Practice Life Issue 10 November/December 2015

December 2015 www.practicelife.biz

Doing it for real Turning around a poorly performing practice

Senior Health Clinics Successful implementation

Letting Go of Your Practice The management buy-out model

Medical Minds Matter Sharing Best Practice Across the Professions

THE MAGAZINE OF SPVS AND VPMA

Hot Topic: Women in Work SPECIAL:

SPVS-VPMA CONGRESS FEATURE

Practice Makes Perfect PPS have been providing successful solutions to the veterinary profession since 1998.

We are the only consultancy providing financial advice and services exclusively to the veterinary profession.

VETERINARY BUSINESS CONSULTANCY Practice Finance & Sales | Wealth Management Partnership and Share Protection | Mortgage Advice Retirement Planning | Employee Benefits

For a confidential, no obligation chat

Call 01527 880345 www.pps-vet.co.uk

Professional Practice Services is authorised and regulated by the Financial Conduct Authority.

Veterinary Insurance Specialists

PPG SI

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

GENERAL INSURANCE Tailor Made Surgery Insurance | Locum Insurance Equipment Finance | Private Medical Insurance Motor Fleet & Home Insurance

Why not have a chat with our friendly team?

Call 01527 909200

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

www.ppsgi.co.uk

EDITORS’ LETTERS

Editors’ Letters

I

would like to start by thanking those of you who responded to the survey sent to SPVS members in September. I appreciate many people find the thought of completing questionnaires a task best avoided, but I am grateful to those who put forward their opinions about this magazine. I am collating the results and will take your comments on board.

As you receive this edition of Practice Life, winter will be here and the festive season fast approaching. For many, Christmas and New Year are enjoyable celebrations but, sadly, this isn’t the case for everyone. For some it can be a stressful time, particularly for those suffering from mental health problems. In light of concerning statistics relating to mental well-being in the veterinary profession, it is important this subject is talked about openly.

I attended a Mental Health and Well-being conference in October, hosted in conjunction with the RCVS’ Mind Matters initiative, which looked at the mental health challenges affecting the medical professions, and called for understanding and support. However, understanding and support are only possible if we are able to recognise the signs of mental illness – the article

by David Bartram in the Well-being section is a great place to start.

A

nother year almost flown by! Not long until our joint congress at Celtic Manor and what promises to be the best event yet, with everything from health to horses, media to mental and law to leadership, plus a dedicated stream for those new to practice management. Ten years ago that was me; fish out of the electrical retail water so to speak, and while I’d seen it all change in that sector over three decades, little did I realise the independent vet practice I was joining would be affected by the same commercial and corporate pressures. Just what the next 12 months will bring is anyone’s guess as we edge a little closer to Paul Green’s (another speaker at Newport in January) prediction that we will have a “national vet” by 2020. Make sure you book your place for a whirlwind couple of days.

As a leader in practice I learned a valuable lesson recently.

We have a border terrier called Toro at home. I always keep him on his lead whenever he takes me for “walkies”.

Conversely, my better half can unclip his leash safe in the knowledge he will sniff around but return to his mistress’s side, butter not melting in his small jowls! At the weekend,

London Vet Show saw the launch of the new RCVS Practice Standards Scheme. So it’s new, but is it improved?

I certainly think so. SPVS Council was supportive of the PSS review and we were deeply involved in the scheme’s development. In the SPVS pages you can read a PSS update from Jacqui Molyneux and I would encourage you to take her advice: have a good look and see how it might benefit your practice.

The subject of women in the profession is our Hot Topic in this edition. This is frequently talked about, particularly the impact the rising percentage of female graduates may have on the future veterinary business landscape. We feature several women’s stories and I must thank those who agreed to contribute here.

SPVS/VPMA Congress 2016 takes place at the end of January and it will be special for me as it heralds the beginning of my year as SPVS president. I was honoured to be asked to take on the role and I am looking forward to representing the society and I hope I will have the opportunity to meet you during the year.

Wishing you a merry Christmas and a happy and prosperous 2016.

Stephanie Writer-Davies, SPVS editor

I delayed the morning walk until lighter and, foolishly, decided to do the unthinkable. I gave him temporary freedom to roam. Before I’d had time to reel in the extender lead, Toro was off like a shot into the bushes.

I winced and tutted, realising I should have known better but then, quite unexpectedly, he reappeared with something in his mouth. He trotted up to me and dropped… a £10 note at my feet! It was only later that I thought about the incident in a different context. All this time I had restrained him on the lead, he had never objected and then, when I allowed him to do so unfettered, he rewarded me with a very useful find.

How true is that of a leader? In practice, we often fail to delegate and therefore may never know of the talents and aspirations of our teams. This simple experience made me think. I have kept the tenner safe and intend to buy Toro a gift at Christmas. Speaking of which, may I wish all Practice Life readers a very happy one and I hope to see you at Celtic Manor in 2016.

Ian Wolstenholme, VPMA editor

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

3

Contents Editors

g

UPDATE: NEWS & VIEWS 5

g

VPMA NEWS

SPVS Stephanie Writer-Davies BVSc MRCVS steph@practicelife.biz VPMA Ian Wolstenholme, Practice Manager ian@practicelife.biz Publisher Mojo Consultancy Ltd 181 Sandpit Lane St Albans AL4 0BT Tel +44 (0) 1727 859259 info@mojoconsultancy.com www.mojoconsultancy.com Advertising and Sales Enquiries Libby Sheridan MVB MRCVS libby@practicelife.biz Tel:01727 859259

Barcelona Banter: News from SEVC g

SPVS NEWS

g

NURSE TALK

g

COLLEGE CORNER

g

VDS NEWS

g

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.

20

HOT TOPIC

21

WELL-BEING

23

Recognising and Responding to Mental Health Problems g

MANAGING PEOPLE

16 28

Turning Around a Poorly Performing Practice g

CLIENT CARE AND MARKETING

30

Senior Health Clinics g

BUSINESS HEALTH AND FINANCE

22 33

The Management Buyout Model g

PRACTICE DEVELOPMENT

36

Giving the Best Goodbye g

CPD SHARED

40

Focus on HR g

Š 2015 Practice Life All rights reserved.

18

Indemnity Breach

g

Articles and photographs are welcomed for submission, though publication is not guaranteed and is at the discretion of the editors.

15

Ensuring Specialist Status

Eva Lambe eva@practicelife.biz

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.

16

Inspirational 50th year congress

Women in Work

www.spvs.org.uk www.vpma.co.uk

11

Cyclescene and Practice Standards Scheme

Sales Administrator

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.

7

CPD DIARY

28

42

2016 Congress Special g

WHAT’S COMING UP

Details of the Spring 16 issue

46 42 28

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

Practice Life z November/December 2015 z www.practicelife.biz

5

News & Views NEW BRITISH VETERINARY LGBT+ GROUP B ri t i s h V e t e ri n a ry

The first meeting of the newly formed British Veterinary Lesbian, Gay, Bisexual, Transgender (LGBT+) Group was held at BVA Headquarters on September 25. The group was set up by Mat Hennessey in July following his attendance at the London Pride March where doctors and dentists were represented, but no vets. He felt there were two reasons to set up the group, the first to support those within the veterinary profession who were LGBT+ and also to show that the veterinary profession supported diversity within society.

The first meeting was attended by about 25 people, including Sean Wensley, the BVA’s new president. A representative from Stonewall talked about their work with large companies to promote equality for LGBT+ workers. There was discussion on how to progress the group and it was decided that it will continue as a facebook group with a public-facing page. Universities were also represented by Association of Veterinary Students and the aim is to set up a group in each of the universities to support students and help to create a warmer LGBT+ environment within vet schools. The group will be at London Pride 2016 and potentially other Pride events.

The group plans to hold an AGM next year where an executive can be set up to start formalising the vision and mission of the group.

For more information visit the facebook page, British Veterinary LGBT.

L

G

B T

Creating a community Promoting equality Providing support BVLGBT is open to anyone wanting to support lesbian, gay, bisexual and transgender rights within the veterinary professions.

We aim to create a fun social network that promotes fairness and equality, and provides support for individuals both working and studying.

bvlgbt@gmail.com

LGBT advert.indd 2

07/08/2015 15:42

Norbrook launches VET for Android An Android version of Norbrook’s existing free iPhone app, Veterinary Excellence Tool (VET), has been launched. VET’s key features include: product dosing calculator, product listing of UK products, territory manager locator and contact details, upcoming events, fluid calculator for infusion rates, and a nutrition calculator to establish daily food requirements. The app, which is aimed primarily at veterinary surgeons, also has a number of features that may be beneficial to farmers and trade stores. To download the VET app, search for “Norbrook” on the App Store or Google Play.

Here at the Practice Life office, we can’t believe another year has flown by!

We hope you’ve enjoyed the various features throughout the year. If you’d like to see your name in print next year – get in touch! We’d love to hear from budding writers.

May we take this opportunity to wish you all a very Happy Christmas and a successful and exciting 2016.

From the Practice Life team

www.practicelife.biz z November/December 2015 z Practice Life

6

NEWS & VIEWS

Calling young marketers working in animal health!

The Veterinary Marketing Association (VMA) is calling on marketers within the animal health industry to nominate talented colleagues for the VMA Young Marketer of the Year Award 2015.

The award is designed to recognise a young marketer who has demonstrated an excellent grasp of marketing products and/or services in the animal health sector and who clearly demonstrates the benefits of the marketing activity they have undertaken.

Last year’s winner, Amanda Melvin, from MSD, said the award opened up a number of fantastic opportunities for her, and she chose to use the £2,000 bursary to complete the Squared Online Certificate in Digital Marketing.

Justin Phillips, Marketing Manager for White Cross Vets, won the 2013 award and encouraged the industry to get involved and nominate. He said: “Entering the VMA Young Marketer award kick-started a fantastic 12 months for me and I would encourage anyone who is passionate about their marketing role, or who has a rising star in their organisation, to enter this year’s award.”

Candidates must be 34 years old or younger on March 18, 2016 and/or have been in marketing for less than five years on March 18, 2016. Entrants must have been working within the animal health industry for the previous 12 months and still be working within the animal health industry on this date.

From L-R: Justin Phillips, White Cross Vets, YMOTY winner 2013, Amanda Melvin, MSD, YMOTY winner 2014, Malcolm Bridges, sponsor, British Dairying and Kate Silverton, BBC presenter and host of the 2013 awards.

The VMA encourages all young marketers to apply, whatever the size of their marketing budget. Submissions must arrive at VMA no later than January 31, 2016.

A shortlist of three candidates will be selected to meet a panel of judges from the industry to discuss their nomination in detail and complete a short case study.

The winning candidate will be announced during the awards ceremony on March 18, 2016, at the Lancaster Hotel, London. Finalists, along with their proposers, will be invited to the ceremony as guests of VMA. For further information visit www.vma.org.uk or contact VMA secretary Colin George on 0844 561 6157 or 07845 141 171 or email secretary@vma.org.uk.

Medivet expands to 123 practices Medivet has become the fourth largest veterinary group in the UK with the acquisition of 12 new practices.

The Medivet group now operates a total of 123 practices, made possible through a new financing agreement with HSBC, the group’s long-standing banking partner.

The veterinary group’s acquisition strategy was enabled by a £25m revolving credit facility from HSBC. The finance facility has been tailored to meet the needs of the rapidly-growing business and the flexible nature of the revolving credit facility allows it to draw down variable levels of funds to purchase new practices and meet its monthly cash flow needs.

Arnold Levy, Managing Partner at Medivet, said: “As a business, we’re different to other veterinary consolidators as we’re privately owned by veterinary surgeons. This helps us to provide a more robust level of care to our patients – tailored to their needs and consolidated across all of our businesses.

As a privately owned company, HSBC’s support has been intrinsic to our achievements and has allowed us to buy practices as and when the right opportunity arises.”

VPMA ANNUAL GENERAL MEETING The Annual General Meeting of the VPMA will be held at the Celtic Manor Resort, Newport on Thursday 28th January 2016 at 5.00pm in the Denbigh Suite.

Full Members must advise the Company Secretary in writing of any business to be raised by them at the AGM at least 28 days prior to the meeting. Please submit any items of business to be raised at the AGM to:Company Secretary: VPMA Limited, 76 St Johns Road, Keering, Northants NN15 5AZ Fax: 0870 836 2250 Email: secretariat@vpma.co.uk

Don’t forget you can send us your press releases on practice successes and initiatives. Suppliers are also welcome to send information on management-related products and services. Email to libby@practicelife.biz Practice Life z November/December 2015 z www.practicelife.biz

VPMA News VPMA President,

Howard Brown

And now the end is near and so I face my final Practice Life edition as VPMA President. It has been great to meet so many managers at all different levels within the veterinary team, some of whom are new to management, some working within it for years and some who have joined us from other industries, transferring their skills.

It has been my pleasure to represent VPMA and the vibrant, multi-skilled members at different functions, events and conferences, all of whom are striving to grow, develop and manage their veterinary businesses.

During my presidential year I have mainly focused on continuing to strengthen the internal structures at VPMA that will, I hope, benefit the association moving forward. I am pleased that so many of you are finding our lunchtime management update webinars helpful. We have also been continuing to work on the bonds between VPMA-SPVS joint events – why not take a look at the congress preview on page 42.

I would continue to encourage and ask you, our members, to give us feedback, opinions and suggestions so that we continue to act on your behalf and support your needs. You all seem a little shy at getting in touch – or maybe nobody actually reads this column!

I’ll send chocolate to those who contact me with their suggestions by the end of the year! president@vpma.co.uk This has been an enjoyable time, and I am looking forward to a jam-packed congress in January, before handing over the reins to Renay. I hope you will find a stream of lectures to suit you, as well as learning from our opening speaker, Alistair Campbell. As the son of a Yorkshire vet, his understanding of our industry along with his communication skills and as a mental health ambassador, he will certainly make for interesting listening.

So, I look forward to seeing as many of you at congress as possible and, for those who are not able to come, please find other ways to engage with us. Working with such a diverse client base, the VPMA is ideally placed to represent us and hold us all together as one team to ensure the businesses we represent continue to grow in the interest of pet care.

Howard Brown

www.practicelife.biz z November/December 2015 z Practice Life

VPMA NEWS

7

Take the Quiz! CVPM Exam Example Question 3 In the third in our series looking at the Certificate in Veterinary Practice Management (CVPM) syllabus, we take a look at Marketing: The CVPM syllabus expects candidates to have a basic understand of marketing principles – especially niche marketing, considering the profession we are in.

It is expected that those working towards the CVPM are familiar with the “7 Ps” and commonly used marketing tools.

As a reminder, the “7 Ps” of marketing (as defined by the Chartered Institute of Marketing) are as follows:

Product Price Place Promotion People Process Physical evidence Candidates should be able to produce a marketing plan to support the aims of a practice’s strategic plan and also be able to implement it and measure how effective it is. This can be included in the required report, and it should describe a marketing plan the candidate has used in his or her practice. The examiners will also ask further questions about marketing in the oral sections of the examination.

The examiners don’t expect all candidates to be ace contributors to Facebook, but they will expect you to know what needs doing in terms of digital marketing/ social media. You will be expected to appoint someone to be responsible for these marketing activities, to ensure it gets done and of course measure how successful a campaign has been. There is no point wasting time or money doing marketing activities if you don’t measure the results!

This month we are asking for written answers to our test question as it seems some of you are a little shy about submitting videos or mp3s.

On to this month’s question, which is: A franchise group has taken over four of the six practices in your area. What marketing strategies could an independent practice use to compete and remain successful?

