into the vet’s consult room, and work towards being touched very lightly by the nurses and then the vets, eventually accepting touch all over their body and full examination. We’ve found it makes a big difference to these dogs. At the end of the programme they love coming in, and some are even known to run into our clinic to hide from something frightening them outside! Yes, it is time-consuming for us, but the rewards are huge. The dogs enjoy their trips, so the owner is relaxed and happy, and we develop a great relationship with them – they’re not going to go anywhere else for their treatment! We also run dental clinics, weight watchers clinics, puppy parties and juvenile check-ups where they come in once monthly for their first year from primary vaccination to first booster.

02/09/2013 11:47

Practice Life z September 2013 z www.practicelife.biz

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College Corner

Practice Standards Scheme – a change comin’ on Change. Bob Dylan sang about it, George Bernard Shaw considered progress impossible without it, and Churchill suggested that perfection could only be reached by regularly embracing it. A central tenet of the Practice Standards Scheme, ever since its launch back in 2005, has been that it will be continually reviewed and, where necessary, changed to keep pace with best veterinary practice. With review periods set at a realistic and manageable five-year interval, we are now approaching the third iteration of the Scheme, representing possibly the most significant changes so far.

other veterinary organisations, have now been tasked with drafting the details. • Recruitment and training of inspectors will be overhauled in line with the changes, increasing our investment in the inspectorate and, at the same time, increasing its accountability. • A new IT platform will help with the coordination and administration of documentation during the accreditation process, and hopefully be developed into a resource for providing help, information and advice.

Proposals adopted

Your feedback

The latest review started last autumn, when we sought your views on an initial concept note. Reponses from SPVS and VPMA, via representatives Anna Judson and Carole Clarke (respectively), were numerous and constructive and were fed into the Practice Standards Group’s discussions in January. More detailed proposals were then developed and put to a special meeting of Council and the Presidents of the main veterinary organisations in June, who gave the go ahead for the following main proposals: • Develop a modular framework for the Scheme • Focus more on behaviours and outcomes than facilities and equipment • Greater differentiation between practices, through bronze, silver and gold categories. There was also discussion about differentiation of Hospitals, sharing of equipment and facilities between premises and a new IT infrastructure to facilitate the accreditation process. In particular, Council felt strongly that, in allowing practices a pathway for improvement, it was important that raising standards should not mean veterinary care became unaffordable for average animal owners.

Working backwards from a planned launch of the revised Scheme in the spring of 2015, there will be three further opportunities to submit feedback on the changes. The draft modules will be available for comment over this coming winter; there will be a consultation on the entirety of the revised Scheme over the summer of 2014; and, a pilot stage will be run and evaluated during the winter of 2014/15. Feedback from VPMA and SPVS members during the first and third phases should be directed via Anna and Carole. So, whilst Churchill’s ‘perfection’ may remain rather more aspirational than attainable, we hope these planned changes, involving as much input from the profession as possible, will prove very much for the better, both for accredited/prospective members and their clients and patients.

Developing three main areas The Practice Standards Group met again at the beginning of August to discuss these proposals in more detail, focussing on three main areas: • The modular approach has been adopted and around 20 different modules will be drafted for consideration (see box), including, for the first time, separate areas like nursing, pain management and client experience. Six different working groups, comprising not only PSG members, but also additional representatives of the British Veterinary Association, its principal specialist divisions and

Draft modules for consideration Staff and management Client experience Clinical governance Outpatient care Premises Medical records Inpatient care Nursing Surgery Anaesthesia Dentistry Diagnostic imaging Laboratory & post mortem Business

Medicines Pain management Emergency and critical care Out of hours Government work General hospital Designated referral hospital* Infection control

*This module would be available in a number of different disciplines, such as orthopaedics, ophthalmology etc.

Practice Life z September 2013 z www.practicelife.biz

VDS News

vds news

Bun in the oven F

red winced, realising he had somehow contrived to put himself in pole position to see Mrs Precious in evening surgery. Her low practice popularity rating was based on the fact, she ‘showed rabbits’ and thereby supposed, she was placed several notches above the veterinary profession regarding all issues lagomorphic. Her propensity to be a tardy payer, invariably after considerable quibbling, did not help matters. Fred wearily called her through, but as she wittered on about how ‘Rosaline was feeling rather jaded having won the National last week and just needed a vitamin boost injection’ his mind wandered off to dream of the mouth-watering rabbit casseroles his mother used to make. A pause in Mrs Precious’s monologue rapidly brought him back down to Planet Earth. Sensing her expression indicated suspicion of his thought processes, he swiftly proceeded with the injection. Mrs Precious looked on in utter disbelief as he held Rosaline by the scruff and drawing herself up into full battle-axe mode, declared ‘how dare you handle one of my little babies like that’! She proceeded to reassure the nonplussed rabbit with a combination of noisy kisses and coos, but Fred, never long of fuse, finally snapped, as Mrs Precious’ previous payment history and insults flashed through his mind. Maintaining self-control, he suggested Mrs Precious should seek veterinary attention elsewhere, before retiring to the practice office for a quiet head pressing moment with the owner’s final rant that she would rather see the local gamekeeper than subject her beloved pets to Fred’s attention ever again ringing in his ears. A day or so later, having forgotten about the incident, apart from the occasional reminder from colleagues congratulating him for sacking such an awkward cove, a receptionist informed him the local practice had requested the notes. Fred chuckled to himself at the thought of the opposition having to deal with the owner’s peccadillos, but his mood darkened when he reviewed the history. There were numerous references to a general reluctance to pay and worse still, an uncomplimentary reference to Mrs Precious’ appearance, bearing a remarkable resemblance to her ‘babies’ right down to the hairy facial moles. Fred realised he could be in hot water and picked up the phone to the Society in a state of some panic. The consultant agreed that in an ideal world the clinical and financial records should be kept separately, so that a client’s history can be forwarded to a new practice without that information, and personal comments should be avoided at all cost. It is perfectly acceptable of course to record the fact that an owner declined a clinical procedure or referral on the grounds of cost, because this directly relates to clinical management and the animal’s welfare. However, entries to the effect that no further treatment is to be given until an outstanding account has been settled are certainly not a good idea, as it does give an aggrieved client grounds to claim that all succeeding veterinary services have www.practicelife.biz z September 2013 z Practice Life

been denied as a result, thereby encouraging RCVS interest. She was, however, able to reassure Fred with a common-sense way forward to keep all parties happy. Altering clinical records is a highly debatable course of action, of which members should be extremely wary, but she explained Fred could simply edit or redact any personal comments likely to inflame Mrs Precious, together with expunging any financial details which could potentially breach both the Data Protection Act and RCVS Code once released to the opposition, or even jeopardise the owner’s ability to gain veterinary attention elsewhere. However, she stressed a copy of the original records should always be preserved within the practice, with a note as to the date and time of the alteration inserted, together with a note of the reason for doing so. This would protect Fred in the event of a subsequent RCVS complaint alleging the alteration of clinical records. Fred was delighted with his escape route and in thanking the consultant he exclaimed that although he sometimes moaned as he signed the VDS cheque, by God he was glad of us when the time came to call. As well as handling negligence claims and providing expert assistance and representation for RCVS complaints, the Society runs a unique advice call service handling over 14,000 calls per year to reassure and help members with the multitude of problems occurring in clinical practice. Don’t be afraid to call!

Well-being

How to be a Happier Vet

- backed up by science

BF aims to support all veterinary professionals through whatever difficulties they are facing in their lives and to help them to continue with their career if that is what they want to do. The long hours and high intellectual, emotional and physical demands of a veterinary career can be tough to deal with and many in the profession will struggle from time to time. However, there are scientifically proven strategies which help to temper challenges and pressures if introduced into daily life. While genetic differences account for around 50% of the variance in the level of wellbeing between individuals, differences in life circumstances – health, income, personal and work environment etc – account for only 10% of the variance. Intentional activities – the choices we make – account for the remaining 40%. This means that we should each accept some personal responsibility for our mental wellbeing, recognising that it is part of an active process and not just determined by our make up or our circumstances.

Those who exercise also feel better about their bodies, even when they see no physical changes. A Texan survey of 2.4 million students found that the most telling tests for academic success were cardiovascular fitness and body composition. To quote Dr John Ratey, the Harvard brain researcher:”Exercise is like fertilizer for the brain … it’s so good, it’s like Miracle Gro.” The image below illustrates the effect on the brain of a 20 minute walk:

1. Give – do things for others Seeing yourself, and your happiness, linked to the wider community can be incredibly rewarding and creates connections with the people around you. Individuals actively engaged in their communities report higher wellbeing and their help and gestures have knock-on effects for others. Helping behaviour should be fulfilling but not overwhelming – 100 hours per year (or two hours per week) has been found to be the optimal time we should dedicate to helping others in order to enrich our lives. The Terman study into longevity expected to find that those who felt very loved and cared for would live the longest but instead found that; “Those who helped their friends and neighbours, advising and caring for others, tended to live to old age.” In financial terms, money spent on activities such as concerts and group dinners out bring more pleasure than material purchases like expensive watches and spending money on other people also boosts happiness.

2. Relate – connect with people This affects happiness more than any other single factor, enabling us to confide and discuss problems, generating a sense of belonging and trust. Not staying in touch with family and friends was one of the top five regrets when Bronnie Ware, an Australian palliative nurse, recorded the dying epiphanies of those in her care.

3. Exercise

Exercise has been shown to improve mood and brain power and has been used successfully to reduce depression and anxiety.

4. Appreciate – notice the world around you Reflect upon, savour and be grateful for the good things in your life. Research demonstrates that writing down and reflecting on three good things that took place during the day can bring long term increases in wellbeing and decreases in depression. Practising mindful awareness of sensations, thoughts and feelings can improve both the knowledge we have about ourselves and our mental wellbeing.

5. Keep Learning New Things Learning encourages social interaction and increases self-esteem and feelings of competency. Set yourself a challenge you will enjoy achieving, rediscover an old interest, sign up for a course or take on a new responsibility at work.

6. Direction – engage in activities that are meaningful to you If veterinary work is no longer your calling, or never really has been, have a purpose that you pursue elsewhere such as voluntary work. Have peripheral interests too, avoiding the vulnerability of allowing your life to revolve around a single component. Practice Life z September 2013 z www.practicelife.biz

well-being

in association with the Veterinary Benevolent Fund

“Don’t be lured into the trap of ‘perfectionism’ – self-defeating thoughts and 7. Resilience – find ways to bounce back Learn to challenge automatic negative thoughts, dispute pessimistic explanations and reframe situations in a positive light. Situations that seem impossibly bad can turn out better than expected, whilst goals that seem incredibly important at the time are only a small part of life. We can experience adversity and come through it. This is a hard one for most vets but don’t be lured into the trap of ‘perfectionism’ – self-defeating thoughts and behaviours associated with unrealistically high goals. Be satisfied with ‘good enough’; only going for ‘best’ when it really matters.

behaviours associated with unrealistically high goals.”

8. Emotion – take a positive approach

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Learn to be optimistic while remaining realistic. Give yourself regular treats but don’t only do those things which bring immediate gratification as too many of them can result in feeling that life is ‘hollow’ and ‘empty’.

9. Acceptance – be happy with who you are Care solely about other people’s approval and you will forever be their prisoner. Identify your personal talents and character strengths and live life in such a way that enables you to use them to the fullest extent. Give yourself permission to be human: rejecting one’s emotions, positive or negative, leads to frustration and happiness. When Ware recorded the most common regrets of the dying in her care, the top one was: “I wish I’d had the courage to live a life true to myself, not the life others expected of me.”

10. Sleep More As well as all its other benefits, sleeping more will make you less sensitive to negative emotions. Sleep deprivation has more impact on the amygdala which processes negative stimuli than the hippocampus which processes positive or neutral memories. The result of this is that sleep-deprived people fail to recall pleasant memories but can easily recall gloomy memories. More information about wellbeing and mental health in the veterinary profession and the work of VBF can be viewed at www.vetlife.org.uk. www.practicelife.biz z September 2013 z Practice Life

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managing people

When the atmosphere turns toxic – dealing with difficult team members Anne-Marie Svendsen Aylott is a veterinary surgeon who works as a leadership coach and trainer. She specialises in cultural change management within organisations – using inspirational leadership to drive employee engagement, happiness and business profits.

ave you ever worked in a place where there was that one person who had the ‘ability’ to spread their mood around like invisible smoke, infecting the people around them? That one person who was always complaining or subtly undermining everything nice there was happening? If you are the manager of such a person – there are things you can do to turn it around.

Prerequisite for change In order to help someone change, 2 things have to happen: 1. You have to believe that people can change 2. You have to say the right things, in the right way and at the right time These days there is significant research that documents the fact that the brain is just like a muscle. When you flex it, it selectively grows in that area. Indeed there is good evidence that the brain can significantly re-wire itself in as little as 5 days (see box). What that means is that anyone can change. Human nature is inevitably far more flexible than we give it credit for and so is the brain. Many people are not aware of this and so can stay stuck in bad behaviour patterns, because they don’t believe that there is anything they can do – they are doomed to always be miserable, negative or pessimistic! In some instances, purely by sharing with your team that anyone can change – the change starts happening on its own. The other thing is to realise is that in order to help someone change, you have to be very precise about what you say, how you say it and when you say it. Remember that there are differences between the person themselves – and what they do. In almost all instances, problems arise not because of the person, but rather because of the behaviours they exhibit. You can think of it as an interactive flow (see figure 1 – but recognise that the arrows can go both ways) where identity is at the very top and more resistant to change, while behaviour is at the bottom. As the flow illustrates, people are driven by their values and the beliefs that sit around those values – and these values and beliefs are directly responsible for the behaviours they exhibit. For every one belief – there are many, many

behaviours and only the person themselves know what belief sits behind the behaviours.

Start with the belief A lot of times challenges arise in the practice because there are uncertainties about the values and beliefs that the practice is focused on. Unless these are verbalised, referred to constantly and highlighted every day, most people will be unaware of them. If the practice does not have official values and beliefs in place, the employees will form their own – often driven by the strongest characters – and these values and beliefs may be opposite to the ones you want as a manager! Useful values could be things like: Practice Life z September 2013 z www.practicelife.biz

managing people

In one experiment, volunteers were blindfolded for 5 days. During these 5 days they worked every day on learning Braille and also on separating out different tones in their ears. After 5 days, a functional MRI scan demonstrated that when they used their fingers to feel, a part of the brain that was normally used by the eyes, reacted. In just 5 days the brain had adapted to new circumstances and rewired itself. Pascual-Leone & Hamilton (2001). The Metamodal Organization of the Brain. Progress in Brain Research, 134, 427-45

In another experiment, a control group was taught to play a simple piece on the piano and practised it for 5 days. The other group was simply asked to visualise it. After the 5 days, both groups had significant increase in the part of the brain that related to how the fingers move. Pascual-Leone et al (2005). The Plastic Human Brain Cortex, Ann Rev of Neuroscience, 28, 377-401

• Mutual respect • Supporting and friendliness • Care and compassion • Always ready to learn Feedback becomes much easier when you have official values and beliefs to focus on and they will often help you change multiple behaviours in one go.

The importance of feedback In order to help someone change, it is necessary to give feedback in a constructive, positive, interactive and TIMELY fashion (as soon as it happens) and to give feedback that is specifically targeted towards their behaviour – not who they are. Immediate feedback can be given using a simple process: 1. Direct the person’s attention to the situation in question: ‘I just heard you say that...’ 2. A sk for the reason (never use the word ‘why’. ‘Why’ implies judgement and gets a defensive reaction. Instead use ‘What is the reason’ which acknowledges that people do things for a reason): ‘What is the reason you chose to use those exact words?’ OR ‘What was your intention with that statement?’ 3. A sk for the outcome: ‘What do you think the results of saying that were?’ / ‘How do you think others perceive that?’ 4. A sk them to identify a better way forward: ‘What would have been a different way to get the results you wanted?’ / ‘What would have been a kinder way to get your point across?’

When patterns or habits are present In some instances you are looking at a trend, at behaviour that is consistently negative over a period of time. In that case you are better off having a private conversation with the www.practicelife.biz z September 2013 z Practice Life

person where you give them a list of specific instances where their behaviours have been out of alignment with what the practice wants. It is important to use specific examples, to include the effect the behaviour has on others and also to be very specific about the behaviours you are looking for instead, e.g.: ‘When you repeatedly say derogatory things about the head nurse, it creates a negative atmosphere where people don’t want to work with you, because they feel uncomfortable with the way you behave. We all like you and would like you to focus on noticing the positive things people do and for you to verbalise that, saying ‘thank you’ and appreciating the effort the nurses put into what they do.’ Notice that in this example, there was a reassurance to the identity (‘We all like you’), and a specific focus on the behaviour that needing changing (‘focus on the positive things people do and for you to verbalise that, saying ‘thank you’). A very useful thing to drop into these conversations is the fact that everyone can change – and that it requires effort and takes time to do it effectively. You may want to add something along the lines of: ‘We all know that these are just habits and that the brain is like a muscle that can change things over time – so how can we help you build your positive brain muscle?’

Follow up The final step is to make sure that you follow up. Ask them how they are doing. Reward the slightest effort and encourage them to keep working at it. And if you have to give them more negative feedback – keep it positive and reassure them that THEY are still liked – then help them identify the specific behaviours they need to change.

managing people

Managing STRESS in the vet team

Practice manager Lisa Cooper from Goddards Veterinary Group shares a few tips on how to manage conflict in the vet team

ets are generally incredibly intelligent people and very driven, they often work long hours and as well as holding down a ‘day job’ will be spending a large proportion of their ‘spare’ time carrying out CPD, and keeping abreast of current affairs. This often leaves little time to strike a healthy work / life balance which can sometimes lead to ‘difficult’ behaviours in the workplace. This can manifest in the following ways:

Irritability – towards other members of staff; this can lead to claims of bullying in extreme cases.

Inflexibility – Can be aggressive, e.g. confrontational refusal to carry out a reasonable request, or passive, e.g. duties not carried out with time management being given as the excuse.