Submit your answers to c&t@vpma.co.uk by Dec 15th

8

VPMA NEWS

Regional Co-ordinator,

Renay Rickard

MEET YOUR REGIONAL ORGANISERS If you are not in touch with your local regional group and would like to get more involved, please contact the VPMA Secretariat: secretariat@vpma.co.uk

Wanted: good organisers!

The regions are at the heart of VPMA’s core values: providing an information and support network for practice managers across the country. But there are some areas where regional meetings are not available to our membership, so we are recruiting new organisers. If this is something you would like to be involved with, why not contact me for a chat? We’re very keen to welcome new representatives. We will also be holding a meeting for our regional organisers – and anyone keen to join the team – during January’s congress. Contact the VPMA secretariat for details: secretariat@vpma.co.uk.

During 2016 I will be contacting members in areas where we do not currently hold meetings to see whether, through a joint effort, we can organise some regional events. So get your thinking caps on and put forward suggestions for suitable venues and topics!

Our regional meetings vary from a small group meeting in a restaurant for a meal and a chat, to half-day, multi-speaker events – let’s set a target to get the majority of our membership to a regional meeting in 2016! The VPMA secretariat are fantastic with the marketing of our regional events and help in any way they can, so it’s very much a team effort when organising these meetings.

I’m looking forward to seeing you at congress and across the regions is 2016!

Renay Rickard – RVN CVPM – VPMA Regional Co-ordinator/ Vice-president

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

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

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

NORTH WEST REGION Janet Hughes & Janie Clare Tel: 07964 505226 ro17@vpma.co.uk

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

BUCKINGHAMSHIRE Julie Beacham Tel: 07710 317310 ro17@vpma.co.uk

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

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

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

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

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

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

al n o i g e R VPMA ’ meeting rs OrganisAeNOR, SATURDAY 30TH

IC M 0PM THE CELT 16 AT 1.1 0 isers’ 2 Y R A al Organ JANU one al Region

s annu For any holding it in January 2016. is A M P ss egional The V ir Congre oming a VPMA R e th t a g or would bec meetin rmation, rested in fo te in in is re o o sm egional wh t some R d require a n k a ting. a r e e is sp n this mee Orga red to d e n d e si tt n a o c to advise like to be ly invited are warm MA Secretariat to u o y s, g VP Meetin ntact the join us.

Please co ntion to te in r u o y of

a.co.uk m p v @ t a i secretar

Practice Life z November/December 2015 z www.practicelife.biz

VPMA NEWS

9

Taking management to the next level VPMA and the College of Animal Welfare (CAW) have put their heads together to promote two accredited qualifications in leadership and management, aimed at the veterinary sector. Delivered by the CAW Business School, the ILM Level 3 Certificate in Leadership and Management is aimed at those working in or aspiring to a leadership position within practice. The qualification is awarded by the Institute of Leadership and Management, and is equivalent to ‘A’ level standard. The ILM Level 5 Diploma is delivered to foundation degree level. Here, Lily Carey, of Portsmouth Vets4Pets, shares her experiences of completing the certificate.

I’ve been working at Vets4Pets Portsmouth since it opened in November 2012, having come from a retail background. After working as a receptionist for around three months, my Joint Venture Partner told me he’d like me to progress at the practice with a view to taking on more responsibility and increasing my skill set. So I completed the ILM Level 3 Leadership and Management course.

Through doing the course, and working in a more administrative role, I’ve gained management knowledge and now have a better understanding of what goes on behind the office door. The course consists of eight written assignments, along with two study weekends at the College of Animal Welfare in Cambridgeshire.

Throughout the course we learnt about topics from an individual employee’s point of view as well as from a team perspective.

ILM recommended we spent about eight hours per assignment, and it was generally easy to find a spare 30 minutes every few days to get researching and typing. The assignments are relatively short (often less that 1,500 words) and so the bulk of my time was spent on research.

Much information was obtained through my workplace’s own policies and procedures, and the CAW website is full of course-related content.

We also had to gather feedback from colleagues, and I thought this gave us a great insight into one another’s roles.

Something I really enjoyed when writing the essays was having a relevant example from work that I could refer to, and being able to provide first-hand insight into many of the topics covered. Since completing the course I feel more confident approaching new situations at work, safe in the knowledge “I’ve written a whole essay

on your question!” If a colleague were to come to me with an issue or concern that I hadn’t had to deal with before, it’s great to know that I could refer back to this course for guidance.

Interacting and working with new people comes easier now.

The leadership assignment was a fantastic way to see how different people really do respond to different leadership styles, and that the way in which you might be leading just isn’t going to work for everyone. It offered a real insight into how a misjudged leadership style can be detrimental to the whole team and we learnt about a variety of styles, and which kind of people are likely to benefit from which approaches to leadership.

I have found myself to be more perceptive to people’s actions and reactions in the workplace, especially since completing the stress and conflict management assignments. Veterinary practices have all the right ingredients to be potentially stressful at times (think emergencies, late appointments and that growing pile of claim forms!), and so acquiring strategies to help others deal with varying situations will always be beneficial, both in and out of the work environment.

As our practice has been growing and developing we’ve taken on more staff. The recruitment assignment helped me greatly with this and I felt comfortable preparing interview questions, holding the interviews with my JVP, and following up with the selection process.

I hadn’t been involved with recruitment before so I was really grateful to have gained practical, applicable knowledge about the process.

This course has been so helpful to me, and I would wholly recommend it to people who are taking the big step into management as it has certainly made the transition run smoothly for me.

The two study weekends were a great opportunity to meet other administrative staff from vet practices, and it was really lovely to swap non-clinical stories and experiences. We had all come from varied backgrounds and yet completely related to one another. My course tutor, Emma Helkenberg, was easy to get hold of and she assisted and guided me with any queries I had.

Although the course is not based specifically around veterinary surgeries, which meant at times I had to provide theoretical examples, it’s a fantastic course for gaining business and managerial skills, and understanding how to implement them. The content and concepts in each assignment really can be used in practice in the future, and the course serves as a great reference point going forward.

VPMA proud to sponsor Head Nurse Congress It was an easy decision for VPMA to sponsor the Head Nurse Congress 2016, as veterinary nurses often take on further management responsibilities without additional training, so supporting the event was a natural fit for VPMA. Membership of VPMA not only gives day-to-day support through its e-group, but also offers monthly management webinars as well as the Veterinary Practice Administration Certificate (VPAC) and Certificate in Veterinary Practice Management (CVPM). VPMA believes that by supporting the Head Nurse Congress it can ensure veterinary nurses are supported and their managerial skills developed.

Mark Hedberg, of the College of Animal Welfare, which runs the Head Nurse Congress, said: “We’re delighted to welcome the VPMA as our main sponsor for Head Nurse Congress 2016; we strongly believe head nurses are an essential part of our profession. We are both humbled and inspired by the response to this congress, and having the VPMA come on board to support next year’s event is the icing on the cake! Their enthusiasm and positive contributions to our event have already made themselves felt and we look forward to a warm and productive relationship during the coming year.”

For more information and booking details, visit http://www.caw.ac.uk/events/head-nurse-congress/.

The Head Nurse Congress will be held on May 14-15, 2016, in Towcester, Northamptonshire.

www.practicelife.biz z November/December 2015 z Practice Life

10

VPMA NEWS

Barcelona Banter!

Ian Wolstenholme, VPMA editor, reports from this year’s Southern European Veterinary Conference, where top speakers attracted delegates in force to the world-class practice management sessions.

By the time Practice Life lands in your practice the memory of the ninth Southern European Veterinary Conference in Barcelona three months previously will be a distant memory. That said, and having attended this event several times for CPD, producing media articles and representing VPMA, SEVC constantly grows and continues to become more relevant for UK vets and support staff in a global arena.

Getting to and from the three jam-packed days is very straightforward and does not blow practice allowances by any means. Crucially, it does provide access to some of the most advanced facilities in terms of medicine, management and networking that I know – and you don’t need to know a word of Spanish!

The practice management programme was, once again, coordinated by Dr Ernie Ward, who ensured that whether you were an experienced or novice manager, there were sessions to suit. I was delighted to see that 2015 attracted one of our own well-known UK presenters, Brian Faulkner, among the list of speakers. Fellow speakers included Steve Kirton, Hector Gomez Asenjo and Ernie Ward covering popular themes from rebranding a practice, practical financial indicators and confidence, to productivity, marketing services and how much money do you want to make!

For me, the most interesting KPI here was that in at least 95% of the practice management lectures, it was standing-room only; so much so that the venue staff had to wheel in a large-screen TV feed from the hall and extra chairs just outside the large auditorium to accommodate the eager delegates. This had to be a first for any management stream – that and coupled with the fact I saw several practice owners “lured” into the business sessions – meant that practices from Poland to Paris and Barcelona to Beijing really do value the need for quality practice management.

Additionally, this year SEVC played host to the XII Congresso FIAVAC and the 21st FECAVA EuroCongress (Federation of European Companion Animal Veterinary Associations) alongside the 200 lectures and presentations by 80 world experts, which covered every aspect of veterinary care.

Various symposia relating to rabies, dentistry, nutrition and 21st century veterinary education were held alongside eight further workshops and wet labs. A record number

Speaker Brian Faulkner

The poster presentations were a popular feature of SEVC

of research poster abstracts were displayed, including three from the UK. With a huge commercial exhibition, international welcome, flamenco show and of course the famous Gran Fiesta, this was yet another successful conference. Perhaps the biggest surprise announcement was that SEVC 2016 (October 20-22) will be moving to Granada between the shores of the Mediterranean and the Andalucian hinterland at the Palacio de Congressos there.

Yes, SEVC 2015 was extremely busy and, once again, I caught up with management stream speakers Steve Kirton, Ernie Ward and Brian Faulkner. They made some interesting and important comments that you can hear by typing in the web links below. Why not take a five-minute break away from your desk for a listen?

Brian Faulkner talks about client satisfaction and confidence: http://1drv.ms/1OHzkPH Steven Kirton and Ernie Ward talk about marketing your practice: http://1drv.ms/1ZUVUYZ Plus, if you have time, the conversations I had last year at SEVC are still available with Rene Van Den Bos: http://1drv.ms/1tPu8xK Andrew Roark: http://1drv.ms/1tPxlxs Wendy Myers: http://1drv.ms/1tPvatS Oh, and did I mention the tapas…?

Practice Life z November/December 2015 z www.practicelife.biz

SPVS News President’s column Nick Stuart It is hard to believe that by the time you read this my presidential year will be coming to a close and congress only weeks away. I am really proud of the way our congress has grown over the years and I feel confident in predicting this one will live up to expectations! If you haven’t booked already, don’t leave it – last year we sold out by the New Year.

Thinking about what SPVS has achieved in the past year, our involvement in reshaping the new Practice Standards Scheme would have to be high on the list. The real mastermind behind this, working tirelessly on behalf of RCVS, has been Jacqui Molineaux – as she is a SPVS past-president, we’ll claim some of the glory too! However, SPVS, led by Anna Judson, have been active members of the Practice Standards Group, and I hope we’ve represented the views of our members in our contributions.

One criticism of the old standards was that it was largely a boxticking exercise. The new standards still have an element of this but, at core level, those boxes are largely legal requirements, so you should already have them ticked. The awards are an exciting addition, as they are much more about behaviours. In the past, for example, it was enough to just own a piece of equipment; now you benefit from demonstrating the expertise to use it to its full potential. The awards recognise customer service, the practice team, clinical care and out of hours and are given at good or outstanding level. SPVS will continue to follow progress of the new standards and I really hope members get behind the new scheme.

I am writing this on my way home from a very enjoyable weekend at the AVSNPI Congress, held on the border between Northern Ireland and the Republic. The majority of practices in Northern Ireland are mixed and most clients are dairy farmers, which is why I found myself at a lecture on the economics of milk production. I promise never to complain again about competition within the veterinary profession!

Seeing the challenges vets face around the country and in different types of practice is something I have really enjoyed. I hope SPVS membership has helped in tackling some of the issues we face in this new and competitive environment.

The autumn conference season welcomed two new SPVS initiatives.

Cycle Scene, where competitive, Lycra-clad young cyclists (young compared to me) tackled some of southern France’s more challenging routes, including Mount Ventoux. You can read more about that on page 15. Hot on its heels came our first Spa Scene, for those who prefer their CPD in a more relaxing setting. If you didn’t manage to join any this year, get them in the diary for 2016, starting with March’s Snowscene in Tignes. I hope to see you there as a very relaxed pastpresident, having handed over the reins to Steph Writer-Davies!

www.practicelife.biz z November/December 2015 z Practice Life

SPVS NEWS

11

SPVS Dates For Your Diary 2015 January 28-30, 2016 SPVS/VPMA Congress The Celtic Manor Resort, Newport.

The society’s AGM will take place at 3.45pm on Thursday January 28. For full details, or to book, contact the SPVS Office or see the VPMA-SPVS Events website.

March 5-12, 2016 Snowscene The Village Montana Hotel, Tignes, France.

There is excellent skiing for all abilities in the extensive Espace Killy ski area.

The CPD speakers will be Dr Clive Elwood from Davies Veterinary Specialists, who will give presentations on gastrointestinal disease, and Martin Whiting from the Royal Veterinary College, who will discuss the disciplinary process and contentious issues. For more information, or to book, contact the SPVS Office or see the SPVS website.

April 11-12, 2016 SPVS Officer and Council Meetings If you have any topics that you would like to see discussed please contact the SPVS Office.

SPVS e h t t a s Join u ner! n i D s a m t Chris s 4-course

ptuou ying a sum It’s a perfect jo n e e b l We’l ber. th Decem cers and meal on 8 SPVS Offi t e e m re to y it n get mo opportun w you ca o h e e s . n d n associatio Council a with the involved om the vailable fr a re a s il eta Further d ce.

SPVS Offi

PLEASE NOTE SPVS new address: Unit 19a, Hatton Country World Hatton, Warwick CV35 8XA

12

SPVS NEWS

What being on SPVS’ Council can really offer young graduates Karmen Webbe, the youngest member of SPVS Council, explains why she signed up and what has inspired her to remain such a passionate and enthusiastic advocate of the veterinary profession Karmen Webbe

I

graduated in 2010 from Cambridge and went into mixed practice in Northumberland. After a couple of beautiful but bitterly cold Northumbrian winters, I returned to south-west London, which is where I grew up. I am currently the senior veterinary associate at Wandsworth Vets, which is part of a family run chain of practices spanning Surrey to Clapham.

As a student I joined the Association of Veterinary Students (AVS). It was an exciting time for the association with the addition of a new veterinary school in Nottingham and a general feeling that the society wanted to become more professional and organise more than the infamous Sports Day. As AVS secretary, I attended BVA Council meetings and quickly learned there was much more to veterinary life than just an impressive collection of scientific facts; I am certain that engaging with the profession at such an early stage in my career is the reason I still enjoy being in practice today. After graduation, it was suggested I might find a role on SPVS Council interesting. I could see that it would enable me to maintain a deeper connection with the veterinary profession and so I applied.

At SPVS’ Final Year Seminar in 2009, I was struck by how enthusiastic the society’s representatives were about the profession; this was refreshing after years of being told to consider other career options by more jaded members of the profession! I feel very privileged to be able to listen to opinions from a group of clearly successful, motivated and ambitious veterinary surgeons who see the importance of contributing to issues that reach further than just the confines of their own practices.

I am undoubtedly the least experienced and august member of Council. However, we are the Society for Practising Veterinary Surgeons and so I consider it important there is at least one Indian among the Chiefs at Council meetings!