Emotional outbursts – Tears, tantrums, instrument throwing, maybe even aggression towards fractious patients.

Burnout – Extended leave on medical grounds e.g. stress; concern over addiction, alcohol or drugs. I am sure that the behaviours above can be recognised in varying degrees both in ourselves and the people that we work with. Managing the behaviours first requires an understanding of the factors influencing them, and also a risk assessment of the problem posed:

Breakdown and investigate: 1. The problem 2. The reasons

Then: 3. COMMUNICATE! 4. Agree outcome 5. Then review

A Case Study A newly qualified RVN has been complaining (not directly to management) that she is being bullied by one of the vets. The vet makes it clear that they don’t enjoy working with the nurse. The nurse is not particularly confident in her duties especially in theatre. The Head Nurse has told the practice manager of the situation as she is concerned that the RVN will leave. The vet has a history of being ‘difficult’ to work with. The practice manager catches the vet over a cup of coffee later that day and asks if there are any problems, to which the vet replies no, everything is busy but fine. The manager asks the vet how she is getting on with the RVN. To this the vet replies that she thinks the nurse is unhelpful, and when she works with her everything takes longer. This means she doesn’t get through her day’s work on time and is always late for evening consults. The following day the manager holds a similar ‘relaxed’ conversation with the nurse, who says that she feels the vet doesn’t like her and makes it clear that she doesn’t want to work with her. But she is trying to be professional about it and only speaks to the vet when spoken to and only about work-related issues. The practice manager concludes that there is an obvious breakdown in the relationship between the two team members and identifies several problems as a result of the two conversations. Going forward, this breakdown would adversely affect them both, as well as others if the situation is not dealt with. There is a possible training need identified for the nurse, but also a concern for the vet who may be having difficulties either personally or work-based, which is manifesting as irritability towards staff. The manager then holds more formal meetings with the nurse and the vet. The nurse consents to a period of mentorship with the senior surgical nurse, agreeing to ‘wipe the slate clean’ and work to re-build her relationship with the vet. On discussion with the vet it becomes clear that she is having difficulties with the number of hours she is expected to work on a particular week of the rota. This would be difficult to change without causing considerable upheaval, and so a change to consulting times is agreed to allow the vet more time for surgery in the afternoon. The manager discusses with the vet the effect that her irritable behaviour is having on the nurse, and the possible knock-on effects on the rest of the team. The vet hadn’t realised she was being quite so obvious with her feelings, and agrees to ‘let off steam’ with the manager rather than the team if she is having difficulty working with any of the other staff. Managing ‘difficult’ behaviours is always challenging. And there will be occasions where the behaviour is so extreme, or so ingrained that it cannot be managed to everyone’s satisfaction. Identifying the problems and the reasons for them, communicating to those involved in the most appropriate manner and agreeing a plan to move forwards, and then reviewing the situation afterwards will improve most situations. And if all else fails, recite the serenity prayer!

Lord, give me grace to accept with serenity the things that cannot be changed, Courage to change the things which should be changed, and the Wisdom to know the difference. Practice Life z September 2013 z www.practicelife.biz

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managing people

The negative

team member... a case story “Communication problems are simply about learning the appropriate skills, applying effort and having the discipline to keep working at them.” The consultant focuses on a number of things: • Identifying the current challenges in the practice • Helping everyone build a picture of where they would like to be • Translating the picture into specific behaviours – what would people say to each other, how would they support each other and what would be the things that are important to them • Helping people realise that changing requires training in specific skills – and communication problems are simply about learning the appropriate skills, applying effort and having the discipline to keep working at them • Pointing out that feeling negative about someone else rarely is about that person – but very often about oneself. When you change how you act towards others – they change as well. Credit: Jonathan Keelty

enny (name changed and different cases combined to protect identities) is a young nurse with a high ambition level. She tends to be late on occasion which can cause problems with others struggling to make up for her not being there. She seems to be convinced that everyone is out to get her and complains a lot about the other team members. The feedback that she has been given seems to have had very little effect on her behaviour. Her general demeanour is very negative and she is constantly complaining about the management, the vets and the other nurses while displaying a lot of emotions and floods of tears. Feedback seems to have no effect on her and is perceived as persecution rather than an attempt to help her. At the same time she is becoming clinically depressed over the situation and struggles with her work. At this point an external consultant is brought in to provide a day of coaching and training for the entire nursing team, not just to help with Jenny but to provide support for everyone to identify how best to work together and influence the practice.

After the training day, the practice manager changed her approach to several things: • She set up weekly meetings with the nursing team to preempt any challenges and provide a forum for discussions. This had the effect of giving her the opportunity to actively help them work together and avoided individuals taking up her time complaining about things – instead everything was discussed openly at the meetings • She consistently focused on the specific behaviour of Jenny and made a point about providing positive, encouraging feedback on the processes Jenny was developing • She used a coaching approach where instead of providing Jenny with the answers, she encouraged her to find them herself. The combination of an initial training day to set the scene, followed by a consistent approach and a refinement of strategy with a focus on specific behaviours, has worked well for Jenny. She is far more positive, has started to engage more with the team and is better able to manage her emotions in the practice. Practice Life z September 2013 z www.practicelife.biz

Client care & marketing

Getting Client Feedback:

Best Practice

Tim Puddle and Jane Fletcher of SMart Kits (www.smartkits.co.uk) have worked with veterinary practices and suppliers for nearly 20 years. They provide practical sales and marketing tools and advice for veterinary practices which help grow their business, including flexible consultancy, workshops and customer satisfaction surveys.

t’s tough out there for a lot of businesses (and vet practices!) and yet there are examples of successful companies and practices which are increasing their sales and profits by delivering what their customers want. Getting and effectively using client feedback is a key part of achieving sustainable business growth. In essence it’s all about understanding how your practice can maximise a customer’s satisfaction by making the right improvements to your service delivery. This then leads to increased customer spend and practice profits. The more observant among you will have noticed that we switched from using the word ‘client’ to ‘customer’ in this introduction and that’s because we feel that ‘customer’ is a better description of how pet owners see themselves these days when they visit a vet practice. We also believe that being able to look through your customers’ eyes is part of understanding their feedback.

Feedback mechanisms: Let’s start by examining the different ways of collecting feedback to understand how satisfied your customers are with your practice: 1. Review the information you already have on your practice management systems as it will tell you about customers’ interaction with the practice through their level of spend, visit frequency, product and service choices and their loyalty in terms of the length of time they have been a practice customer. 2. Collate ad-hoc feedback, both positive and negative, from direct contact with your customers (in reception, on the phone, in the consulting rooms). Every contact with a customer is an opportunity for feedback so be open, listen and encourage the dialogue. 3. Create and offer an online, telephone or in-practice customer satisfaction survey. The quality and content of feedback will be influenced by what you ask and how, so think carefully about your questions, aim to be precise and succinct and keep the survey as short as possible. 4. Organise customer focus groups and ongoing panels of customers to gather their feedback. 5. Ask the practice team in meetings for their views and feedback on customer satisfaction. www.practicelife.biz z September 2013 z Practice Life

client care & marketing

“There are lots of ways of getting customer feedback so you need to be aware of the dangers of information overload when you’re looking at too many of 6. T ake part in and/or monitor customer views on social media (e.g. Facebook, Twitter, Pinterest). Our most recent holiday for example was booked due to a recommendation from a friend coupled with online feedback from other guests which influenced us far more than any travel agent literature or Sales Agent recommendation. But remember that in Britain we love to tell others all about our experiences especially when they’re not favorable so you may not enjoy reading all of the comments! There are clearly lots of ways of getting customer feedback so you need to be aware of the dangers of information overload when you’re looking at too many of these data sources. You also need to bear in mind that feedback instigated by the customer is often at either end of the spectrum; those customers who are very satisfied or those who are very unsatisfied, and that you may be missing out on hearing the views and needs of the silent majority of your customers.

located, having good product knowledge, informally feeding back customer comments, handling complaints and a staff suggestion system to name but a few. Jane experienced firsthand how handling a customer complaint successfully increased customer loyalty. Thirty years on she still has friends working for the company. Research from Harvard has shown that satisfied employees stay longer thereby keeping their expertise and customer relationships within in the company. High staff turnover understandably has a negative effect on customer satisfaction.

Establishing a customer-focused culture

Actions speak louder than words

Leading businesses are waking up to the fact that customer satisfaction is a key business driver. The most recent Institute of Customer Service (ICS) results show that companies with an above average customer satisfaction score had on average a year-on-year sales growth of 9% compared to 3% for those with a below-the-sector ICS index score. Waitrose are a premium food retailer which regularly tops the league in surveys completed by the ICS and they have just achieved record financial results. My partner Jane Fletcher used to work for Waitrose, part of the John Lewis Partnership, as a store manager and buyer. It was nearly thirty years ago when Jane was a Graduate Trainee on the shop floor and Waitrose didn’t have ICS surveys or any other survey for that matter. But they did have a service culture established through a clearly defined way of working and treating customers. The clear and simple protocols were followed by all the ‘partners’ from the top down which included for example, greeting customers, showing them where products were

An article published by the ICS quoted that while 95% of companies claim to collect customer feedback data, less than one third then initiate activities to improve the customer experience – and just 10% deliver action based on the information they receive. So a word of caution: customer feedback is only useful if you do something productive with it. If customers and staff see no action has been taken from their feedback, you also run the risk of alienating the people that have taken the trouble to respond and they will think twice before participating again! Once you have decided that changing the way in which you do things is the right approach, there are some key principles in taking action; analyse the data to decide which actions will have the greatest positive impact on your business, be realistic when planning changes which may take time to bear fruit, let your customers know what you’re doing and why, share customer feedback and business measures with your team and track your success by gathering ongoing customer feedback.

these data sources.”