There are times when the issues we tackle are not ones I have direct experience of, but I remind myself that a fresh pair of eyes is never a bad thing. I find it odd that so few younger vets seem to engage with big veterinary issues or be aware of the many societies that would enable them to get involved. It seems to me that change within the profession often comes from the top down because of this. Remaining on SPVS Council has opened my eyes to the many directions in which I could take my career and has encouraged me to be more ambitious. I recently helped interpret responses from a SPVS questionnaire, designed to determine whether there is a shortage of vets, and whether this could be helped by a review of the tier-two points system for vets by the Migratory Advisory Committee. There was a strong feeling from the respondents there was attrition in the number of vets after the five-year qualified mark, and my personal experience among my peers reflects this.

Career development It appears once the euphoria of graduation and the terror of being a new graduate have worn off, it is easy to look at long working hours with mediocre pay and wonder whether it’s time to move on. I believe the profession needs to realise there is a goldmine of bright, hardworking, and highly goalorientated individuals who are disappearing because of lack of career progression. I hope the Five-Fifteen focus group being introduced to Congress by SPVS will help inform young vets about their career options and help them better achieve their potential. I feel that I have received a lot of mentoring from those around me on Council (whether they were aware of it or not) and it would be great to be able to offer this to more people.

My interests on Council lie in engaging with students and also with mental health in the vet professions, and I am the SPVS-nominated representative at VBF meetings. It is a very interesting time to be in this role as the VBF, Vet Helpline, and VSHSP are all being overhauled, rebranded, and reorganised to improve accessibility. I have also attended four Final Year Seminars and very recently helped out at the Nottingham University Business Game. It’s all been great fun and has helped me maintain the passion and enthusiasm that I initially felt on being accepted to veterinary school.

I suppose, at this stage in my career, I fall into the “supporting vets” part of SPVS’ tagline. However, I hope I can be increasingly useful in the “developing practice” part.

Being on SPVS Council is definitely a decision that has helped shape my career for the good and I hope young vets reading this might also decide to get involved. Being a vet is so much more than just a job and that can be a negative or positive thing. Becoming involved in SPVS has definitely shown me the positives.

Practice Life z November/December 2015 z www.practicelife.biz

SPVS NEWS

13

THE BIG REVEAL:

Practice Standards Scheme updated in line with profession’s concerns The Practice Standards Scheme has undergone a review and here, following its unveiling at London Vet Show, Jacqui Molyneux of the Practice Standards Group, reveals what’s new and the benefits of membership to practices

T

he Practice Standards Scheme (PSS) was introduced in 2005 after agreement from BSAVA and BVHA to amalgamate their schemes. An extremely important, but often forgotten point is that the standards laid down in the scheme are not determined by officers or staff at the RCVS, but by a Practice Standards Group (PSG), where all the large veterinary organisations are represented. It also includes two nurse representatives and a lay member.

Fifty-seven per cent of practices are currently members of the PSS – not bad for a voluntary scheme – but the PSG felt this could be higher. So we asked the profession what they did and didn’t like about the scheme. The consultation results showed us that, although there were positives, there were some serious criticisms, in particular that the scheme was just a box-ticking exercise. For example, a practice could have an ultrasound machine, but there could be noone in the practice who knew how to use it.

It was also felt the scheme didn’t really address clinical standards in a practice. Equine practices that didn’t have stabling facilities could only ever achieve core status and this was not considered to be a fair representation of their standards.

The comments were taken on board and the PSG investigated what veterinary surgeons in other countries were doing. The American Animal Hospital Association appeared to have tackled some of the issues and they were extremely helpful in the early stages of developing our new PSS. However, their scheme is really only for the US equivalent of UK veterinary hospitals (hence the reason only 17% of their practices are members) so, in order to make our new scheme relevant to potentially all practices, we decided to try to amalgamate the AAHA scheme with our existing one.

No mean feat!

The group also wanted to produce something that would offer true value to participating practices in marketing terms. We regularly heard the criticism that the middle tier – General Practice – was a very broad category and people wanted a way to let the public know what they were particularly good at. Although the scheme is never going to become a household name, it was felt that if scheme members had something to shout about, it would help with marketing; particularly if the RCVS provided a toolkit to help.

So what has been carried over to the new scheme?

The basic categories of Core, General Practice and Hospital are unchanged, and practices will be automatically moved over at their current level when the new PSS is launched in November. www.practicelife.biz z November/December 2015 z Practice Life

And what is new? In the new scheme, all the criteria have been reorganised into modules of which there are 19 in total. Each module features criteria that are mandatory at Core, GP or Hospital level; these relate very closely to the current scheme, meaning that everyone who is a member currently should be able to satisfy these criteria. Practices will be able to apply to be assessed for various awards under the new scheme.

For small animal practices these awards are: • Team and Professional Responsibility • Client Service • Patient Consultation Service • Diagnostic Service • In-patient Service • Emergency and Critical Care Service For equine practices, Patient Consultation Service is replaced by Ambulatory Service and there is no Emergency and Critical Care Service award.

For farm practices there are four awards: • Team and Professional Responsibility • Diagnostic Service • Client Service • Consultation/Advisory Service Each award is made up of a group of modules and some contribute to more than one award – for example, the new Pain Module contributes to In Patient Service and Patient Consultation Service. Within each award there are many criteria, each of which has a points value.

14

SPVS NEWS

Good or Outstanding Awards are given (based on Ofsted nomenclature) depending on the number of points attained.

Once a practice has received an award they will be able to advertise that fact in the practice’s marketing materials – imagine how powerful it will be to say that you have been externally inspected and achieved an Outstanding Award for In-patient Service?

I don’t for a minute think many members of the public will be interested in whether a practice is good/outstanding at Team and Professional Responsibility, but I suspect that it will become important in the future when practices are recruiting new team members; we know that 61% of new graduates look for PSS membership when they are choosing their first job and, it is my opinion, that this will only increase.

One of the many exciting aspects of the new PSS is the IT system developed to go with it. This will allow practices to upload documents prior to their inspection and it will have a calendar facility for reminders about

practice essentials. It also will allow practices to see very clearly where they are on their PSS journey, showing when a Good or Outstanding award status has been attained.

It was very important too that a group of PSS inspectors was trained, who would be able to inspect the new behaviour criteria and act as advisors to practices.

We had a huge response to the adverts and the successful applicants are undergoing external training.

I am truly excited about the new scheme, although I accept there will undoubtedly be teething problems.

But I know too there are many practitioners eagerly awaiting the PSS launch. If your practice is already a PSS member, why not peruse the new award categories and consider which you may want to be assessed for?

This can be done outside your normal four-year cycle.

If you are not yet a PSS member, can I urge you to think about it again – if you look at how it works I think you’ll be pleasantly surprised!

“If you are not yet a PSS member, can I urge you to think about it again – if you look at how it works I think you’ll be pleasantly surprised!”

All solutions great and small Expert accountancy advice for every practice actice From accounting and tax through to benchmarking and Sage software advice, there is nothing Hazlewoods doesn’t know about the veterinary industry.

Our 20+ years’ experience working with veterinary practices means that not only do we understand the problems you face, but we can our potential. also provide tailor-made solutions to help you maximise your

To find out more about our services, please the Vet Team Tel: 01242 680000 Email: vets@hazlewoods.co.uk Web: www.hazlewoods.co.uk @Hazlewoods_Vets

Practice Life z November/December 2015 z www.practicelife.biz

SPVS NEWS

15

CYCLESCENE Nick Stuart reports on the new addition to the SPVS scenes repertoire, Cyclescene On the morning of September 13, 17 participants gathered at St Pancras station and boarded the TGV to Avignon. Just seven very comfortable hours later, we disembarked and took a taxi to the pretty Provencal village of L’Isle sur la Sorgue where we were to spend the next six days

A

few of the keenest cyclists brought their own bikes, but the SPVS office had arranged for most of us to hire excellent bikes flocally. The next morning the group split naturally into three; the lycra-clad speed merchants at one end and the “good lifers” at the other, led by James Cronin, whose ambition each day was to find the easiest route to a recommended cafe or bistro. I rather nervously joined the middle group and did my best to keep up, with my fitness improving as the week went on.

The highlight of the week (or not, depending on your view) was Mount Ventoux, a mountain that will be well known to Tour de France followers. At just under 2,000 metres, it is one of the toughest climbs in the competition – having spent two-and-a-half hours on the solid uphill climb, I can verify it is extremely challenging! The conditions didn’t help as that particular morning was the only time it rained all week. And it wasn’t ordinary rain, it was driving sheet rain right into our faces all the way up.

Visibility zero, effort maximum; temperature at the top freezing, and the resulting discomfort extreme! But we all made it and after a very short stop for photos in the gloom at the summit, we legged it down to a cafe two miles below where the sun came out and we were able to slowly thaw out.

I am aware I may not be selling this trip well, particularly to less enthusiastic cyclists, so let me reassure you that, overall, my memories of the week are of cycling at a comfortable pace through one of Europe’s most beautiful areas at one of the loveliest times of year. All around us was a fabulous blaze of gold, bronze and red of ripened grape vines with harvesting in full swing.

We were very lucky to have among us Rod Little, a keen cyclist, who has a house in the area. He was able to lead us on some memorable routes off the beaten track. One day we stopped at the picturesque hillside town of Gordes, famous for having been partly destroyed by the Germans during the Second World War in a bloody reprisal for French resistance activity. It was rebuilt to its former glory after the war.

Another great ride was to Saint Remy de Provence, where we rewarded ourselves with a three-course lunch. The afternoon ride home was much more sedate. And of course, every evening we had to refuel with the excellent food www.practicelife.biz z November/December 2015 z Practice Life

provided at our hotel. The deal of e6 for as much wine, water and coffee as you could consume was difficult to resist.

The week was not just about having fun of course; there was some serious learning to be done as well. Brian Faulkner, from The Colourful Consultancy, covered a wide range of subject matters from his Colourful Vet repertoire, such as how to make and retain profit through leadership, staff confidence and ways to approach those difficult conversations with staff or partners.

This dovetailed very well with our second speaker, James Cronin of Eight Legal. James tackles employment legislation head on, making the point that the wrong person in a small team can have long-lasting negative impacts on the rest of the staff and, ultimately, your practice profitability.

His lectures started with ensuring you have watertight, appropriate staff contracts and progressed on to what to do if someone really isn’t fitting in and/or damaging your business, and your options for a mutually agreed parting of the ways.

This was our inaugural Cyclescene, but the consensus at the end of the week was that it should become an annual event. Our thanks go to Brian for instigating, organising and speaking at this first event. There was much debate about whether May or September is the best month, so let us know your thoughts at office@spvs.co.uk. If you would like to be kept up to date as plans develop, let us know. Otherwise, watch this space for details of Cyclescene 2016!

Nurse Talk 16

NURSE TALK

In association with

BVNA Announces Chosen Charity of the Year!

The British Hen Welfare Trust BVNA President, Sam Morgan, has announced the association’s nominated charity of the year for 2015/2016.

The British Hen Welfare Trust (BHWT) has been chosen to benefit from BVNA’s promotional and fundraising activities to be held over the coming year. The BHWT wrote to BVNA earlier in the year to highlight the charity’s work to promote the welfare of commercial laying hens and the rehoming of ex-battery layers.

In 2005 the BHWT became the UK’s first registered charity for commercial laying hens and now has over 30 pop-up points across the country where people can adopt ex-battery hens. Within its first 10 years, the charity has seen 40,000-50,000 “ex-bats” being adopted each year as family pets.

This work has been achieved through The BHWT’s work is made volunteer-led teams and possible through volunteers by working with 50-plus farms around the country that allow hens to be collected prior to slaughter at the end of their commercial laying days.

Explaining what piqued her interest in the BHWT, Sam said: “Coming from a farming background and having a grandmother who was extremely fond of chickens, the pictures of the hens and aims of the charity immediately impressed me. I wanted BVNA to help promote not only the rehoming and health of backyard hens, but also the aims to work with the farming industry to promote welfare for chickens.”

With so many hens being rehomed in backyard environments, the charity has developed veterinary support for its hens by working with St David’s Poultry Team in Exeter.

Veterinary courses have been designed by the team to improve knowledge within practice.

A spokesman from the BHWT said: “There is no doubt the British Hen Welfare Trust is breaking records, with its 500,000th laying hen due to be rehomed towards the end of 2015/early 2016 and it could not be a more fitting celebration for their 10th anniversary to be announced as the BVNA Charity of the Year for 2015/2016.”

To find out more visit www.bhwt.org.uk

CERTIFICATE The Level 4 Certificate in Canine and Feline Veterinary Health Nutrition (QCF) is a qualification for qualified veterinary nurses and others working within the veterinary profession wanting to further their knowledge and understanding of the importance of nutrition in canine and feline health and disease.

Bursaries are available for this course through ROYAL CANIN® Please contact your Veterinary Business Manager for further information royalcanin

.ie

royalcanin

.co.uk

© ROYAL CANIN® SAS 2015. All rights reserved.

Practice Life z November/December 2015 z www.practicelife.biz Royal Canin PRACTICE LIFE 0015 .indd 1

16/02/2015 15:34:51

NURSE TALK

17

BVNA appoints Equine Nursing Coordinator BVNA is delighted to introduce its newly appointed Equine Coordinator, Bonny Millar, CVT (USA), REVN, RVN. Bonny has long been involved in the equine veterinary world, being Senior Nurse at Rossdales Equine Hospital in Newmarket. Bonny is also a BVNA Past-President and is currently Chairperson of the BVNA Executive Advisory Committee, she is a published author and regular speaker, teaches and assesses equine veterinary nursing students, is equine nursing editor of VNJ, and served as a Vet Tech in the 2012 London Olympics and Paralympics.

The BVNA prides itself on representing VNs at all stages of their career and being the voice of the veterinary nursing profession – and REVNs are certainly no exception. There has always been an equine representative on BVNA Council; the objective of this role

being to liaise with council members on developments that affect REVNs and monitor and observe issues that affect BVNA with regards to equine nursing.

BVNA felt this role really needed an individual who could truly represent the unique area of equine nursing, and Bonny fitted the bill perfectly. Bonny will be representing equine veterinary nursing and, in particular, act as an ambassador for REVNs and student veterinary nurses who are following the equine pathway.

We will also be drawing on Bonny’s passion and interest in the equine veterinary nursing field to generate ideas, give recommendations to Council on ways to interact, promote and enhance the relationship between the BVNA and its equine nurse members and the benefits to them. Bonny will be planning top quality, affordable CPD for REVNs in easily accessible locations in the UK, so look out for these over the next 12 months.

Bonny was responsible for organising our outstanding two-day equine symposium at BVNA Congress in October and we are hoping to reach out to our equine veterinary nurses in many more ways in years to come.

BVNA 50TH CONGRESS 2015: SIMPLY INSPIRATIONAL BVNA’s new president, Sam Morgan, reflects on one of the biggest – and best – nursing congresses to date

BVNA Congress saw over 1,300 RVNs, students and support staff flock to the Telford International Centre to listen to the amazing lectures, meet a wide range of exhibitors and let their hair down by socialising in style.

Lecture topics were diverse, ranging from ways to educate nurses to a raw food debate, with many sparking off debates within the sessions. The following lectures had over 300 attendees each: toxicological emergencies, CPCR, anaesthetic monitoring and intraoperative hypotension! The workshops sold out before congress even started, and they received excellent feedback.

Our two-day equine symposium attracted 60 equine nurses due to a brilliant programme put together by Bonny Millar.

It was great to offer CPD to nurses across our vast profession.

There was also a writing workshop put on by Taylor and Francis, publishers of VNJ. This attracted a number of budding authors, so look out for their first articles coming soon!