Practice Life z September 2013 z www.practicelife.biz

client Care & marketing

Client feedback Case Study Dawn Kent, Practice Manager from Willow Veterinary Centre, a two-practice business in Newport Pagnell, shares her experiences in obtaining and acting on client feedback

“The findings were not what we had expected, but they were very clear – we needed to increase our opening hours!”

t Willow Veterinary Centre we consider our practice success to be in no small part due to our on-going collection of, and positive response to, client feedback. By tailoring the way we deliver our service to match the real needs and expectations of our clients (both current and potential), we have seen significant increases in turnover and profit. It’s been crucial to find out what pet owners actually want, and not guess at what we think they want – because experience has shown us that they are not the same! Customer feedback data is particularly valuable if an experienced eye can

interpret it and marry it up with the practice’s ethos and goals. So we chose to partner up with an external company for our project. We began by commissioning Onswitch to carry out Vox Pop street research in the town that our part time branch served. They interviewed two groups of local owners – those who used us, and crucially, those that had chosen not to. The findings were not what we had expected, but they were very clear – we needed to increase our opening hours! We were convinced the awful parking availability was a barrier to footfall, something we couldn’t really alter significantly, so this revelation highlighted something we could, and did, easily solve.

Practice examples and benefits Here are just a few examples from practices we have worked with on how they have gained customer feedback and acted upon it: – a senior partner regularly works at reception getting close to customers and the customer facing team, – a practice has regular staff meetings to discuss customer satisfaction. The practice makes improvements to the complaints procedure as a result of the feedback and achieves greater vet continuity with customers, – a practice introduced clearer, written information for customers to apply treatments at home, – a practice created specific slots for nurse consultations to spend more time with pet owners and – a senior vet acted on the feedback, calling customers who had little niggles thereby helping to avoid the issues becoming big problems to the delight of the customers. The approach that these practices and others took included being open to customer feedback in all its many forms (quantitative and qualitative), interpreting it and then using www.practicelife.biz z September 2013 z Practice Life

Keen to ensure that our practice became the first choice of every local pet owner, we then asked the same company to run a series of focus groups to explore our proposed marketing campaign. We wanted to raise awareness of our ‘Willow Way’ of doing things in the local community and get across the message that we were different and that our experienced, passionate and professional team cared deeply about providing the very best service to owners and pets alike. The focus groups findings indicated key geographical areas to target, enabling us to create an engaging direct mail campaign to reach our selected potential clients. And it worked – awareness soared and brought impressive numbers of new client registrations. We were also able to track the registrations to the exact areas we targeted. Overall we considered the whole project a great success. We went out and asked pet owners what they wanted from a great practice, and followed it up by showing them why Willow was that great practice. And we haven’t stopped asking clients for feedback – there are always ways we can improve still further!

the information to make improvements. It’s a team effort so everyone needs to be kept in the loop, sharing what’s working and what needs to be improved and then taking action together. Gaining customer feedback therefore is not a oneoff event but one which needs to be built into the practice culture as part of the way it does business. The benefits from getting customer feedback include; • Practices know how their customers really feel • The feedback gives individuals and practices opportunities to consider how to improve their service • Customers are encouraged to return to practices where they feel genuinely valued and appreciated • Positive customer feedback motivates the practice team to do even better. Your next step: we would suggest that you should review your current practice mechanisms to get customer feedback and see how you could use that information. Then think about introducing new feedback mechanisms if necessary. And in the spirit of sharing and learning together LET US HAVE YOUR FEEDBACK!

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business health & finance

Is your practice in good financial health? Mark Harwood has been at Hazlewoods Accountants since 2003 and works solely with veterinary practices, advising on a wide range of practice, business and tax matters. Hazlewoods provides a benchmarking service to clients, looking at Key Performance Indicators (KPIs) and helping them set and reach targets for future performance.

mong the many day-to-day queries that we receive, the question of whether a practice is successful or not, regularly comes up. It’s swiftly followed by another question: just what do we mean when we say ‘successful’? Is there a definition or criteria that we can measure success by? In this article we are of course focusing on the financial side of success. For this purpose we can put a definition on success as a practice that is sustainably profitable. But it’s interesting to note that a common theme runs through most practices that sustain profitability. Indeed, it’s a standout feature and one which goes hand in hand with clinical excellence. It’s a feature which has become more apparent as the veterinary market has become increasingly competitive and the recession has hit. Simply put, success comes from putting the clients at the forefront of everything that the practice does. Make clients happy and they will want to return to your practice. They will tell their friends, family and contacts about you. Get this right and half the battle towards achieving healthy finances is already won. In this article, space dictates that we focus predominantly on small animal, although many of the principles apply equally to farm, equine and mixed practices. To give you an idea of how significant the winning and keeping of a client is, the average spend (excluding VAT) over the lifetime of an animal at a small animal practice is £3,000. Certainly not to be sniffed at!

So What Does A Profitable Practice Look Like? It’s all very well striving to be a highly profitable practice, but how can you tell a poorly performing practice from one that is flying? There are of course no hard and fast rules, but illustrated above (Fig.1) is an example of a small animal practice that is below average profitability based on our benchmarking data. By its side, is a practice that is performing well above average profitability based on our benchmarks. In both cases, the practice has 5.75 full time equivalent vets. www.practicelife.biz z September 2013 z Practice Life

Fig.1

EBITDA stands for Earnings (i.e. profit) Before Interest Tax Depreciation & Amortisation. It provides an indication of the underlying financial performance of a practice, irrespective of its structure (e.g. sole trader, partnership, LLP, Limited Company), debt levels, policies on writing off the values of assets (depreciation/amortisation) and exposure to tax. Where necessary, EBITDA is further adjusted to exclude private costs/ income and exceptional items, e.g. one-off repairs/legal and professional fees etc. EBITDA gives an indication of the amount of cash a practice generates before capital expenditure and drawings/dividends. It is worth mentioning that an owner may be happy with the performance of their practice, even if it is supposedly “below average” profitability. For most owners, maintaining a good work / life balance is very important. However, as you will see as we consider each of the financial headings above in more detail, many of the actions that can help turn a poorly performing practice into a high performing one require very little, if any, extra work.

business health & finance

1. Turnover It sounds simple, but focusing on turnover is surprisingly often forgotten. Keeping an eye on the pennies with good cost control will not by itself make a high performing practice. Without a comparatively decent level of turnover for any given level of costs, there will not be any profit. For new start-up practices, growing turnover is absolutely critical. For established practices, it is still important that turnover grows. With cost inflation, profitability will fall in real terms unless turnover increases. Clearly a practice’s turnover will depend to a great degree on its number of vets. The average turnover per vet for a Small Animal practice based on our data is around £230,000 per annum, although there are regional variances, with the South East and in particular London generally achieving higher figures. Some practices achieve significantly higher turnover per vet figures, even as high as £500,000+, although this tends to be the exception as opposed to the rule. The below-average performing practice in the example above (Fig.1) has a turnover per vet of £200,000 compared to £260,000 for the above average performing practice. For ideas on boosting turnover see later. It can also be useful to consider how making improvements to a practice’s pricing structure and charging can help make improvements to turnover per vet. Fig.2

Fig.3

the mix of sales between fees and drugs. Fees are items such as consults, injection fees, laboratory work and operations, whilst drugs are POMs, PMLs, food, fleas and wormers etc. The higher the proportion of fees, the higher the gross profit margin, all other matters being the same, as fees do not have associated costs that form part of gross profit (remembering that when we are talking about gross profit, staffing costs are not included). Referral practices will tend to have a higher proportion of fees and a correspondingly a higher gross profit margin. Whilst the average Small Animal fee to drug ratio based on our data is 1 : 0.62, a lower (or indeed higher) ratio is not right or wrong as clearly your practice may have expertise in a particular clinical area that will drive the mix of fees to drugs. Rather it can be interesting to monitor the fee to drug ratio over time to see how it impacts on the gross profit margin.

How can you boost gross profit?

Some examples are shown in the table above (Fig.2): In this example, a few of the practice’s prices are lower than might be considered ideal (please note all figures are illustrative only) and a number of items are routinely undercharged compared to what they should be charged out at. By “correcting” these areas, turnover per vet would increase by just over £23,000 per annum. With our example practice which has 5.75 full time equivalent vets, this equates to around £132,000 of turnover that is not being charged.