Exhibitors showcased all the latest products and were on hand to answer questions or queries delegates had. The exhibitors had brilliant stands to show off their products, with the most memorable being Hook a Duck from Veterinary Times/VN Times and of course Bertha bus from Onswitch! The happy hour held each

www.practicelife.biz z November/December 2015 z Practice Life

Sam Morgan (centre), new BVNA President.

evening celebrated BVNA’s 50th year with drinks and cake. Social events included a fantastic quiz night organised by the BVNA office staff, which raised funds for the charity of the year, Hounds for Heroes. The Saturday night entertainment was a Sci Fi convention, which prompted some of the most fantastic costumes seen on this planet!

The AGM held on Sunday was an emotional affair. Sadness and best wishes for council members that were leaving, especially Helen Ballantyne, Kirstie Sherman and Lucy Hayne, who were all part of a strong officer team. Their guidance and experience will be missed.

Fiona Andrew then handed over the presidential chain to myself – I was absolutely delighted as I’d waited 17 years for this moment!

Apart from the lectures, exhibition, fun and socialising, what makes BVNA Congress a real success? The answer is simple… it’s the delegates. The early discount BVNA offered as part of its 50-year celebrations certainly attracted many of you. Thank you for being the most supportive delegates yet and we look forward to seeing you all again next year.

College Corner

ENSURING SPECIALIST STATUS Earlier this year the Royal College of Veterinary Surgeons (RCVS) beefed up its Code of Conduct on the circumstances under which veterinary surgeons and practices can use the terms “specialist”, “specialising” and associated terms to describe their services. Here, Luke Bishop, RCVS Communications Officer, explains the new guidance and how it may affect practices The path to gaining RCVS Specialist status is not an easy one – it involves hard work and study to develop the requisite expertise in a particular area of practice. Applicants must have at least a diploma-level qualification, make a tangible contribution to their field with national/international acclaim, as well as publishing widely on their chosen subject.

Specialist status is also reaccredited every five years, meaning that the holder must maintain his or her expertise through publication, teaching, reviewing, examining, and attending and participating in national and international meetings to retain the accreditation.

Those who fulfil all these criteria quite rightly earn their place on our List of Specialists (www.rcvs.org.uk/listofspecialists) and earn the right to refer to themselves as an RCVS Specialist in practice.

The individual’s specialist status also appears on the RCVS Check the Register search tool (www.rcvs.org.uk/checktheregister) and on their practice’s entry on our Find a Vet search engine (findavet.rcvs.org.uk).

To ensure the integrity of RCVS Specialist status is upheld, at its June 2015 meeting, RCVS Council approved changes to the Code of Professional Conduct for Veterinary Surgeons so that only those who hold the status can refer to themselves as such. The same protections also apply to those holding the new Advanced Practitioner status, introduced last year.

What do the changes entail?

The Code of Conduct now states: “Veterinary surgeons must not hold out themselves or others as specialists or advanced practitioners unless appropriately listed with the RCVS.” Only those holding the status should refer to themselves as a “specialist” in a certain area or imply they hold this status.

For example, a practice must not imply a member of staff holds specialist status through the use of terms such as “specialising in feline medicine” or similar.

Laura McClintock, Standards and Advisory Manager at the RCVS, explains: “In practical terms, this does not mean that veterinary surgeons have to become an RCVS Specialist to practise any particular specialty, for example, feline medicine. However, they cannot describe themselves as a “Specialist in Feline Medicine” unless they are on our List of Specialists.

“We would, however, allow those who aren’t on the List of Specialists to say, for example, they ‘Have a special interest in feline medicine’, or they are ‘Experienced in feline medicine’ or their ‘Practice is limited to feline medicine’ when promoting their services.

We feel these phrases allow the veterinary surgeon to highlight their interest in an area of clinical practice without implying RCVS Specialist status.”

Making referrals As the new text in the Code makes clear, the guidance does not only apply to how individual veterinary surgeons refer to themselves, but also the terminology that is used about other vets.

This is important in the context of referrals. Therefore, in Chapter 1 – Referrals and second opinions – of the supporting guidance to the Code, we now state that, when making referrals, veterinary surgeons must ensure “The client is made aware of the level of expertise of appropriate and reasonably available referral veterinary surgeons”. So if the veterinary surgeon they are referring to does not hold Specialist or Advanced Practitioner status then it should not be implied that they do.

Steps to take Although the changes regarding the use of specialist and similar terms is in the Code, we have decided not to enforce this until after March 2016. This is to allow veterinary surgeons and practices time to familiarise themselves with the amendments and make changes to ensure they are compliant.

Laura explains: “We are not aiming to catch people out with this Code change and we recognise that individuals and practices may have been using terms such as ‘specialist in’ or ‘specialising in’ historically without any intention to mislead. However, it is important both the integrity of Specialist status is preserved and that the potential for clients to be misled about the experience and skills held by a veterinary surgeon in a certain field is minimised.

“Ahead of the enforcement of the new guidance, we ask that veterinary surgeons and practices check their websites, office stationery, name badges and so on, to make sure that there is no terminology that could fall foul of the new requirements.”

Applying for RCVS Specialist status The application period to be included on the 2016 List of Specialists has now expired; however, please look out for information on the application period for 2017 on the RCVS Specialist webpage (www.rcvs.org.uk/specialists). The application period is expected to open in summer 2016.

Further information To read the Code of Professional Conduct for Veterinary Surgeons in full visit www.rcvs.org.uk/vetcode – the amended text is at paragraph 3.5. You can download our Code of Professional Conduct app here www.rcvs.org.uk/codeapp, which allows you to access the Code and its supporting guidance while in practice or out and about. For in-depth advice about any aspect of our Code or supporting guidance you can contact the Professional Conduct Department on 020 7202 0789 or profcon@rcvs.org.uk.

Practice Life z November/December 2015 z www.practicelife.biz

COLLEGE CORNER

19

PROTECT THE VN TITLE! RCVS Specialist and Advanced Practitioner are not the only titles being protected through our Code of Professional Conduct – it also now states that both veterinary surgeons and veterinary nurses must not hold out others to be veterinary nurses unless they are qualified and registered as such.

This new guidance complements our current campaign to obtain legal protection for the title “veterinary nurse”, so that only those people who are qualified and registered as such can call themselves a veterinary nurse.

We are pushing for this change because the current situation is that anyone can technically call themselves a veterinary nurse – a situation which we think could potentially compromise animal welfare as well as mislead the public. With the help of legislative experts we have drawn up our own Veterinary Nurse (Protection of Title) Bill, which we aim to get onto the statute books.

In August we launched an e-petition on the official Government Petition website, which, within just a few weeks, received well over 10,000 signatures. We have until February 14, 2016 to get more than 100,000 signatures so that protecting the title veterinary nurse in law will be debated in Parliament – so if you haven’t already, please sign and encourage your clients, family and friends to do so as well.

®

Details of the campaign, including a video explaining what we aim to achieve, and a link to the petition, can be found at www.rcvs.org. uk/vntitle. You can also download a template letter to your local MP, which encourages them to support the campaign and our Bill, and help to raise awareness of the campaign on social media via: www.twibbon.com/support/protect-the-vn-title.

The picture is clear with our buying group.

on your purchases Immediate net net pricing

No product restrictions. No waiting for rebates.

To put this completely into focus, let us analyse your purchases for you.

Contact 0845 057 5550 or email us support@mivetclub.com *From an analysis of purchases for a 4 vet practice

Building a solid future for your practice on concrete foundations. www.practicelife.biz z November/December 2015 z Practice Life

20

VDS News

Indemnity BREACH Mr Shoestring, having recognised the writing was on the wall for smaller farming concerns like his, had diversified into a number of different areas, including a boarding kennels, petting zoo, pet shop and garden centre.

Any call to his premises would therefore be rather a lucky dip for the veterinary team regarding the species involved. But all visits shared one similarity, Mr Shoestring’s constant desire to save money, cut corners and reject veterinary advice.

One day Kate received a call from the local council as they had received a complaint about Shoestring’s boarding kennels.

Apparently an inmate had died and the owner had hit a brick wall trying to find out about her beloved pet’s demise from the proprietor. The environment health team fancied a trip out and wondered if Kate could accompany them to provide a veterinary report.

Not really thinking of the consequences, Kate readily agreed, but soon regretted her enthusiasm on arrival at the increasingly shabby premises. Business was clearly not going well and the boarding kennels looked like a rundown Stalag 17 for dogs.

Kate’s nostrils were soon hit with the unmistakable l’eau de parvo and, when questioned, Shoestring mumbled that he had been meaning to call as several dogs had “the runs”. On closer examination it was clear there was a serious outbreak of haemorrhagic gastroenteritis so Kate administered treatment and called for nursing reinforcements, along with supplies from base camp.

Samples collected confirmed parvovirus was the culprit and the council team identified Shoestring had not only been letting boarders in without checking their vaccination status, contrary to his licence, but had also mixed up his “puppy farm” activities with the boarding facility.

The environmental team shut Shoestring’s animal businesses down and subsequently prosecuted him, ably supported by a damning but factual report from Kate. The result was a ban on keeping animals for five years, together with a three-month jail sentence.

A professional job done well you may think dear reader, but this was just the start of a three-year nightmare for poor Kate.

Eighteen months after the court hearing a letter arrived from the local solicitor Delay & Robhem LLP notifying the practice of a claim Shoestring was intending to bring against them.

The solicitor’s letter made for entertaining reading given the obvious lack of strength of Shoestring’s allegations, not least as he had pleaded guilty in court, presumably on their advice. Essentially the ne’er-do-well’s claim was based on an allegation the practice had failed to advise him appropriately regarding infectious disease control on his facility. To cap it all the missive concluded with a claim for £200,000 (good grief - Ed.) for loss of business and reputation.

Still, £200k was £200k so Kate sensibly picked up the phone to call a friend. The consultant, on learning the sorry tale, also felt Shoestring’s claim was speculative to say the least, but nevertheless there was a job to be done, so she instructed the Society’s solicitors immediately.

As the sums claimed were significant the case was elevated to a higher court with the associated increased costs and the other side’s delaying tactics at every stage simply serving to increase both the Society’s legal bill and the stress on our beleaguered member.

After two years of Shoestring’s team manipulating the legal system, all parties eventually found themselves on the court steps.

It took the judge little time to deduce that the quantum of the claim was a try-on, but she did feel that our member had some liability in the matter, agreeing with Shoestring’s disingenuous allegation, supported by his veterinary expert report, that he had not been made aware of the danger of parvovirus in his facility by his own vet, Kate. Regrettably, as is often the case with such clients, the clinical records were brief and did not support our member’s view that Shoestring had been repeatedly advised on preventative health matters, but simply ignored their recommendations.

This judgement led to a second hearing where Shoestring was told he would have to substantiate the losses claimed. He singularly failed to do this of course, but it took yet another gold-plated court hearing to determine the business losses arising from our member’s minor “breach of duty” were in reality minimal. Critically, however, Shoestring’s legal costs were awarded against the Society.

Still Kate was relieved considering the matter to be all over but Shoestring, who had clearly spent his time in jail usefully studying the law at the tax payer’s expense dropped his paid advisers, seemingly considering he could do a far better job and six months later launched an ambitious self-prepared Judicial review of the decision.

This cost him next to nothing, but necessitated yet another hearing to ensure the British Justice system was being seen to be fair to this litigant in person. They decided they were of course, and our member’s ordeal was finally over, but at what financial price? This claim cost the Society a shade under £250,000 solely in legal fees, all starting from a seemingly innocent small animal visit.

The moral of the tale is claims for business losses are substantial and if the court determine a minor adverse finding against a veterinary surgeon, even if the damages directly associated with the breach may be small, the legal costs are still payable and so indemnity limits can soon be challenged.

This salutary tale could happen to any of us of course, but we have specifically identified that both small animal claim settlements and the legal fees involved in defending members’ reputations have been steadily rising over the past decade, repeatedly threatening the £125k indemnity limit most small animal vets select.

Fortunately Kate, a cautious soul, had selected a higher indemnity level to reflect her mixed practice role so we could defend her all the way but, increasingly, claims risk being compromised to avoid the sorry situation of a member having to dip into their own pocket to defend their professional reputation.

For this very reason the Society has decided to raise the minimum indemnity limit for domestic pet practice to £250k for little or no increase in premium in 2016. Mutuality at its best!

Practice Life z November/December 2015 z www.practicelife.biz

HOT TOPIC

WOMEN IN WORK...

Gudrun Ravetz is poised to take on one of the veterinary profession’s most senior and influential roles: BVA president, a position that demands great leadership and managerial qualities. With women often-quoted as having superior leadership skills, why, she asks, are we still facing gender inequality and pay discrepancies within our profession?

S

o, what defines me? I am a woman, a vet, a mum, a wife, a pet owner, BVA Junior Vice-president, SPVS Past-president, runner, biker (push bike) and swimmer.

They all define me, but none should make any difference to what I do or how I do it; or should they?

We know from the SPVS survey that female vets are earning less than their equivalent years’ qualified male vets. This is also a national trend where, on average, women earn less than men for equivalent jobs. Historically, in the veterinary associations, there have been – and still are – substantially more men in positions of leadership than women. There are significantly more men who have leadership and financial stakes within a practice than women. Working mothers seem to have more accusatory press headlines than working fathers, and less than 5% of fathers take more than two weeks’ paternity leave.

So is it all doom and gloom? Of course not. If I felt like that I would not have enjoyed my career so far. Being a vet has allowed me to have a diverse and interesting career, being a wife and mother has given me untold joys, being involved in veterinary politics is an honour and incredibly rewarding, and running, biking and swimming keep me sane to do the other stuff. So what defines me? All of it because it makes me, me. www.practicelife.biz z November/December 2015 z Practice Life

An Office of National Statistics report1 gives some interesting statistics; 42% of working women are part-time compared to 12% of men. From the age of 22, men have higher rates of employment than women. This gap narrows as age progresses and women rejoin the labour market after having families.

Seventy-two per cent of married or cohabiting mothers are in work; this is the average and numbers are lower for women with younger children and increase again as children age.

Interestingly, the opposite is true for men with children.

They are more likely to work than men without children.

These statistics also indicate that men tend to work in professional occupations with higher pay and women dominate in caring and leisure employment. In professions in general, it is more of a 50:50 split, but only 33% of managers, directors and senior officials are women. Men form the majority in the top 10% of all earners, with the split widening significantly from age 29.

We are seeing this reflected within the veterinary profession too. Part-time working has increased, there is a pay discrepancy between men and women, women will take time out for families, but then most wish to return to work, and men are more likely to be leaders both in veterinary politics and in employment.

In a profession that is becoming feminised we need to adapt to this shift, embrace the positives and confront the negatives for the sake of both genders.

Our clients are likely to have similar work-life balancing acts as our staff. They are going to want practices to be more flexible with opening hours and staff may want more flexibility for personal reasons. Non-traditional shift patterns may work well around the school run, but it is not just about accommodating families. It is about accommodating working patterns that are right for employees no matter what they want to do with their leisure time, which are also right for the practice, clients and our patients.

In a talk given at London Vet Show, Colette Henry2 discussed how women may make better team builders, better understand family responsibilities and are more effective as leaders. Bolton and Muzio3 discussed that feminisation of law and management “Encouraged a more participatory and consensual working culture and a more empathetic approach to management.” In a caring profession where working as a team is vital, we should be seeking out these skills in our veterinary employees and leaders.

22

HOT TOPIC

There is an argument that we could do nothing and let market forces sort out the current inequalities experienced by women. But feminisation within law and management has led to vertical segmentation. In 2008, 55% of salaried solicitors were women, but only 22% were profit-sharing partners3. Female trainees, assistants and partners all earned less than male counterparts.

Feminisation of law and management may have led to a polarisation whereby women occupy salaried, less highly-paid roles, while men occupy the more lucrative leadership roles.