2. Gross profit So what is gross profit? This is set out in the following table (Fig.3). The average Small Animal gross profit margin (Gross profit/turnover) based on our data is 73.1%. Practices in the South East which generally command slightly higher prices tend to have a slightly higher margin. A practice’s gross profit margin is driven to some degree by

– Reviewing buying terms regularly with your wholesaler / buying group, lab and clinical waste suppliers to ensure that you are getting the best overall deal and level of service. – If you refer work to other practices, reviewing any referral fees to ensure that they are competitive. – Making sure your practice has an appropriate pricing strategy. – Taking steps to reduce undercharging, as considered above.

3. Staffing costs We generally consider that an efficient proportion of Small Animal staffing costs to sales is between 38% and 45%, although there can be exceptions outside of this range. It is important to note that this includes an equivalent market rate salary for any owners plus employer’s NI. A typical figure is in the region of £52,500 to £55,000 although they can be higher or lower depending on the nature of the work undertaken by the owner, e.g. first opinion, specialist, referral etc and the area of the country. Any directors’ remuneration, directors’ pension costs should be excluded and replaced with this equivalent market rate salary. Practice Life z September 2013 z www.practicelife.biz

business Health & finance

We generally find an efficient staffing mix in terms of relative % for each staff type, for a Small Animal practice to be as follows (Fig.4) (please note the £000 figures are illustrative only and the costs include an equivalent market rate salary for owners as well as employer’s National Insurance). Fig.4

Just because a practice has a ratio higher than 45% does not necessarily mean it is overstaffed or that its staff are overpaid. Whilst this can be the case, it is often that the practice is turning over less than it should for any given level of staffing. Boosting turnover can help to bring the ratio back to a more acceptable level. It can be useful to compare individual vet’s turnover as a proportion of their “package”, being their gross salary plus the value of any benefits, e.g. car, accommodation etc. A typical range based on our data is between 16% and 25% with 19% currently being average. Clearly there can be distortions where staff other than vets book work to the vet system. One way to overcome this issue is to allocate such turnover to the vets based on their respective individual turnover. Monitoring these ratios over time and between vets can be very enlightening. They can also provide a useful tool to assist in appraisals and when considering pay rises. An example of this is shown in the table below: (Fig.5) Fig.5

Successful practices are good at mentoring staff and providing them with on going support, rather than simply waiting for appraisal time. Regular staff meetings can help here. What about the issue of what pay rises to give? One way to approach this matter is to decide on an overall budget for pay rises and then split it between staff based on individual merit as you feel is appropriate. This way, you will avoid overstretching the budget. This is a different approach to an across-the-board increase, although it is accepted this can be appropriate in some cases. We often find that owners say that they don’t have the time to put in place all the ideas that they would like to at the practice or that they are simply out of new ideas. Holding regular staffing meetings and encouraging staff to share their own ideas can work well here. A good practice manager can also be invaluable in helping drive practice initiatives forward and motivating staff.

4. Overheads Generally an annual review of overheads is sufficient at most practices, to ensure that the best value service is being obtained. When reviewing overheads over time, pay particular attention to any exceptional / one-off costs that need to be excluded to show the underlying trends. Managing the financial information in your practice The quality of financial information varies considerably between practices. Some will manage their finances using basic turnover and bank balance information. Others look at key data including turnover, gross profit and staffing costs, whilst some go a step further and produce regular management accounts by branch / division. Relatively few practices produce cash flow projections. Cash flow projections can be really helpful, particularly when deciding how much can be taken out of the practice as drawings or remuneration. Recognising that cash is not the same as profit is part and parcel of this. With the increasingly competitive veterinary market, coupled with times still remaining relatively tough for many, access to high quality and timely financial information can make a big difference. It enables practices to see trends quickly and act accordingly. We generally find that if a considered budget is drawn up, it is more likely to be hit.

Final word

In this example, whilst vet 2 has a higher package than vet 1, their package as a percentage of turnover is actually lower. www.practicelife.biz z September 2013 z Practice Life

Turning a poorly performing practice into a successful one is not rocket science although it can often feel like it. The best practices do the basic things well. For many practices, making improvements will depend upon making small changes in certain areas as opposed to a wholesale change in the way they do business. The ideas considered above are by no means

business health & finance

exhaustive and different practices will find different things work for them. For most practices, it would not be unrealistic to expect that each vet could generate say an extra £50 per day in what they charge. In our example above of a practice with 5.75 Full Time Equivalent vets, with an assumed 220 working days per annum, this would give an extra £63,250 turnover per annum. The reality is that additional turnover and profit can often be generated without carrying out any additional work. Clearly where there are also opportunities to increase footfall as well, the potential for improvement is even greater.

The author welcomes questions from readers and can be contacted on 01242 680000 or mark.harwood@hazlewoods.co.uk This release has been prepared as a guide to topics of current financial business interests. We strongly recommend you take professional advice before making decisions on matters discussed here. No responsibility for any loss to any person acting as a result of this material can be accepted by us.

boosting Turnover MARKETING

CLIENT CARE

VETERINARY/TECHNICAL Vet

Staff

Reception

Consult Room

Waiting Room

Letter/ Text Phone

Letter/ Text

Visit Follow Up

Visit

Phone

Other Clients

Dogs/Cats

Internet

Nurse

Phone

In Patient

Vet

Nurse

Out Patient Other Patients

A good way to think about boosting turnover is to look at the “client journey” and all of the contact points they have with your practice.

Before a client gets to the practice Let’s consider how a practice can engage a client before they even arrive. There are many ways in which practices communicate with their clients. Successful practices engage clients in a range of ways and by doing so encourage them to remain loyal to the practice. For example: – Having an up to date, simple to use and informative website. Don’t forget to include details of any current offers. Having a great website is all very well and good, but ensuring that your practice comes out towards the top of internet searches is also invaluable.

– Using social media. Whilst the likes of Facebook and Twitter are not for everyone, more and more clients have been brought up with technology as a part of their everyday lives and this will only increase. It is at least worthwhile considering whether using social media could benefit your practice. Bear in mind that if you choose to use social media, updating it regularly is important – out of date media can be more damaging than no media at all. – Giving clients the choice of how you contact them, for example text, email, post or telephone or indeed a combination of these. Different clients will have different Practice Life z September 2013 z www.practicelife.biz

business health & finance

preferences so it is important to cater for these, whether in house - for example using your vet system - or by taking advantage of services provided by suppliers. Some practices send reminders to clients to administer the likes of flea/ worming products to their pets and to also remind them when they should be getting low on these and that extra supplies are waiting for them at the practice. – A vaccine amnesty can prove a useful way to encourage owners to ensure their animals are vaccinated. That said, a successful vaccine amnesty can suggest that a practice is otherwise poor at ensuring animals remain within vaccine protocol! – Asking clients to confirm if they have any change in contact details when they visit to ensure that your vet system is up to date. – Using well trained and enthusiastic reception staff. The key part receptionists play is often overlooked. They are the point of contact for potential and existing clients when they make an enquiry. Monitoring call to consult/bookings over time can be an eye opener and can help to highlight staff that may benefit from training. A mystery shopping exercise can be helpful here as well.

Clients arriving at the practice – Having opening hours that are convenient for your clients. Whilst for smaller practices, opening 7 days a week or even 24-7 may not be feasible, many practices are offering extended opening hours, including weekends and evenings. If your practice has the edge on local competition with opening hours, it can be another tick in the box when clients are choosing which practice to go to. – Good car parking. Whilst this is often hard to change, the benefit of having easily accessible and sufficient car parking should not be underestimated. – Courteous staff can make a big difference. – Having details of latest practice offers on show. – A clean waiting room with literature to read and entertainment for children.

In the consult room – Encouraging all vets and other staff to be proactive as opposed to reactive about the health of animals under the practice’s care. This is not just about financial opportunities, as after all this approach is in the best interests of the animal. Regular discussions with clients, for example (by no means an exhaustive list) about vaccines, fleas/wormers, diet, dentals, insurance, microchipping, nurse clinics, offers on the go and general animal health can be really beneficial. – Taking the opportunity to capture information about an animal’s healthcare can prove invaluable – this can go hand in hand with the discussions mentioned above. Some practices operate a traffic light type system of rating certain areas of an animal’s healthcare, e.g. teeth, weight, renal function, arthritis etc, with green being good, amber in need of attention and red being critical. An alternative would be to use a numbering system, e.g. 1 to 5. Using the vet system to record this information should mean that over the course of a year, the practice has undertaken a clinical audit of all its active clients. This can provide hugely useful to help target marketing www.practicelife.biz z September 2013 z Practice Life

initiatives, e.g. offers on dentals, weight clinics, healthy pet foods etc. Practices that find this approach works for them are successful in getting all vets to buy in to this being part of a consult or health check. Nurses can also help here.

Post consult – Where vets find that they have spare time at the end of a consult, it can provide a good opportunity to walk with the client to reception to help them book to a follow up appointment, that may otherwise be missed. – S ome practices, as well as offering nurse clinics, also offer clients the chance to meet nurses immediately after a consult to discuss ways they can be proactive with the health and care of their animal, e.g. diet, flea/worming products, micro chipping etc. With the client at the practice, this can prove an easy way to “work up” sales and benefit the health of the animal. – Whilst there are pros and cons to the likes of insurance products and pet health clubs, and they are not for everyone, offering these to clients can be a good way to encourage loyalty to the practice. Offering direct claims, where time is available to administer, can also make matters easier for clients. –P romoting pet food. Whilst we would certainly not suggest removing a consult room to fill it with pet food(!), the sale of pet food remains surprisingly low – indeed only around 3% of pet food is sold through veterinary practices. The average pet food turnover per vet per annum based on our benchmark is around £12,000. Promoting pet food represents a missed opportunity in many cases. –F ollowing up operations by calling clients in the few days afterwards suggests a caring practice. It also provides an opportunity to encourage clients to book follow up appointments if it was missed whilst they were at the practice.

Other thoughts –E nsuring that the practice has an appropriate pricing strategy. Many practices are unaware that they are perhaps expensive on routine items where it is generally accepted that they need to be competitive locally, e.g. vaccines, whilst they charge too little on items that they could reasonably and fairly charge more for. At Hazlewoods, we help our clients review their pricing to help them ensure that it is appropriate. Reviewing prices on a regular basis, e.g. annually for non-routine items, is important. –E ncouraging vets to charge properly. Lost income through undercharging is perhaps one of the biggest failures of many practices. Using the vet system to “package up” common procedures can help to avoid this, as can regular invoice reviews. Another idea is to ask all vets to diagnose a case, to see how what they would charge may differ. –R eview the composition of turnover, e.g. vaccines, neutering, dentistry, consults, injection fees, hospitalisation etc. This can be interesting to look at both over time and between vets, helping to highlight where incoming generating opportunities are being capitalised on or missed. It can also be helpful when considering which areas to focus on as regards undercharging. –R eviewing your out of hours service, whether in house or outsourced, to ensure that your clients are getting a good service and you, a good deal.

practice development

STRATEGIC

Business Planning for Vets Richard Killen is a senior partner at Highcroft Vet Group, which has a 1st opinion vet hospital and referral practice with 35 vets in South Bristol, along with 6 other clinics in Bath and surrounding areas. He shares his thoughts on how vets can adopt business planning strategies within their practices...

en years ago the word strategy was hardly known within the veterinary industry. However the idea of Strategic Business Planning (SBP) in veterinary practice has become an essential part of running a successful business. The veterinary industry is undergoing huge and fundamental changes on many fronts and for practices to meet and survive these ever increasing challenges, the importance of SBP has never been so vital.

What is it? Various definitions exist, but SBP is basically a plan of action or policy designed to achieve a major or overall aim. Another way of defining it is a strategy that bridges the gap from “where the practice is now” to “where we want the practice to be in a number of years”.

Why do it?

How to do SBP

Quite simply businesses that carry out good SBP are proven to be more profitable, more successful, have better motivated employees and a good future. It will strengthen your practice’s competiveness, prepare for various possible threats and help in the efficient use of your practice resources, finances, time and energy. SBP will influence many parts of the practice such as human resources, training, marketing, capital spending and finance. It will give Partners, Directors, Managers and Employees alike clear direction of the practice aims and help significantly in deciding and implementing the actions that will be required to achieve these aims. Practices cannot stand still. They need to be forward thinking, evolve, possibly reinvent themselves and differentiate themselves from other practices to keep ahead of competitors. Many changes are occurring within the profession, such as increasing numbers of veterinary graduates, a rise in corporate practices, development of internet pharmacies, and increasing client expectations and demands. Practices need to be prepared for these challenges. All practices can perform SBP from one-vet clinics up to the largest multi-site group.

There are various methods of implementation, as with all things. It is important to give yourself time to do it; SBP is a complex undertaking, considering a large number of factors and needs adequate time allocated to it to do it properly. This can be difficult in busy practices when faced with the challenges of day-to-day work, but it is worthwhile setting time aside to perform SBP. All owners of the practice and senior managers should be involved in the planning process. A clear mission statement for what the practice stands for and an achievable, equally clear vision and direction for the practice will need to be agreed by all. This has to be a long-term goal and is not for dealing with day to day problems. Examples of a practice vision include: • The type of practice you want to become e.g. a hospital, referral centre, low cost practice or boutique practice • Opening new branches or becoming a multi-site practice • Opening within new areas • Expanding a single site • Purchasing new practices • Mixed practices changing to separate large and small animal divisions.

Practice Life z September 2013 z www.practicelife.biz

practice development

• Becoming more profitable, with better cost controls, debt reduction and less borrowing. • Preparing for the exit of one or all owners, with a potential sale in a certain number of years • The addition of new services to the practice e.g. dog walking. • Improving overall customer care e.g. extending opening hours and employing dedicated out-of-hours staff. It can be difficult to decide on a practice vision when multiple partners or directors have differing views and ideas. An external business advisor may be useful to facilitate this process. Many factors will need to be considered when deciding the practice direction and planning to achieve this aim. The personal life aims and ambitions of the practice owners will perhaps be the most influential factor (again, this can be contentious in a multi-partnership practice). An honest review of the present practice position, resources, competitors (both current and future), ever changing client behaviours and needs, finances, local and national economy, overall veterinary industry, profitability and client profiling needs to be done. There are many other examples of factors which should also be considered and the relevant factors will vary between practices. SWOT (strengths, weaknesses, opportunities and threats) analysis is very useful in facilitating the process of SBP.

Planning to achieve the vision When planning how to achieve the vision, be bold and be prepared to think outside the normal veterinary box. Look at other companies and other industries for ideas. Business advisors can also assist with this aspect of planning. Communicate the vision to your employees, but use your discretion on the details e.g. new branches or sale of the business. This will enable employees to understand the reasons for change and they will respond by becoming more loyal. Long-term employees can often present a barrier to change and clear communication of the practice vision will help these individuals to make the changes required to achieve the overall aim. This information can be disseminated via either individual or team meetings.

Checking you are on-course Regular checks are needed to ensure your business is oncourse to achieve the aims. There needs to be some form of objective measure of how well these targets are being met. Frequent reviews by the practice owners and senior managers are essential, to ensure that the tasks necessary to meet the objectives laid out in the 90-day plan are being performed. Within my own practice these reviews are held monthly. Situations may arise where it is necessary to change the practice vision, for example a decline of the local economy. The practice leaders play a vital role in ensuring the success of SBP. Nothing will happen unless there is strong leadership within the practice to push the whole process forward, with continuous focus on the end-point of the vision.

Benefits of SBP There are many possible and wide-ranging benefits of SBP, which can include: • A stronger and better practice that is able to meet and rise to challenges • Survival in a constantly changing marketplace • Increased profitability and practice value • A sense of achievement for the owners and employees alike Many practices will already be doing SBP; some formally and others on a more ad hoc basis. A constantly evolving profession and increasing competition between practices are challenges that will not go away and make the utility of SBP more relevant than ever. SBP has helped significantly in the growth of my own practice and has helped to form part of a management structure to work towards a happy and profitable team.

Within our own practice 90 day plans are prepared with approximately 10 significant objectives. These objectives are identified as the most important steps towards achieving the practice vision over a 90-day period. Examples of these objectives vary and may include: • Identification of new sites for branch practices • Checking the current RCVS Practice Standards Scheme regulations regarding hospital requirements, • Acquiring new equipment • Exploring the feasibility of opening on Sundays • Installation of improved accounting software • Updating the induction programme for new staff members • Disseminating the practice mission statement and vision to the employees The owners, practice managers, head nurse and lead receptionist have their own 90 day plans, which are, in most cases, shared with their respective teams. 90-day plans are an on-going project and should be reviewed & reset every 90 days.

www.practicelife.biz z September 2013 z Practice Life

“When planning how to achieve the vision, be bold and be prepared to think outside the normal veterinary box.”

practice development

We asked two practice owners for their thoughts on strategic planning and MBAs. Here’s what they told us... ‘Is an MBA vital for strategic thinking? No, I don’t think it is. I know many brilliant strategic thinkers who are just naturally great at this. For the rest of us mere mortals, an MBA can provide a very useful framework. It helps to ensure that we don’t leave anything out when we look at our business strategy. One of the key things I’ve learnt from my MBA studies is that there are lots and lots (and lots) of models for strategy, financial planning, personnel development and just about anything else you can think of. Models are very useful in giving a structure to one’s thinking, but none can replace reality and there’s always a place for instinct and gut feel. So it’s not vital, but it’s certainly helped me to ask some questions I might not have thought of before, and to make me feel a little more confident that I’m not overlooking anything critical’

Adi Nell Senior Partner Medivet Ltd

‘I believe that strategic thinking is like surgical planning. You know the rules of engagement, you appreciate the external factors, you respect your biological environment, you know your operating field is hazardous, you prepare by the book but you adapt according to the individual, guided by your gut feel and personal experience. In business the drivers are both internal and external, you respect the hazardous field and the rules imposed by commercial forces and market, you prepare for challenges according to the book, but you adapt your approach when something unexpected starts to bleed. You use your experience or your gut feel to recognise a bleeder and you don’t wait for the patient to bleed out, you deal with it head-on. At least this is how I approach business. Personally I think that the key to success is not about having no fear of failure; we should all have fear, it’s about committing everything, as if not doing so were worse than losing everything. I think it’s best to start with nothing, because then you can’t end up further back than when you started. There is a certain comfort in that as long as you don’t become attached to material things and can find a motivation for all of it which transcends financial gain.’