Some of these statistics mirror the current position in the veterinary sector and there is a risk that if we are passive about feminisation, this position will become the norm to the detriment of our whole profession.

It is important in moving forward that we see past gender and avoid polarisation. A vet writes MRCVS after his or her name, not male or female. Understanding the issues around feminisation and finding solutions should not alienate either sex nor is it a call for positive discrimination. We need to get to a point of equal opportunities not create equal outcomes as the outcome is then up to the individual.

If we are to move forward with this the whole profession must be on board. Veterinary businesses need to embrace equality and treating employees of both sexes fairly can bring loyalty and unlock talent that may otherwise have been missed.

And we, as veterinary associations, need to support, mentor and guide vets along the way.

Ultimately, we also have to take personal control of our own destiny. I am lucky in that I have had good veterinary role models both male and female and incredible support from a husband who doesn’t see gender as an issue and takes an equal role in childcare. But male and female vets need to be realistic, especially around childcare, and sometimes sacrifices have to be made. I hope I am a good veterinary professional, but my husband and son are more important than anything, and I am realistic that this might limit some of the things I want to do.

References: 1 Office for National Statistics, (2013). Women in the Labour Market.

2 Professor Colette Henry (2014) Talk given at London Vet Show.

3 Bolton S C and Muzio D (2008). The Paradoxical Processes of Feminisation in the Professions: The Case of Established, Aspiring and Semi Professions, Work employment and society.

CASE STUDY: PART-TIME HOURS FITTING ROUND FAMILY LIFE Sally Hart, BSc, BVetMed, MRCVS, describes her experience of working part-time in practice, including the great bosses who made it possible, and the down side of not being able to see clinical cases through to conclusion

F

or 10 years after qualifying as a vet I worked full-time and, at one point, looked into a partnership in a small animal practice.

I married my husband Simon four years after I qualified and we had our first child six years later. I wanted to work part-time to look after the boys, but I also knew that to carry on working at the same practice, I would need to be prepared to work my share of the late evening shifts, weekends and on-call.

The practice I was working for at the time was happy to arrange my weekends so mine didn’t clash with Simon’s duty weekend. My mum was willing to come and look after the boys for my late shift and stay for the night if I was on-call when Simon was away with work. The boys went to a local nursery for a couple of sessions each week. While the children were young I wanted to be around them as much as possible and was very fortunate to be offered my current job, which has no on-call and I am now doing school hours three days a week.

Practice Life z November/December 2015 z www.practicelife.biz

HOT TOPIC

The holidays are covered for the kids by using holiday clubs and some help from my parents. I made a decision to work part-time and I enjoy my work very much. I have been fortunate to have had some very rewarding jobs and really understanding bosses, who made working part-time as easy as possible, although I do feel that I spend a lot of my time rushing about and looking at the time. I am able to get to the majority of the performances and events at school, and am able to drop off and pick up, which is important to me.

But, working part-time does come at a cost to career progression. I did start doing the small animal medicine certificate a few years ago, but I wasn’t seeing enough cases during my part-time hours and it was hard to put the necessary time in to complete it – perhaps it is something for the future when I am “needed” less at

23

home. Another downside for me to working part-time is that it isn’t always possible to see cases through to the end, which can be disappointing, frustrating and also sad at times, but again this is something that may change in future.

I have many friends who work part-time within the profession so there is plenty of scope to be a vet and a parent, but it requires understanding employers, lots of organising and, of course, some juggling. Support from friends and family that can be called on – sometimes at very short notice – is a huge help. I guess I will never achieve as much within the veterinary profession as if I had worked full-time, but I am very happy with the choice I made – fortunately, there is room in the profession for women with different commitments, priorities and circumstances to enjoy a fulfilling career.

CASE STUDY: FINDING THE HOURS TO JUGGLE A PARTNERSHIP AND YOUNG SON Charlotte Brereton, BVM&S, MRCVS, discusses the challenges of working full-time as a partner and spending time with her son, and asks why there is still stigma attached to working mums

I

always wanted to be a vet but didn’t have the confidence in school to get the grades required, so I qualified as a veterinary nurse. Then, after plucking up the courage to try A-levels at night school and passing them, I got a place at the Royal (Dick) School of Veterinary Studies, qualifying as a veterinary surgeon in 2011, and was married shortly after!

I started my veterinary career in an independent practice where, due to the particular circumstances, I was quickly left to run the practice.

Qualifying later in life caused me an inner dispute – one half of me was very career driven and I wanted to www.practicelife.biz z November/December 2015 z Practice Life

own my own practice and the other half wanted to start a family. This dilemma is different for men as there is less pressure on the father to always be there. In my experience, however, there is a stigma attached to working mothers. One person said to me: “Why have children if you are going to work full time?” I don’t think many fathers are asked this question.

Not being one to shy away from a challenge, I have managed to do both! My son was born in January 2014 and, when he was only a few weeks old, an opportunity came up to own Llantrisant Vets4Pets. With my husband’s full support (he is a fire fighter so we work child care around his shifts), and my family behind me, I jumped at the chance.

Our son was only four months old when I returned to full-time work, which was very hard. I made sure I could work my 40 hour week in four days so that I could have an extra full day at home. Living close by, I spend as long as possible in the mornings with my boy, and also go home at lunch time, which gives me extra precious time with him.

However, those first six months of ownership and motherhood were hard and I feel my work-life balance wasn’t good. But, with the support of family and my amazing work team, this is improving. Although it is still hard leaving my son, hopefully by the time he has a long-term memory, I will have paid off my business loan and can decrease my hours.

Although there are difficulties, I would definitely recommend becoming a partner even if you have or want a family. It is challenging to juggle it with family life, and you have to make some sacrifices, but concentrating on the bigger picture was what helped me to keep focused.

My advice would be to communicate well with your other half and try and make the times that you do spend together full of fun memories.

WELL-BEING

RECOGNISING AND RESPONDING TO MENTAL HEALTH PROBLEMS IN PRACTICE Evidence suggests levels of psychological distress are elevated in the veterinary profession compared with the general population (Bartram et al, 2009). Work can play an important role in supporting the health and well-being of employees, which, in turn, can enhance effectiveness and profitability within the workplace. David Bartram provides an overview of how to recognise potential signs of mental health problems, how to give assistance and when to involve others Psychological distress and mental ill health affect people who are in work as much as the rest of the general population. Employers in many situations do not recognise, or choose to ignore, signs of mental ill health and, according to a survey by Shaw Trust (2010), grossly underestimate how many of their employees may need help.

At any one time within the general population, one worker in six will be experiencing depression, anxiety or problems relating to stress. The proportion rises to more than one in five if alcohol and drug misuse are included (McManus et al, 2009).

The cost to businesses arising from mental ill health include sickness absence, reduced productivity at work (presenteeism) and replacing staff who leave their jobs because of mental ill health. Simple steps to improve the management of mental health in the workplace, which include prevention, early identification of problems, and enhanced access to support, may enable employers to save a proportion of these costs and, at the same time, help employees whose health and careers are at risk of spiralling downwards into chronic ill health.

What about the distressed employee – are measures to keep them in (or return them to) work likely to be harmful to their health? There is good news here – work is, on the whole, good for mental and physical health (Waddell and Burton, 2006) and, for many people, being at work in a supportive workplace can be part of the solution rather than the problem.

What, then, can employers do to create healthy, productive workforces and to manage the psychological distress that will always be present and affecting their businesses? There are several key principles: • Understanding of the potential positive and negative effects of work on mental health, and the reasons why better management of mental health at work makes good business sense.

David Bartram

Potential early warning signs of mental ill health in the workplace • • • • • • • • • • • • • • • • • • • • • • •

Working slowly Making mistakes more often Unable to concentrate Disorganisation and forgetfulness Poor time-keeping Increase in unexplained absences or sick leave Mood swings Unusual displays of emotion, such as frequent irritability or tearfulness Unable to delegate tasks Trying to work much too hard Over-reacting to problems Restlessness and agitation or tiredness, lethargy and lack of motivation Apparent loss of self-confidence and self-esteem Withdrawal from social contact Lack of interest in appearance or diminished personal hygiene Hand tremor Poor judgement or indecision Practising under the influence of alcohol or drugs Erratic or changed behaviour (nurses may notice this first) Being overtly aggressive or defensive Inappropriate dispensing and drug ordering Inability to communicate effectively Disappearing from the practice in a low mood but returning shortly appearing much happier • Increased client complaints • Difficulty in coping with emergencies

• Preventing mental health problems that are directly related to work. This may include, for example, providing mentally healthy working conditions and practices in line with the Health and Safety Executive’s management standards on work-related stress; adopting an organisation-wide approach to promoting the mental well-being of all employees, including the development and implementation of a wellbeing policy; adoption of a management style that encourages participation, delegation, constructive feedback, mentoring Practice Life z November/December 2015 z www.practicelife.biz

In Association with the Veterinary Benevolent Fund

and coaching; and providing employees with opportunities for flexible working according to their needs and aspirations in both their personal and working lives.

• Training for line managers to help them identify and respond with sensitivity to employees’ emotional concerns and symptoms of mental health problems.

• Intervention to improve access to care, particularly access to medical and evidence-based psychological support, which, wherever possible, enables people to continue working.

• Effective rehabilitation to facilitate the reintegration of vets and vet nurses with respect and sensitivity back into the workplace following a mental health problem.

Early intervention Managers and employees should be aware of common mental health conditions, how to identify early signs and symptoms and, most importantly, have undergone training to have the confidence to approach someone who is showing signs of distress and signpost them to appropriate help.

Individuals often require encouragement to seek help for mental health problems. They may perceive that support is of no value because it cannot change their circumstances, be concerned that seeking professional help may adversely affect their career, or believe they should be able to cope with their own problems. It is of concern that, among the general population, only around a quarter of people with a disorder is receiving any treatment.

Vets and vet nurses have access to the full range of healthcare professionals and support agencies available to others, such as Samaritans or the family doctor. However, there are several alternative pathways to care and support available to members of the veterinary profession. Vetlife Helpline and Vetlife Health Support are independent of other veterinary organisations, free of charge, and confidential.

David Batram was a director of Vetlife for six years and is currently a member of RCVS Council.

References: BARTRAM, D J, YADEGARFAR, G & BALDWIN, D S (2009). A cross-sectional study of mental heath and well-being and their associations in the UK veterinary profession.

Social Psychiatry and Psychiatric Epidemiology 44, 1075-1085.

MCMANUS, S, MELTZER, H, BRUGHA, T, et al (2009). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. Leeds, NHS Information Centre for Health and Social Care. www.ic.nhs.uk/pubs/psychiatricmorbidity07.

SHAW TRUST (2010). Mental Health: Still the Last Workplace Taboo? www.shaw-trust.org.uk/files/mental_health_report_2010_final.pdf.

WADDELL, G & BURTON, A K (2006). Is work good for your health and well-being?

The Stationery Office, London. www.dwp.gov.uk/docs/hwwb-is-work-good-for-you.pdf.

Further reading: BARTRAM, D, O’CONNOR, R, ALLISTER, R & FOWLIE, D (2012). Recognising and responding to mental health problems in the workplace. In Practice 34, 480-486.

BARTRAM, D, CURWEN, A & HARDY, B (2012). Building a thriving workforce. In Practice 34, 355-361.

BARTRAM, D & TURLEY, G (2009). Managing the causes of work-related stress. In Practice 31, 400-405.

BARTRAM, D & GARDNER, D (2008). Coping with stress. In Practice 30, 228-231.

BARTRAM, D & BALDWIN, D (2007). Understanding depression: the ‘black dog’. In Practice 29, 612-615.

BARTRAM, D & BONIWELL, I (2007). The science of happiness: achieving sustained psychological wellbeing. In Practice 29, 478-482.

www.practicelife.biz z November/December 2015 z Practice Life

How do I raise my concerns with a colleague?

• Have a conversation in a neutral and private space.

• Make sure there are no interruptions. Switch off your mobile phone.

• Ask open, non-judgmental questions. For example, “I was wondering how you were doing?” Don’t ask loaded questions such as “What is wrong with you then?” or “Are you stressed or something?”

• Describe specific reasons for your concern, avoiding accusation or blame.

• Listen empathetically. Allowing someone to talk about their feelings can bring them a better sense of clarity, perspective, resolution and control. Always allow the person time to answer. Be patient.

• Do not attempt to diagnose.

• Demonstrate your respect for the individual.

• Try to put yourself in the other person’s shoes and see things from their perspective.

• Ask what kind of support they would most appreciate at this moment.

It might feel appropriate at this stage to begin to discuss some immediate possible changes at work.

• Suggest other possible sources of support such as Vetlife Helpline, Vetlife Health Support, Samaritans or their GP, but don’t tell them what to do.

• If they talk about self-harm, suicidal thoughts or intent, take them seriously. Around two-thirds of people who die by suicide communicated their intent to others.

• Assure them that the conversation will remain confidential, unless they consent to you informing others.

• Afterwards, if the experience was particularly emotionally challenging for you, unburden by sharing your feelings with someone you can trust.

PATHWAYS TO CARE, SUPPORT AND ADVICE Vetlife Helpline 0303 040 2551 or helpline.vetlife.org.uk Vetlife offers a confidential 24-hour listening and sign-posting service by telephone and email for vets, vet nurses, students and any family or colleagues who are concerned about someone in the veterinary community. It is staffed by trained volunteers who have experience of the veterinary professions.

Vetlife Health Support 07946 634220 or healthsupport@vetlife.org.uk Vetlife Health Support provides professional advice, assessment, collaborative care and case management services for vets, vet nurses and students with substance misuse, eating disorders and other mental health problems and, where necessary, provides onward referral to specialist services.

Samaritans 08457 909090 Emotional support for those experiencing distress, despair, or suicidal feelings.

Vetlife website www.vetlife.org.uk Provides information and support for veterinary professionals. Topics include professional issues, such as managing conflict in the workplace and handling client complaints, and personal issues, such as loneliness and finance.

26

WELL-BEING

MEDICAL MINDS MATTER With mental health firmly in the veterinary profession’s sights of late, Jenny Stuart reports from a cross-profession initiative, Medical Minds Matter, held to encourage the sharing of best practice and experiences to improve mental health recognition across the professions Isolation was implicated as a key trigger for mental health problems and vets in Australia were particularly exposed to working alone. Isolation could be geographic because they had moved to work in a remote rural area, or to a city a very long way from friends and family. Isolation could also occur within a practice if a vet felt incompetent or insecure and was unable to ask for help, or because he was the boss and isolated from his staff.

Bereavement can lead to a feeling of isolation, as can retirement. Working to tackle suicide, Dr McErlean explained, was not only important per se, but because suicide was the tip and visible evidence of a much larger mental health iceberg. He described an initiative to spread the message in Australia, which included educating and informing the profession so that they were better equipped to recognise and deal with signs of mental health problems both in themselves and in colleagues.

Support groups from the various professions shared their experiences with the audience. Rory O’Connor, National Co-ordinator for the Veterinary Surgeons’ Health Support Programme also co-ordinates or advises programmes for dentists and doctors, and so was well placed to make comparisons. David Bartram shared some of his research into the mental health landscape in the veterinary profession, and Anna Rowland described the support given to doctors with mental health problems and, in particular, how this is handled within a “fitness to practise” process.

Jenny Stuart

As part of their Mind Matters initiative, RCVS, in partnership with Maudsley Learning, ran a one-day conference for medical professionals, with delegates from dentistry, human medicine and pharmacy attending.

A number of lawyers also attended, together with a representative from the Architects Registration Board.

The aim of the Medical Minds Matter day was to investigate whether there were commonalities with respect to mental health problems within the professions and to share experiences and best practice. The event also sought to consider where the gaps were in knowledge and provision and to look at potential joint initiatives going forward. Former RCVS president and RAVC’s Honorary Colonel Commandant, Colonel Neil Smith, chaired the event.