Noel Fitzpatrick Managing Director at Fitzpatrick Referrals Ltd

strategic planning Case Study Ronnie Soutar, aquaculture and veterinary business consultant and former Director of Veterinary Services at the University of Edinburgh muses on the benefits of having a strategic business plan that you can adapt

here are, in my opinion, two important things about a successful strategic plan. First, have a plan. Second, don’t get too hung up about sticking to its details! In creating the strategic plan, it’s important to be honest about where you are starting from. I don’t think you can beat a good old-fashioned SWOT analysis for that. A vital factor is to begin by involving the stakeholders; that certainly includes your staff but should definitely also involve clients, and indeed suppliers, if you want an accurate picture. The same is true for the next stage, which is deciding where the practice is going. The more you involve those who will be part of making it happen and who will be affected by it, the more chance it has of success. A good strategic plan is as much about preventing problems as creating opportunities. As an example, the implementation of a short-term plan for developing the general practice side of our equine services clashed with the long-term strategy for developing referral services. Practitioners who felt we were poaching first-opinion cases were not going to send their clients to us for referrals. They made their feelings clear and we adjusted the plan, but we could of course have avoided the problem by seeking their views first. That obvious flaw in our plan demonstrates the importance of the big picture in developing strategy, but it is also important to allow flexibility within sub-units. So you might have a general strategy for the practice as a whole, but allow those who work in branch practices to develop a local plan which meets their needs without disrupting the general direction you are taking. And that brings me to the second point – not treating your strategy as if it were set in tablets of stone. Sticking rigidly to an established strategy is a really good way to miss opportunities! Again, this is obvious if you think it through – in the absence of an effective crystal ball, none of us actually know what the world is going to be like in 5 or 10 years’ time. So you might put a lot of effort into developing a really good 5 year plan, stick to it and achieve all of your goals, only to find that the environment in which you are now doing business has changed so dramatically that you are worse off than you were before. So, based on experience, this would be my advice. Create a strategy, being as inclusive as you can be in its development. Follow it as a guide but use all of the available information you can get to tweak and fine-tune it as you go. Stay aware of new opportunities which can be blended into your strategy and watch out for threats which may require you to adjust your plans. And only write down the essentials, because someone is sure to point out the errors in your five-year-old vision!

Practice Life z September 2013 z www.practicelife.biz

CPD Diary

Boost your business in just two days! SPVS-VPMA Congress, 30th Jan - 1st Feb 2014 Celtic Manor Resort Have you got two minutes to read this article? Yes? Well read on for how you can boost your business and maximise your learning in record time. No? Then you definitely need to carry on reading. We want to help you get the very best out of every CPD second you’ve got. Take just two days out in January to charge-up your business knowledge at the Joint SPVS-VPMA Congress 2014.

Tracey’s sessions at congress; they’re worth the registration fee in themselves!

Why you need to come:

ROAR!!!

• NAVC award-winning speaker and leadership guru Katherine Eitel challenges you to find your inner lioness (yes, you too guys!) • John Lewis Main Board Director and Head of HR Tracey Killen highlights what we can learn from one of the UK’s most successful companies • New for 2014 Dedicated equine practice management stream with KPIs, marketing and equine receptionist training • New for 2014 Are you at that stage of your career where you’re thinking of setting up your own practice? Don’t miss our stream on essentials for the new veterinary practice: business models, finance, marketing and more • In-depth coaching stream for experienced managers and leaders • New for 2014 Create a healthy, happy team: Mental Health & Well-being • Practical take home tips on social media, engaging with your local community, salaries, compensation and recession-busting business strategies and more • Networking and meeting friends old and new with a fun social programme and exceptional exhibition!

Fresh from the North American Veterinary Congress (NAVC) where she held audiences gripped, veterinary business guru and leadership lioness, Katherine Eitel, will be pitching into both our personal development and team performance streams. With a focus on building a positive and productive workplace, Katherine looks at self-development, training, and internal and external communication including how to deliver information that sticks. In her final session she’ll share with us her findings from her pre-congress tour of some UK veterinary practices. GULP. See all the topics she’ll be covering under www.vpma-spvs-events.co.uk/congress

And you’d like to do all that in the comfort of a 5-star luxury hotel at a great price? Done. The Joint SPVS-VPMA Congress is the biggest dedicated vet management congress in the UK. If you’ve been on any of the joint CPD days during the year, you’ll know that the two associations tackle the issues that lie at the heart of veterinary business. We know that you want to hear from speakers who ‘have been there and done it’ and our speaker selection includes experienced managers, vets and industry experts.

Can veterinary practice learn from John Lewis? Would you like to run your practice as efficiently and effectively as the award-winning John Lewis Partnership? Well, here’s a thing: HR and Main Board Director of the John Lewis Group, Tracey Killen is no stranger to the challenges of running a veterinary practice. Her husband, Richard, owns and very actively manages Highcroft Veterinary Group, with 6 first opinion practices and a referral practice in and around Bristol. In a plenary session Tracey shares the secrets on building gold-star customer loyalty and some HR fundamentals that apply whether you are responsible for 84,000 staff as she is or just a handful. Tracey will also host a session on bonuses and staff remuneration with Mark Beaney from Hazlewoods. Do not miss www.practicelife.biz z September 2013 z Practice Life

Stay well Association members will know that mental health and wellbeing is a key focus for both SPVS and VPMA this year, with both dedicated to helping vets and managers and their teams keep well. Hence why we’ve devoted a whole stream to this topic at congress, to help you recognise and deal with stress and mental health problems in your staff or yourself. Vet psychologist Brian Faulkner chairs this agenda that looks at stress management techniques, work-life balance, the subject of personality profiling and more. The world famous Oxford Mindfulness Centre based at Oxford University will also share with us the stress-busting techniques it has been working on with corporate vet group CVS.

5 star luxury at affordable prices! Carry on the stress-busting theme by enjoying all the facilities at the congress venue, the 5 star Celtic Manor Resort. Home of the Ryder Cup 2010, the resort is famous for its golf course and driving range. For those bringing partners (shhh... or for yourself... we won’t tell anyone...) there’s a luxury spa with swimming pool, gym, sauna and steam room plus a range of treatments. Voted Meeting and Incentive Travel (M&IT)’s ‘Best UK Hotel 2011, 2012 & 2013’ and Conference and Incentive Travel (C&IT) ‘Top UK Conference Hotel’ for five years running, this venue is not to-bemissed. We have negotiated hard to get some fabulous 5* room deals for you at rates you won’t believe. Celtic Manor is just off the M4 in Newport, 10 minutes over the Severn Bridge. By car it is 90 minutes from London Heathrow, and 45 minutes from both Bristol and Cardiff-Wales International Airports. It is 10 minutes from intercity rail services at Newport, with direct trains to Cardiff, London Paddington, and Birmingham.

CPD Diary

So who should come? Practice owners & directors, practice managers, vets and those about to embark on practice ownership, head nurses, receptionists, client care staff, administrators and finance staff and anyone with an interest in practice management. There are group discounts for those bringing multiple persons from their practice as well as substantial discounts for SPVS and VPMA members.

So: two minutes reading and just a two-day commitment to get 2014 off to the best start possible. What are you waiting for?

With huge thanks to our sponsors who have made this congress possible! Platinum Sponsors

Gold Sponsors

Read more and book online now at www.vpma-spvs-events.co.uk/congress or by phoning 01453 872731. Early Bird Rates are available until the end of October!

Silver Sponsors

Social butterflies! We know that you’re a competitive bunch so get your thinking caps on for the Thursday night pre-congress Networking Dinner... with general knowledge quiz! Pit your wits against your colleagues and trounce the competition. It’s a great kick-start to your congress. Friday night sees the return of the Sparkling Reception and Banquet with live music and entertainment. Enjoy a sumptuous 4 course dinner in 5* surroundings and do some well-earned relaxing after your day’s learning.

Bronze Sponsors

Bringing a spouse or partner with you? We’ve a choice of 3 great activities (subject to demand): Golf Clinic (1-2 hours) (Friday 31st January – 11:00am) Each group of golfers will be paired with a PGA qualified golf professional and will spend key time working on basic fundamentals and swing positions that will dramatically improve your game. Absolute beginners and experienced golfers welcome! Includes a Celtic Manor logo golf ball. £12 + vat per person Cooking Masterclass: Bread Making Experience (2 hours) (Friday 31st January – 2:00pm) Join one of Celtic Manor’s talented chefs in the kitchen for a chance to roll up your sleeves and get hands-on at the bread making cookery masterclass. £25 +vat per person Cardiff Castle Excursion (4 hours) (Saturday 1st February – 10:00am) Enjoy a day excursion to Cardiff Castle. Your visit includes transport, entrance to the castle and free audio and guided tours.

Practice Life z September 2013 z www.practicelife.biz

CPD Diary

Thinking of buying a new practice toy? Don’t miss the Focus on Diagnostics day to help ensure your return on investment... Diagnostic equipment is one of the most expensive purchases you’ll make and you simply cannot afford to get it wrong. This day is the perfect opportunity to have all your questions answered and help you develop a clear strategy on just how you’re going to make your new tool work for you. With business workshops running throughout the day to help with finance modelling, procedure pricing, tax efficiency and more, you’ll get all the vital information you need. A dedicated trade exhibition features leading suppliers of diagnostic equipment and services, from lasers and digital X-rays to endoscopic units and lab machines. Workshops include: • Improving your team’s diagnostic’s ratio • Building a practice strategy for investment, pricing and charging • The financial and clinical case for in-house vs outsourced labs • Making the most of your digital X-ray • Can you afford NOT to offer laparoscopic spays? • Profitable dentistry and more... Speakers include expert suppliers and practising vets, with first-hand experience of the clinical and financial benefits of the various technologies on offer. The day takes place in Solihull, and costs just £100+VAT for SPVS and VPMA members, including workshops and lunch. Non-member rate £150+ for the full day. See the full programme and book online at www.vpma-spvs-events.co.uk or on 01453 872731.

www.practicelife.biz z September 2013 z Practice Life

cpd diary

BVNA Congress Offers Management Stream Friday 11th - Sunday 13th October 2013 | Telford Conference Centre, Shropshire The British Veterinary Nursing Association (BVNA) is offering a vast choice of lectures for nurses throughout its three day event including a full stream of management lectures on Friday 11th. The management stream will cover a variety of subjects to

Practice ownership & moving into management

help delegates understand what individuals can get out of

(Tracy Mayne Memorial Lecture)

responsibility, ownership and success within a practice.

Speaker: Rachel Smith RVN This lecture will provide delegates with an insight into how they

What does it take to be a head nurse?

could become a partner or practice owner; providing advice on

Speaker: Kirstie Shield DipAVN (Surg) RVN

how to lead a dedicated team of veterinary staff and how to grow

The role of the ‘Head Veterinary Nurse’ or ‘Nurse Manager’ is

a business. Rachel will tell her story and along the way offer

essential in the day to day running of the veterinary practice

guidance and advice on ways to build knowledge and experience

and carries a number of responsibilities. As a key member of the

which will provide any budding entrepreneur the best grounding for

veterinary team, this role often requires management and leadership

becoming their own boss.

skills as well as clinical competency and the maintenance of high standards of nursing care. If you are looking to move into nurse management, have recently

Social networking – a marketing tool Speaker: Alison Burden-Blake,

been appointed as a head nurse or even if you have been in the role

Director of Veterinary Marketing School

for a while and are looking for another perspective, this lecture will

With more and more veterinary practices using social media such as

focus on how identifying the key attributes necessary to be the head

Facebook and Twitter as a marketing tool speaker, Alison Burden-

nurse will facilitate the successful leadership and management of

Blake, shares with delegates how to use social media to successfully

your clinical nursing team.

help grow their veterinary practice. Alison explains that social media is no longer just about marketing; it’s about PR and customer care.

anaging appraisals and performance reviews; M every end has a start!

Responsible/ethical use of social media

Speakers: Helen Sanderson and Renay Rickard RVN CVPM

Speaker: Nicky Ackerley, Director of HR Support Consultancy

The emphasis will be on how to engage your team into the process

This session will prove invaluable to employees, employers and

so that reviews are something people will look forward to rather

practice managers. Delegates will learn about the important legal

than dismiss or even worse dread.

implications of using social networking sites such as Facebook,

During the lecture the application of a simple and effective review programme that involves the whole team will be discussed. Also

Twitter and LinkedIn. The BVNA provides an Industrial Relations Service for its members,

how to include ways to amend current appraisal systems and how to

which receives many calls from people who have abused these sites,

start a new one including use of solid induction processes, use and

many of which have resulted in dismissal. This lecture will explain the

development of job descriptions and how to develop your team.

legal pitfalls of using social media, what can be seen as employees

How to devise your own “key performance criteria” within your

abusing the sites, the disciplinary process to follow if an employee

team that will help to ensure you are all working to a common goal

has abused the workplace and the benefits to practices when the

and the need to identify not just where you would like to be – but

sites are used correctly. The lecture will also cover the benefits of

how you are going to get there!

social networking when used effectively.

To view the full programme and see what else is on offer please visit www.bvnacongress.co.uk Practice Life z September 2013 z www.practicelife.biz

SPVS / VPMA Congress 2014 30 January - 1 February â&#x20AC;˘ Celtic Manor Resort

Kick start your 2014 CPD by taking two days out with your team at a 5 star resort and with A star speakers! Full programme and registration at www.vpma-spvs-events.co.uk

Where the Practice Team Comes Together

what’s coming up Preparing for Business Partnership Wednesday 9th October, Hartsfield Manor, Surrey (10:00 – 16:30) Contributors: Peter Gripper, Anval; Tracy Bainbridge, Park Veterinary Group

Are you about to take on a new business partner? Are you about to become a new owner? Failure of a partnership is expensive and traumatic; success can transform your business. This one day course will look at the demands, pitfalls and rewards of entering into a new business partnership for both the owner’s and the prospective new partner’s perspective – be they a vet or practice manager.

“Spoke to others going through the same process; well delivered and engaging”. focus on diagnostics Tuesday 15th October, Solihull

Veterinary diagnostic services and equipment have always been important tools of our trade. But fast-paced developments and the increasing availability of ‘specialist’ equipment and services can make it difficult to decide on what purchases or upgrades are necessary in your practice.

There will be workshops on diagnostic essentials, new technology, product updates and how to maximise the benefits from equipment and services. Finance models for new equipment will be discussed as well as key internal factors you need to assess and address before making a commitment.

What is needed versus what is ‘nice to have’? How do you make full use of 21st century tools but ensure a return on your investment?

Exhibitors will include laboratory and diagnostic imaging companies, suppliers of clinical pathology and other specialist diagnostic tools and services.

This one day event brings together top suppliers of diagnostic equipment and services with the answers you need.

This event is expected to be very popular – we encourage you to book early.

training the veterinary receptionist Thursday 24th October, Village Hotel Solihull (10:00 – 16:30) Contributors: Brian Faulkner, Vetpsych; Nicki Glen, NG Marketing Receptionist training and quality control is one of the biggest challenges of running a veterinary practice. Veterinary receptionists need a spectrum of skills, but all too often veterinary receptionist training is ad hoc and ‘on the job’. This can result in inconsistent approaches within the team as well as gaps in knowledge and an inconsistent client experience.

You will be shown how veterinary receptionists are pivotal in ensuring pets, owners, nurses and vets work together to achieve optimum clinical resolution. And how, by getting this right, they contribute to optimum financial resolution. It goes without saying that happy, effective receptionists are key to a positive and productive practice culture.

2014 joint spvs/vpma congress Where the Practice Team Comes Together

With a packed programme of problem-busting lectures from veterinary business experts together with specialist small-group Bringing together vet practice owners, managers, finance, HR and working sessions we’ll help yout to hone your management skills client support teams to spend two days learning and sharing, this and drive your practice forward in 2014. Put the date in the diary now and look out for further information is the best CPD investment you’ll make this year. and updates on www.vpma-spvs-events.co.uk Harness the knowledge and support of your colleagues at the UK’s foremost veterinary business and management congress.

“An excellent opportunity to stand back from the day to day tasks at work and take a broader view of things”. “The best bit? Getting away with my team!”

“It was good to meet other practice managers and be able to share thoughts and offer support.” In the next issue... Dec/Jan: Staff Development Plans | Fresh Ideas for Business | Engaging with the Media Practice Life z September 2013 z www.practicelife.biz

Accountants, Taxation & Practice Development Specialists to the moore scarrott Veterinary Profession CHARTERED ACCOUNTANTS

Our service is completely flexible which enables us to fit within the practice management team at any level in a cost effective way. We offer a free of charge, no obligation initial meeting and discussion, anywhere in the UK. Financial and management accounts Practice management and development advice Practice structuring, restructuring and finance Full outsourcing service and payroll bureau Taxation - compliance and mitigation strategies Full benchmarking service Forensic services Practice properties Succession planning Sage accountant partners

Veterinary team partners: Andy Moore andy.moore@moore-scarrott.co.uk Steve Headon steve.headon@moore-scarrott.co.uk Marcus Longbottom cmsl@moore-scarrott.co.uk Nick Lawrence nick.lawrence@moore-scarrott.co.uk

www.moore-scarrott.co.uk Calyx House, South Road, Taunton, Somerset, TA1 3DU Telephone: 01823 282100 Fax: 01823 254396

Competition bearing down on you?

www.medivet.co.uk

Medivet has the solution A new practice opening is a real threat to existing practices nearby. If there’s one opening near you, don’t just grin and bear it: tackle your competition by partnering with Medivet. You’ll feel safer and more secure knowing you’ll be able to compete much more effectively and share the risk with us. As a Medivet partner, we will work hard to maintain and improve your profitability and to give you the business support you need. Call today and find out how a Medivet partnership can help make beating the competition easier. T: 01923 470000 E: partnership@medivet.co.uk