Among those contributing was Dr Brian McErlean, who gave a presentation via Skype from Australia, where he is coordinator of the One Life Suicide Prevention Project for the Australian Veterinary Association. The suicide rate among vets in Australia was shown to be four times that of the population as a whole. Dr McErlean explained that suicide was complex, that there was no single cause, but there were classic risks, such as marriage breakdown, business failure and/or substance abuse.

Sharing experiences A number of attendees had directly experienced mental health problems, either personally or through a family member or colleague. The Vice-chair of the Doctors’ Support Network spoke about how her own depressive illness was made very much worse by the way the A&E department she was working in handled her return to work. At one point she was told it was unheard of for anyone to be allowed to work in the department without being on the out-of-hours rota. However, she was aware of at least one person, returning to work after a heart attack, who had been exempted from nights on medical advice.

This brought into focus the need for mental illness being treated on the same footing as physical illness by employers.

The day was not only about mental illness, there was also discussion about how to improve mental well-being within the workplace. Tony Coggins, Head of Mental Health Promotion at the South London and Maudsley NHS Foundation Trust, explained the rationale behind his programme, namely that purely in economic terms, the NHS could not afford to manage levels of mental health problems among staff and, therefore, it made complete sense to implement a positive approach to health and well-being.

His workshops encourage participants to realise that they can work on their own happiness and mental well-being in the same Practice Life z November/December 2015 z www.practicelife.biz

WELL-BEING

Delegates enjoyed an informative and interactive event

way as they might work on their physical fitness or improve their diet. As a broad generalisation, he said, 50% of happiness can be attributed to genetics and10% to life circumstances, but that leaves 40% for the individual to influence through behaviour, physical exercise, taking up hobbies, engaging in voluntary work or meditation, for example. Mr Coggins shared research that showed doctors who were in a positive emotional state diagnosed patients more effectively.

A recurring theme during the day was education; both in terms of being able to recognise signs of mental health problems within yourself and others, but also understanding how your own actions and behaviours might impact the mental health of others. The disciplinary process within the different professions was discussed and, in particular, how making a mistake can escalate from something that would not in itself have been a disciplinary issue to something more significant.

An individual tries to cover up a mistake, for example, and due of the deceit rather than the actual mistake, they find themselves subject to a disciplinary process, which is both stressful and isolating and can lead to a nervous breakdown and even suicide. Bosses were urged to think about the culture within their practices; does it encourage their vets and nurses to feel able to admit mistakes?

Towards the end of the day, delegates took part in group exercises to look at what is lacking in mental health provision within the professions and how they might work together to bridge the gaps. There was general consensus that better education about mental health is required in terms of www.practicelife.biz z November/December 2015 z Practice Life

27

Colonel Neil Smith chaired the event

recognising signs in yourself and others, but also how to encourage well-being among your practice staff. One suggestion was that every practice meeting should have “wellness” on the agenda, providing an atmosphere where people felt able to talk about how they were feeling.

Another suggestion was for practices to have mental health first aiders within their teams in the same way as they are required by law to have someone with a “first aid at work” qualification and an appointed person for health and safety.

One delegate, Dr Anne Finn, is a GP who consults on mental health in the workplace. She worked for Unilever and was responsible for introducing an innovative mental health initiative for all their staff. RCVS Chief Executive, Nick Stace, asked her to share some of her key takeouts from that process.

Communication was key, she explained, whatever initiatives you decide to introduce it is essential you use good websites, chat rooms, champions and exemplars to get the message out. Perhaps most interestingly, she said that at Unilever, engagement in the programme and professional training was only really taken seriously when it became mandatory. This led to a general discussion about how mental health could potentially be built into the new Practice Standards Scheme.

Another suggestion was that mindfulness training should be a compulsory part of the vet school curriculum.

You can read an article entitled Recognising and responding to mental health problems in practice on page 24.

MANAGING PEOPLE

D N U O R A G N I N R U T TURNING AROUND

a poorly performing practice...

It’s one thing telling vets how to make their practices happy, profitable places, but another doing it for real. Vicky Gower draws on a wealth of experience in helping practices turn a profit and here outlines the early steps taken when her consultancy took the plunge and purchased a failing veterinary practice to “practice what they preach” using a PA service is far more efficient and their hourly rate is less than yours; concentrate on doing what you are good at!

T

here is a good chance you are reading this article because you are worried about the performance of your practice and looking for some help and direction. Well, we have good news. Of the practices we work with, most come with similar problems: low profitability, lack of direction, no planning for improvement or the fear of a competitor moving in nearby. We can safely say all these businesses have not only survived, but thrived, in these difficult times.

You may assume that, as a consultancy, it should be easy for us to turn around a poorly performing practice; after all, that is what we are telling you to do. Last year, we decided to join in and bought a small first-opinion practice, which had suffered through some extremely unfortunate circumstances. So we are living the journey and practising what we preach!

Profit – keeping tabs on it In business, vets are good at knowing what their basic income is – the vast array of practice management systems ensure that we do, but that is usually the easy part. Many practices, however, are not so good at keeping a close eye on outgoings and profit.

Unless you are lucky enough to have a great Practice Manager with good financial skills, you may rely on your accountant to let you know how the past year went (usually several months after year end) and that may be too late.

Monthly management accounts are essential and easy to produce. There are some versatile and easy to use software systems available. Unfortunately, we see too many practice owners trying to keep their own accounts in their precious spare time, which is not a priority compared to veterinary work, and is rarely up to date. Hiring a book keeper or accountant or

Had a bad month? Don’t panic!

It is important not look at individual months, it is too narrow a window and too variable to be of any planning use – and what can you do about it anyway? The best planning period is quarterly, which gives you 13 weeks to plan and implement strategies. Arrange strategic meetings to review performance for the last quarter and compare it to the same quarter from the previous year to see how your business is performing. Then plan the next quarter’s activities and targets.

You need to set financial goals from your quarterly and annual accounts. Check your outgoings against these rough guidelines:

This simple model shows 10% profit, which is typical of many UK practices and, for some, this would be a desirable goal. From our perspective, however, 10% profit is really only the break-even point. We would expect a successful practice to achieve 20-25% profit consistently, allowing money for reinvestment into the practice and a decent return on investment (ROI) for the owners. These are benchmark measures only and every practice will be slightly different.

Once you know your figures you will be able to spot an area that looks like it is under-performing, and good management accounts enbale you to drill down to find out why.

From the practice finances we analyse, almost without fail we see salaries over 45%, sometimes over 50% (including the partners’ reasonable salaries). Your accountant may suggest Practice Life z November/December 2015 z www.practicelife.biz

MANAGING PEOPLE

this is due to over-staffing but, more usually, it indicates poor team performance. A typical knee-jerk decision could be to reduce staff.

The more productive solution (unless you have receptionists filing their nails, nurses reading magazines and vets having long and luxurious lunch breaks) is to look at productivity and ensure your team is charging properly for time and services.

The commodity we are selling is firstly veterinary expertise, backed up by a nursing and support team, along with diagnostic and surgical equipment and a vast stock of medication. Think of your business as selling units of professional time.

How much is our time worth?

Using a formula, we can calculate what an individual practice costs to run per available consulting hour, then divide it by the consultation time (usually 10 or 15 minutes) and this is the minimum to charge a client (plus VAT) – and remember if you do not charge, that fee is only coming off that 10% profit, nowhere else.

What we did We found in our newly acquired practice that the hourly charge-out rate was 20% below the required figure. There were several lower consultation rates, and free of charge consults – mostly post-op – were discretionary. Now there are only two consultation fees, with Cons 2 now almost as much as Cons 1 (some changes have to be introduced gently!) and postop care packages in place so the previously FOC consults are pre-paid.

As with most practices, a bit of guesswork was involved in pricing procedures, aligning closely to prices charged by neighboring practices (how did they work theirs out?). There were a few increases, which were not related to any increase in costs or consumables. Again, once costs of equipment, consumables, overheads and time are known, the proper cost of a procedure can be calculated and a fair and profitable price charged.

Finance is a huge subject and we have only just scratched the surface, but the real success in turning around a practice is determined by the team implementing these changes.

It is all about the people Do you have the right people in the right roles? A simple question, but many businesses don’t have this right. This isn’t an easy problem to deal with if the answer is no, but there are processes to follow once a staff issue has been identified.

Quite often poor performance is due to a lack of training and understanding of the requirements of a job function. If there are not clear job descriptions, reporting lines, protocols and key performance indicators then it is unlikely that every member of the team can be aligned and performing their role to the best of their ability.

Without all or at least some of the above processes in place, this may be the point when you think about running away and hiding! Just to start thinking about creating all of this paperwork is enough to make your head spin, and it is natural to do nothing as the project can seem never ending.

In reality, it is never ending, but it’s not so daunting when you start to chunk it up, delegate tasks and slowly build your www.practicelife.biz z November/December 2015 z Practice Life

29

processes. There is lots of help and great information available, so do not reinvent the wheel. There is a list of resources at the end of this article.

A problem we see commonly is that there are not enough administrative and customer service roles filled in many practices. Reception – being the first port of call for clients and the face and voice of your business – is a good place to start. Are you giving excellent and consistent customer service? If anyone answering the phone or greeting your clients is not doing so to an excellent standard then you are letting the whole business down. There is a general reluctance to spend money on non fee-earning members of the practice team when, in fact, they free up vets and nurses to be doing what they are excellent at.

Great customer services – gain them and retain them To address this chronic under-sourcing in our practice, we promoted a very capable receptionist to Practice Manager (and joined her to our Platinum Practice coaching programme), engaged an assistant for her and hired three extra part-time receptionists. We also use a telephone answering service with a dedicated veterinary team who take all engaged and unanswered calls, so we never miss a call to the practice.

The result of all of this is that our clients are attended to immediately, never have to wait or call back and always hear a welcoming voice. We have implemented a new Pet Health Club scheme to bond our clients and offer them some attractive savings and an opportunity to interact on a regular basis.

Costly, yes; profitable, definitely.

The practice runs along a continuous improvement principle, so everyone in the practice has a voice and can put forward ideas to be implemented, teams are responsible for projects and there are clear roles and responsibilities.

Of course there are many other strategies in place and many still in the pipeline. Turning this practice around is an ongoing process and we do appreciate that it takes time to get things done, but we have a clear plan and vision, which are shared with the team.

It has been great putting into practice what we have been teaching and what we have learnt while teaching others.

We would go as far as to say it has been fun having a practice of our own to use our processes on – although we think some people think we are slightly mad when we admit that.

This is a very brief overview of what can be done and what we have actually done ourselves. If you would like some help, or just a chat, please give us a call, we are always happy to help and share our experiences.

Further reading: www.vetpol.co.uk www.vetdynamics.co.uk Vicky Gower is Co-director, with Alan Robinson, at Vet Dynamics UK, which provides business education, analytical and consultancy services for independent veterinary practice owners and managers. Vicky was one of the first non-vet practice owners who took a financially insecure practice to a highly profitable and stable business. Vet Dynamics has helped more than 600 practices achieve financial stability, autonomy within their team, and the ability to enjoy being a successful business owner in a most gratifying profession.

CLIENT CARE & MARKETING

SENIOR HEALTH CLINICS Senior health clinics tend to be one of the hardest to get up and running. We understand the need for such a clinic, and we can easily decide what we want to cover, so why do they often fall short? Nicola Ackerman discusses the elements of successful clinics and how to tailor them to suit you and your clients

T

he aims of senior health clinics can be broadly split into three areas.

1. Prevent disease by identifying and reducing risk factors.

2. Identify and manage current disease and age-related deterioration as early as possible, also slowing further progression.

3. Help an animal achieve the best quality of life in its remaining years.

It is important to distinguish between natural ageing changes and diseases that occur normally in later life – arthritis being a classic example. Arthritis is not an inevitability of old age, and it can be treated. We will all have heard an owner talk about how their pet is slowing down now that she is older, or sleeping more. Most owners take it as fact this is due to an animal’s age.

By talking to the owner and explaining their cat is in pain due to arthritis, and that medications, diet and supplements can help, most seem happy to take action and act on your advice.

What should a senior clinic consist of?

The most important aspects of any senior health clinic are to take a detailed history and conduct a full physical examination of the patient.

You’ll then need to determine which diagnostic procedures are appropriate – which tests you offer will be determined by what you, as a practice, want to charge (or not), and of course what equipment and resources you have available.

The clinic can simply be based on a clinical examination, urine sample analysis and blood pressure check. Urine specific gravity and urine protein concentrations should be included as early warning indicators of developing renal failure. Older patients receiving treatment with NSAIDs should have six-monthly urinalysis and renal function tests (BUN, creatinine, phos). A more in-depth clinic may include full blood biochemistry and haematology analysis.

History taking

Taking a full clinical history is the foundation of the clinic.

This can be done using a questionnaire, followed up with questioning, or simply by questioning the owner during the clinic.

Clinical examination

A thorough clinical examination of the dog or cat needs to be performed; whether a veterinary nurse or a vet performs this depends on the type of clinic you are hoping to set up. Input from a veterinary surgeon will be required in any diagnosis situation; even if this is to diagnose good health. A thorough clinical examination should take around 30 minutes.

Therapeutic protocols

Any therapeutic protocols will be based on your findings. It is likely nearly every ageing animal you see will require dental treatment and placing on a senior diet as a minimum.

Premium dental diets are generally based on diets tailored to senior pets’ requirements. As mentioned previously, the key aims of senior pet clinics are to prevent disease later in life and to increase quality of life. This should be the message you promote with your senior clinics. Clients may have difficulty accepting they have paid for the clinic/tests but that nothing was found, so supporting the prevention/longevity aspects for pets can be helpful.

Setting up the clinics Firstly, have a practice meeting to discuss the potential of starting up the clinics. There is no point putting in lots of hard work if you don’t get support from your team. Discuss what you want to achieve, and ascertain if anyone is keen to help. Once you have formed your team, have a separate meeting to discuss what things you wish to cover in the senior health clinics. Will they be free or a set fee? Will you do urinalysis and a blood pressure check, and follow up with bloods if necessary? Are the clinics to be nurse led, or vet led? What will you call the clinics? How will you promote them?

Once you have determined the format for the clinics, communicate this to the rest of the practice. Everybody needs to be on board if your clinics are to be a success.

Many food manufacturers and pharmaceutical companies produce literature on senior health clinics, which may help save time when setting them up. Reps from these companies can also be a valuable source of information as the chances are they will have helped set up senior clinics in other practices.

Promotion and publicity

How are you going to inform your clients about your fantastic new senior pet service? A robust communications plan will ensure your clinics get off to a flying start and that your clients know what to expect. Cost-effective ways of promoting a new service or clinic include: • Sending out information with vaccination reminders.

• A waiting room display.

Practice Life z November/December 2015 z www.practicelife.biz

CLIENT CARE & MARKETING

• Leaflets/flyers to hand out in reception.

• Holding a client evening.

• Recommendations from clients.

This last point is the most significant: a happy, bonded client will provide you with more new clients through word of mouth than other methods. Why not personally invite clients to your senior health care clinic? A quick phone call or card in the post may be all it takes to get a client hooked on the idea of keeping their beloved pet well and therefore around for as long as possible.

Conclusions Senior clinics for cats & dogs are exceptionally important in helping owners prevent pain and illness, and for identifying those animals showing changes, and to help educate and support owners. One aspect that will increase the number of pets seen in older age is ensuring that owners are accustomed to bringing

31

their pets in to the practice, and normalising the requirement for a health check with a RVN. Further reading: BSAVA Scientific Proceedings: Nursing Programme. 2004 and 2007.

Fortney, W D (2005). Veterinary Clinics of North America: Small Animal Practice. Geriatrics.

Elsevier Publications.

Jevring, C and Catanzaro, T (1999). Healthcare of the Well Pet. W B Saunders.

Nicola Ackerman, BSc(Hons), RVN, CertSAN, CertVNECC, VTS(Nutrition), A1, V1, C-SQP, HonMBVNA Nicola is Senior Medical Nurse at The Veterinary Hospital in Plymouth; she graduated from Hartpury College with an honours degree in equine science, and subsequently qualified as a veterinary nurse in 2002.

Nicola sits on the Veterinary Products Committee of the VMD, and is a regular adviser to BVNA. She has sat as a BVNA officer and is past editor of Veterinary Nursing Journal and frequently contributes to veterinary publications and textbooks. Nicola won the BVNA/Blue Cross award for animal welfare in 2010, and has gained various SQP awards.

CASE STUDY: OLD FRIEND CLINICS AT THE VETERINARY HOSPITAL GROUP

W

e start off our Old Friend Clinics by asking owners to complete a questionnaire about their pet. A nurse will then run through the questions and pick out the relevant information for the vet. The nurse also completes the urinalysis and blood pressure measurement.

When we initially set up the clinics, the next step was to take a blood sample and for the vet to complete his or her examination, look over the blood results and relay them to the owner. Depending on the result, either the vet or nurse would have a further consultation with the client to discuss recommendations. A set fee was charged for the full service.

We found that uptake of the clinics was poor and gathered that price appeared to be the problem. So we made the clinics free, unless any further diagnostics (blood tests) were

required. The decision was long debated, but we found that the “spin-offs” outweighed the cost of a free urinalysis and blood pressure check.

The clinics are now solely nurse led, unless they feel an animal requires a consultation with a vet. The amount of dentals we perform has increased, along with the percentage of older animals being vaccinated and treated for fleas and worms.

The underlying principle of older pet clinics is to improve welfare for the animals. In some cases you will find an animal in ill health and it must be referred to the vet – but many owners were scared to take the animal to the vet initially due to fear of it being euthanised. Many clients are unaware of what can be done to help their elderly pet – a great example being the management of incontinence in older dogs.

CASE STUDY: SENIOR CLINICS AT METZGER ANIMAL HOSPITAL

T

his US practice chose to concentrate on a single aspect of senior pet care: dental health. Metzger’s senior programme is based on five steps.

1. Reception. The receptionists weigh all patients entering the practice and use an age/weight chart to ascertain whether the pet is classed as senior. Clients with older pets are given a questionnaire to complete.

2. Technician. The vet tech helps owners with any problems filling out the questionnaire, and reinforces that the pet is senior (some clients don’t like to think of their pets as old). The vet tech then identifies significant information from the questionnaire. A dental check is performed on all animals and a photograph taken of their teeth.

3. Veterinary surgeon. The vet emphasises the dental message, and lets the client grade their pet’s dental health by comparing

www.practicelife.biz z November/December 2015 z Practice Life

the photograph of its teeth against a dental wall chart. The vet discusses the effect dental disease has on other body systems.

Those animals that require dentistry are booked in, and all animals have a full blood biochemistry and haematology run as standard prior to anaesthetic.

4. Schedule, schedule, schedule. Compliance in senior health clinics is vital. There is no point in a client spending lots of money, and the practice investing lots of time, if the owner doesn’t comply with the information given. Follow-up checks are booked, whether specifically for dentistry or for other problems that were identified.

5. Rewards. Everyone works better when rewards are given, including clients. In this five-step programme, all animals seen during the senior programme are given a voucher for money off their annual vaccinations.

32

CLIENT CARE & MARKETING

ARE GERIATRIC CLINICS BENEFICIAL? The figures speak for themselves – offering nurse clinics and extended services can contribute to your practice’s bottom line, along with firmly bonding clients to their favourite vet surgery. Aiz Baig, Product Manager, Merial, looks at how these benefits can be realised in practice

A

geing is a progressive decline in intrinsic physiological function leading to an increase in mortality1.

Increasing owner awareness through clinics is critical for the appropriate management of these physiological changes, such as arthritis and dental disease, so that animal welfare can be improved. Geriatric clinics are an excellent tool by which clinical teams can identify and treat the needs of older animals to help improve their quality of life and at the same time improve client bonding and engagement with the clinic. Geriatric clinics also provide an opportunity for clients to interact with the practice in non-pressured circumstances.

Veterinary nurses are in an ideal position to ensure that clients receive accurate and knowledgeable advice from qualified individuals. In addition, veterinary nurses can encourage open communication and can give proactive advice before a clinical situation becomes stressful to the owner. This will help build and maintain client relationships, bonding owners to the practice during an important time in their pets’ lives. It is also advisable to make sure a veterinary surgeon is available on site during clinic times. This helps to insure that clients have easy access to a vet should the need arise.

Ultimately, nurse clinics may also contribute to practice 1 06/11/2015 13:29 turnover Medivet_PracticeLife_DEC15.pdf as well as strengthen your clients’ loyalty.

Providing extended services can help strengthen the bond with your clients, increase the number of visits they make to the practice

NDED E T X E R U ing O

Suppor t

and also potentially increase their average spend per visit2,3,4.

Nurse clinics can benefit all three parties – the practice, the client and, of course, the pet.

A large veterinary group established geriatric clinics in several branches to help identify unmanaged cases of osteoarthritis.

During a 12-week period, 45 canine osteoarthritis cases were identified, which could then be appropriately managed.

Geriatric clinics are an excellent tool by which clinical teams can identify and treat the needs of older animals to help improve their quality of life and at the same time improve client bonding and engagement with the clinic.

FACT: Approximately 68% of dog owners are not aware that arthritis and weight gain are linked5 FACT: Dental disease affects more than 87% of dogs and 70% of cats over three years of age5 References: 1. Alcedo J, Flatt T and Pasyukova EG (2013). Neuronal inputs and outputs of aging and longevity. Front Genet 4:71.

2. Volk, J O, Karen, B S, Felsted, E, et al (2005). Executive summary of the AVMA-Pfizer business practices study, JAVMA, 226(2), pp 212-218.

3. Volk, J O, Karen, B S, Felsted E, et al (2011). Executive summary of the Bayer veterinary care usage study, JAVMA, 238(10), pp 1275-1282.

4. Lambert, A (2009). Increasing client footfall, In Practice, 31(8), pp 406-408.

5. Banfield Pet Hospital, State of Pet Health 2012 Report, Available at: www.stateofpethealth.com (Accessed: October 2015).

6. Independent Vet Care, personal communication, December 2014.

FAMILY

Medivet . That’s why miles away ill spent of s W 0 a.

0 ic 10 South Afr in e nearby or t ’r ec ey South oj th pr ve er ti ily, wheth wlds’ rhino g to his na Dr Will Fo amily is fam re returnin t fo or be pp et su iv r Med tate to didn’t hesi t working fo years as a ve er ve. ve es fi R t rs la fi ha s years” hi Amak back many tablish the s e o g t e Africa to es iv d n with Me undation “Associatio ilderness Fo gside the W on and care al al ks he or t, w and to trea Today, Will ng hi cks. ac ta po at o rhin poaching to prevent ’ve survived ho w ting s al ec ot im about pr for the an ign. is passionate pa m ily m ca fa o in et hind the rh Our Mediv be the lly fu of s re d we’ awarenes animals, an and creating s g it in is ng ti ra or nd pp Through fu mitted to su ivet is com project, Med . re mily where you' extended fa of a family rt 0046. pa 47 be 23 to 19 0 If you’d like ll Daniel on ca d, te or supp to valued and ill’s work go e about W or o m in t rh ou et To find s/mediv John - MEDI et.co.uk /new VET www.mediv Will - EXTENDED SENIOR PARTNER FA

F

46 01923 4700 l ie n a D ll a C co.uk t@medivet. recruitmen et.co.uk www.mediv

e great to it would b you hear from

P.S.

MILY MEMB ER

Practice Life z November/December 2015 z www.practicelife.biz

BUSINESS HEALTH & FINANCE

LETTING GO

of your veterinary practice the Management Buy Out model As soon as you start your veterinary business venture, it’s time to think about your exit strategy and who may be the successor to your hard-earned business, writes Riz Akhtar

E

very business owner, whether a sole proprietor or in partnership, will at some point want or need to exit from the business they have built or acquired. In my personal view, owners should treat themselves as custodians or guardians of a business as eventually they will have to relinquish their reign.

Owning a business means we naturally become emotionally involved with it. After all, we put in the long hours and make personal sacrifices to promote and grow our new venture to fulfil its potential. We don’t want to then lose what we have worked so very hard for. For this reason alone, it is imperative to keep in mind your exit strategy, right from the start. This will enable the preparation and selection of appropriate trustees, to whom you can pass on the business you worked for.

Exit from a business can take many forms; an outright sale to internal staff or sale to external buyers, either to a private owner or to a corporate organisation. Another form of exit is “succession”, meaning the process of inheriting a title. This could be succession to a member of staff or to a member of your family.

We often get so preoccupied in the day-to-day management of our startups that we can’t see the wood from trees. Even if you don’t have the time and are not yet ready to focus on finding a successor, you should keep succession in the back of your mind.

When the right person does comes along, your vision and values can then be filtered through so they stay embedded within the business once you have relinquished control.

A favoured form of succession among business owners is the management buy out model (MBO). MBO is a form of acquisition where the company’s existing managers acquire a large part, or all, of the company from either the owner or the parent company. It is important to distinguish this from management buy in (MBI), where external managers are brought in to acquire the business from its current owners.

In my view, this is tricky, and has is high risk as existing staff may react negatively. This can also bring cultural changes and introduce different ideologies and values.

MBO allows for business owners to plan their succession gradually and in stages, enabling staff to take part in executive decisions. The advantages of MBO are that your successors understand the fundamentals of the business, they know the existing staff and, most importantly, they know the client base.

Don’t lose sight of what your practice or company is doing once you are considering exiting, as many owners tend to stop investing and, thus, let the business run down. When adopting a MBO, I would encourage investment into plant, equipment www.practicelife.biz z November/December 2015 z Practice Life

and marketing; the business will grow and simultaneously the skill set of the intended staff will develop, so equip them to take the business forward.

Once your key MBO individuals are identified, robust training should begin. Include financial management training specific to the business well as core technical skills required for a principal vet, to sustain and develop the business.

The mechanics are simple once your successors are identified.

Finance or capital can be raised through a combination of personal savings and bank loans. Your bank manager should be your first port of call as he or she will likely know your business and your staff already.

When structuring a successful MBO ensure it is flexible until the point of exiting the business completely and that it is financially robust and tax efficient. Consult your advisors and accountants regularly.

In my experience, at the point of full and final exit, the return on your investment into the business can be equal to, or even greater than, the 100% you initially invested. We have also seen practices where, after retirement of the original founder, the MBO team were already preparing for the second tier team to take part in the expansion of the practice into new locations.

MBO does come with some disadvantages; however, these can be overcome and the benefits of a MBO far outweigh the disadvantages. During succession, you could select the wrong participants in the first round, which could derail your vision, but as a business owner you must trust your instincts and judgements to continue in the right direction. It is therefore advisable to seek legal advice to put together contractual formalities to reassure both parties. I would also suggest that while you undergo a MBO, before exiting from the business completely, you retain majority share and control of the business until the point of retirement.

It is inevitable you will have to leave your practice at some point so thinking about how you will do it is best done sooner rather than later. Phasing yourself out of your business has the potential to generate more income for you than if you sell it outright. And knowing that what you worked so hard to build up will continue for years to come is not only priceless but a very soothing way to enter retirement.

Riz Akhtar has extensive experience in advising vets on how to achieve tax efficiency and maximise profitability. He works alongside numerous vets and veterinary practices, helping owners develop strategies for growth and successfully manage their accounts from start-ups to exit strategies.

www.raaccountants.com

34

BUSINESS HEALTH & FINANCE

CASE STUDY: BECOMING A PARTNER AS A NON-VET

LEPTO 4

Available now

Rebekka Fiorani describes how her career developed from evening kennel assistant to practice manager and then partner. All without a veterinary background!

A

Lepto2 or Lepto4?

To find out which is most tailored to your clinical needs, contact your Virbac Territory Manager to arrange an appointment Virbac Vaccine range: Core vaccines for dogs and cats Kennel cough and Rabies vaccines The 1st vaccine in Europe against Canine Leishmaniosis Supported by VIP, our online system for text alerts, emails and personalised printed literature Tailored practice support for a lifetime of care

Vial images shown are for illustrative purposes only. CaniLeish® contains Leishmania infantum Excreted Secreted Proteins (ESP) at least 10mcg. purified extract of Quilaja saponaria (QA-21):60 mcg for injection for the active immunisation of Leishmania dogs from 6 months of age to reduce the risk to develop an active infection and clinical disease after contact with Leishmania infantum. Legal Category: POM-V . Canigen Lepto2 is an inactivated Vaccine containing Leptospira interrogans serovar Canicola and Leptospira interrogans serovar Icterohaemorrhagiae. Legal Category: POM-V . Canigen Lepto4 is an inactivated Vaccine containing Leptospira interrogans serogroup Canicola serovar Portland-vere, Leptospira interrogans serogroup Icterohaemorrhagiae serovar Copenhageni, Leptospira interrogans serogroup Australis serovar Bratislava and Leptospira kirschneri serogroup Grippotyphosa serovar Dadas. Legal Category: POM-V .

For more information please contact your Virbac Territory Manager or Virbac Ltd, Woolpit Business Park, Windmill Avenue, Woolpit, Bury St Edmunds, Suffolk IP30 9UP. Tel: 01359 243243 Email: enquiries@virbac.co.uk www.virbac.co.uk www.my-virbac.co.uk PLEASE USE MEDICINES RESPONSIBLY. www.noah.co.uk/responsible

VIR 5247.3 Lepto 4 Ad 88.5x259mm.indd 1

s a non-vet, I had never considered that buying into a veterinary practice would be possible. I started off in a practice as an evening kennel assistant aged 16. I loved working at the practice but knew I was not cut out to be a vet or a nurse, so didn’t have any long-term plans to stay there.

In 2001, however, I was offered the full-time position of branch manager after having spent a couple of years working on reception part time.

I immediately loved the challenge and responsibility of running the branch practice and seeing it grow, both in terms of clients and turnover. I spent three years learning as much as I could about veterinary practice management under the watchful eye of the then group practice manager.

In 2004, at the age of 25, I took over the management of the group (two small animal surgeries, a dedicated equine facility and ambulatory farm practice).

It was a very steep learning curve, going from branch manager to practice manager. Once again I threw myself wholeheartedly into my own learning and into growing the practice. I was very fortunate that the two partners trusted me and allowed me to make mistakes! They had little interest in managing the practice – they both became vets because they wanted to be vets. This attitude allowed me to really take the practice on and treat it as if it was my own.

In 2008, during one of our regular management meetings, the partners offered me a partnership. I was astounded!

In the 12 years since opening the practice, they had not taken on another partner. Assistant vets had come and gone due to lack of partnership potential. I felt very privileged to be offered the partnership and really didn’t think twice about accepting.

The process to set it all up took quite a long time. I took independent financial advice, and an accountant valued the practice. Once a final figure was agreed, I approached the practice’s bank, which offered me a business loan over 15 years. In August 2009, I handed over enough money to buy a house and I became a partner!

We told the staff in a practice meeting – it’s fair to say there were mixed reactions. Although the day-to-day job didn’t change for me, the weight of responsibility did. I felt very aware for quite some time that I was now responsible for 50 people’s mortgages. Which in a way, I always had been, but it certainly weighed heavily on my mind for the first 12 months. Six years on and I have absolutely no regrets.

It’s hard work, but then it always was. Instead of just treating it like my own, it is my own and I feel very proud and privileged to be in this position.

Practice 25/09/2015 15:14

Life z November/December 2015 z www.practicelife.biz

BUSINESS HEALTH & FINANCE

35

CASE STUDY: SELLING IN TO A VETERINARY PRACTICE This case study aims to highlight how, by developing staff with a vested interest within a business, you can ensure success for your venture far into the future What: A veterinary practice based in the midlands, run by a highly skilled technical vet, was built up from nothing. The founder had a wish that the practice would continue with the same core values on which it was built, the self-same values that are delivered to its loyal patients.

two young and energetic partners, who displayed great enthusiasm in running the business. The practice moved to a modern building in a more affluent location, in preparation for its envisaged future growth. The business has since grown substantially and now, after its second valuation, the founding partner’s 52% share of the business, at the age of 60, is worth considerably more than the 100% ownership he started off with. This was substantially more than the founding partner thought possible.

The founding partner can now exit the business with peace of mind, knowing that the practice will continue to be run with the same core values on which it was founded, and staff and patients face minimal disruption.

So, a few years on, the practice continues its journey far beyond just the founding partner.

Who: The founder believed deeply in the notion of “Run your turn and hand over the baton” to a new team, a team with the energy to run the next phase. The founder’s values of building a team that not only worked well together, but also shared the same aspirations, was key to the practice’s success.

How: The founder planned and developed his team with the vision that the practice would not be sold externally, but instead to those who had been a part of its continued growth. This made great commercial sense, the loyal patients would continue to be seen by the same team, who would retain the same core values.

The business was valued, at which point the founder decided it was time to bring in a business partner.

But he still wished to keep control until he turned 60, when he would hand over the business and exit.

In his pursuit of suitable business partners within his team, he noticed a nurse who had joined at the age of 16, as a school leaver. After many valuable years contributing to the practice, the nurse developed her skills to the point of running the place. He decided she would be a perfect managing partner in the business.

Of all the vets in the practice, a young, aspiring vet displayed immense technical knowledge and skills that would take him far, so he was also selected.

The team members were assembled and were delighted with the offer the owner made.

“The founder planned and developed his team with the vision that the practice would not be sold externally, but instead to those who had been a part of its continued growth.”

J3818 - Advert - Practice Life Magazine December 2015-v2-AW.pdf

C

M

Y

Preparing for succession His bank manager was approached to raise finance.

Advisors were consulted for help to structure the business for tax efficiencies, as well as flexibility, in preparation for succession. The bank was happy to extend finance to the chosen pair. It was acknowledged there was an opportunity for growth within the practice, and the members were part of the business already and had a vested interest in continuing to develop it commercially.

Jointly, the nurse and vet bought 48% of the business and the original owner kept 52%, as well as overall control.

The founding partner then released some of the locked equity, extracting a lump sum, not only to enjoy his life but also to reinvest in purchasing a freehold property.

The icing on the cake came when the founding partner turned 60. He had become part of a larger team that included CM

MY

CY

CMY

K

www.practicelife.biz z November/December 2015 z Practice Life

1

11/

PRACTICE DEVELOPMENT

Giving the

BEST GOODBYE Putting in place simple practice protocols could ensure vets don’t lose clients after euthanasia, says leading hospice vet Susan Gregersen

A

s a busy clinician, do you ever wish you could do more for your patients – and clients – at the end of life? I certainly did. Since leaving emergency medicine and normal practice in 2005, I have personally dealt with more than 5,000 end-of-life situations and in-home euthanasias as a leading, UK-based hospice vet.

Since 2012 my practice, Vets2Home – Peaceful Pet Goodbyes, has been the first in the UK to specialise solely in offering in-home palliative medicine and euthanasia services around the clock. This is also known as in-home animal hospice and is dedicated to helping my own and referred clients say goodbye to their beloved pets – and I believe that general veterinary practice can and should offer aspects of this ervice, too.

Do you ever let the daily frustrations of working in a normal, busy practice get the better of you? You spend most of the scant, 10-minute consultation trying to diagnose, cure or repair the lovely animals presented to you – and then you suddenly find yourself acting as the executioner, social worker and funeral director. Dealing with delicate clients and patients becomes

even more volatile and potentially challenging at the end of life (EOL); when do you not feel overwhelmed, inadequate, unprepared or floundering as to how best support your client at this vulnerable time?

Well, I know how I felt working in normal practice juggling all those diverse tasks. Although it was more than 10 years ago, I remember how borderline schizophrenic it felt to have to change my cheerful mindset in an instant as I went from a puppy vaccination to a euthanasia. One minute you’re in a relatively happy situation, the next you’re having to extend heartfelt compassion to a longstanding, loyal client, or – perhaps worse – one you’ve never met before. You’re thrust into the most intimate and vulnerable of circumstances with just 15 minutes to euthanise their four-legged family member or, in some cases, “fur child”. That is, I believe, an almost impossible task without feeling utterly inadequate and emotionally stunted.

I decided to turn my back on traditional veterinary practice and make a career out of transforming my lurking compassion fatigue into compassion satisfaction. Now I have the time, Practice Life z November/December 2015 z www.practicelife.biz

PRACTICE DEVELOPMENT

knowledge and skills to best care for patients and clients when they need this care the most. Compared to being in normal practice, it gives me a real sense of purpose and job satisfaction.

It feels like an immense reward to have an active role in giving clients a beautiful and dignified experience of parting with a furry family member.

Becoming an active partner in this field came as a revelation to me, and it is the reason I feel compelled to share what I have learnt. I want to help colleagues, both new and more seasoned, develop this under-served area of clinical practice, because I wish I had been better prepared when starting out, and had also had access to CPD training later on.

How it works in practice The subject matter of end-of-life and euthanasia may be intrinsically sad and emotionally charged but, just like a top orthopaedic surgeon who is committed to his or her chosen field, by not having any other distractions and by paying attention to every detail, post-operative complications can be minimised.

Repeated and consistently successful outcomes – where the client knows their animal had the best end – by far outweigh the inherent sadness.

This can be achieved by putting in place practice protocols.

Knowing exactly what to do and what to say by working to a set of simple, proven steps makes the whole practice team feel empowered and useful. It’s the same as a surgeon following the proven steps in a successful cruciate repair, where lots of practice makes perfect. As end-of-life/euthanasia is an unavoidable and inevitable part of veterinary practice, isn’t it about time we fully adopted this “unwanted stepchild” and made it a legitimate part of our practice protocols?

An Onswitch survey last year suggested that almost one in five (19.1%) of clients did not return to their normal practice with a new – or another – pet after euthanasia. This result, and the fact that euthanasia is the only procedure that has been singled out in the 13 classifications of the RCVS complaints process, speaks volumes about the intangible but poor state of affairs in practice when it comes to the last experience that pet owners have at this memorable time.

The failure to return to their practice represents a huge, silent financial loss to vets that has so far not been accurately monetised, although my colleague, The Pet Loss Vet Caroline Hewson, conservatively suggests it costs vets tens of thousands of pounds in lost income.

In general business, it is accepted wisdom that the cost of attracting new customers significantly exceeds the cost and value of retaining existing ones. So shouldn’t we, as the caring profession we are perceived to be, start spending time and resources applying palliative care and the philosophy of animal hospice to produce as many consistently happy outcomes – and clients – as possible?

What hospice care entails Originating in the United States during the last decade or two, animal hospice is defined as comfort-oriented care for the patient in the last stages (days, weeks or months) of life, the patient and unit of care being the pet and the whole family. Contrary to common belief, the vast majority of hospice cases have a planned end with a two-step euthanasia, preferably at home. Palliative www.practicelife.biz z November/December 2015 z Practice Life

37

medicine and animal hospice is best done in the comfort of the client’s and pet’s own home, but many of the principles are easily applicable and manageable from a bricks-and-mortar practice, as several established, leading practices in the USA have successfully demonstrated for years.

The five Ps of end-of-life care Adopting proven steps for the last stage of life is a practical way to address the area of client expectation management and pave the way for successful outcomes. The end of life should be perceived as the first step of the new client life cycle where the handling of this last stage leads the way to a returning client and hence far more team effort and resources should be placed here than anywhere else. These main areas could include (but are not limited to) the suggested summary of the five Ps of EOL care (author’s suggestion): 1. Pre-euthanasia consultations: Using a checklist to address practical, medical, financial and emotional concerns before acutely needing this information. This also supports the client in the initial anticipatory grief stage and is perceived as “setting the stage” so the client sees the practice team as actively approachable and involved every step of the way on this difficult journey – just like the practice was on the exciting new puppy/kitten journey.

2. Preparation and palliation: Including offering medical and comfort-orientated aspects of animal hospice to assist the pet and the client in the preparatory stages, leading to acceptance and readiness for euthanasia and impending loss. Memory/ legacy work also starts here especially if children are involved.

All treatment options should be made equally available to clients at this stage: diagnostics/treatment, active hospice, natural death (only if hospice-assisted) and euthanasia.

3. Personal: Making the EOL journey more personal by assigning a designated, trained contact person (or small team) who conducts the pre-euthanasia (bonding) consultation and ensures all concerns (medical, social, emotional and spiritual) are addressed and followed up all the way.

4. Place: Ensuring the location for EOL care/euthanasia is determined, preparing suitable “comfort rooms” or, where possible, actively offering home visits. Outsourcing less feasible/practical parts to dedicated EOL practice if available in your area.

5. Practice protocols: Identifying and addressing client touch points before, during and after the euthanasia/death, such as call handling, waiting room arrangements, hand-out materials, 24/7 contact numbers, bereavement support, sedation protocols for all species encountered, aftercare options plus team support and practice-supported facility to share difficult situations (professional supervision).

This short list gives an idea of the potential complexities of successfully managing this challenging last stage of pet ownership. Beginning to focus on this life stage makes both good business and practice management sense on so many levels.

Ultimately, though, it benefits the beautiful, treasured animals who are the reason we, as veterinary professionals, do what we do – and who we should remember are at the epicentre of all our combined efforts.

38

PRACTICE DEVELOPMENT

CASE STUDY: BEING AN ALLY IN PRACTICE HELPS CLIENTS AND REVENUES Practices may – inadvertently or otherwise – drive away owners from their doors after the euthanasia of a pet. It’s time to change things and offer a new service to help those involved cope with the loss of a pet, writes Ali Samuels

L

OSING a pet is the saddest part of the journey we share with our beloved companion animals. It is what many of us dread most – owners, vets, nurses and receptionists alike, but preparation is key to coping at this sad time.

Following the deaths of my two horses I recognised there was a gap in veterinary practice, when it came to supporting both pet owners and members of practice staff at the times of euthanasia or loss.

Having worked for 25years as a palliative care nurse for humans I looked at the provision of services for human loss and took inspiration from organisations such as Macmillan and Marie Curie support. I started to explore my idea for a pet loss model, which could be used in veterinary practice as the implications of pet loss are complex, and touch all areas of the business and staff welfare.With the help of Hilary O’Dair, veterinary surgeon and fellow director, ALLY was established and is now an organisation for pet loss and provides accredited training courses.

Through ALLY, I wanted to introduce a new protocol to help staff support clients who are experiencing pet loss. Not only did I feel the emotional needs of owners and staff were not being addressed, but practices were suffering financially from pet loss too. This initiative offers practices the opportunity to

improve client retention, enhance a practice’s reputation in the community, and attract new clients.

The courses we run are aimed at VNs and receptionists, and are delivered through small experiential group sessions. The content explores the human-animal bond, grief, loss, the effects on different individuals in society today, building personal resilience and confidence, keeping emotionally safe at work, issues around euthanasia, further development of communication skills and implementation of the service within veterinary practice.

On successful completion of the course, trainees become registered ALLY Supporters and their practice becomes a member of the organisation, showing owners that they have chosen to take this approach.

For more information visit www.allyforall.com Alison Samuels is a former Registered General Nurse and Founder of ALLY. She worked for 25 years within human palliative care nursing, including 10 years in a hospice. She has an Advanced Diploma in Person Centred Counselling. Following the deaths of her animals, Ali identified there was no national formal accredited training and provision for pet loss similar to that available for human loss (Macmillan and Marie Curie support) and so she developed ALLY. Ali is the Managing Director and a trainer for the ALLY accredited course.

EXPANDING OUR OFFERINGS, INCREASING OUR SUPPORT

growing our business,

to support yours

At Elanco, we embrace the responsibility to help our partners address the global challenges we all face. Our recent combination with Lohmann Animal Health and Novartis Animal Health further expands the comprehensive set of products and knowledge services we offer; increases our investment in new product development; and expands the global footprint of our field team.

UKFCAEBR00043

These advancements enable us to be er serve as your partner in solving your greatest business challenges, and in advancing a vision of

food and companionship enriching life.

For further information please contact Elanco Animal Health, Lilly House, Priestley Road, Basingstoke, RG24 9NL Tel: 01256 353131 Email: elancouk@elanco.com © 2015 Elanco Animal Health

Elanco_PL_127.5x180mm_FInal-2.indd 1

14/10/2015 17:39

Practice Life z November/December 2015 z www.practicelife.biz

CPD SHARED

Focus on

HUMAN RESOURCES As the profession faces a recruitment crisis, it is essential to get your staff appraisals and management processes in order. Practice Manager Katie Bull reports from the inaugural SPVS-VPMA CPD day that examined just what practices can do in practical terms to keep staff happy and attract new recruits

A

s a Practice Manager in a Tier 3 small animal veterinary hospital, and not having a veterinary background, I have learnt very quickly the challenges of getting vets, nurses and non-clinical staff all working together. This, combined with the shortage of current applicants for clinical roles, means it is even more important to look after your current staff so you keep them, and to attract new members.

The Focus on Human Resources day run by SPVS-VPMA brought together a host of quality speakers and exhibitors offering training, recruitment and legal support. The seminar was split into two streams, allowing the 80-strong audience of business owners, managers, vets and nurses to choose which speakers they wanted to hear.

Lynn McKeown from Zoetis looked at a three-stop performance management process. Many practices conduct appraisals for their staff, but Lynn also talked about role clarity and communication as some of the biggest factors that result in unhappy staff.

The energetic James Cronin from Eight Legal decided against a PowerPoint presentation and instead gave a list of discussion points for contracts of employment. This gave the audience a chance to ask specific questions, which resulted in a fascinating exchange of views, such as “Can you change staff contracts that contain a generous sick pay clause?”

Inspiration from across the pond Katherine Eitel, who had travelled from sunny California to be with us, was an inspiring speaker. Katherine runs the internationally renowned Lioness Learning company. She spoke about the importance of meaningful meetings, and the need for leaders to provide their staff with clarity and inspiration. This relies on owners and management having a clear vision for all staff, so everyone knows what they are working towards, however big the idea!

She also armed the audience with tips on holding crucial business conversations with staff throughout the year, as well as during their appraisals. Her second talk was titled Becoming a Great Leader.

Katherine drew on her personal experiences and inspired the audience to “think like a leader” and take responsibility, even if this means challenging your own belief system.

Georgina Hills from Vale Vets and Vale Referrals spoke about recruitment, and the importance of practices selling themselves

to recruit the right person, especially in the current recruitment climate. She reminded us that non-permanent staff (locums) will also be vocal about your practice so make sure they get a good impression when working with you. She gave practical tips on handling the recruitment process, such as acceptance of staff leaving, a chance to review the role, advertising, interviewing, the induction process, and the three-month review.

Other speakers included Nick Steele from event sponsors, Zoetis, who talked about managing change, sharing proven techniques, and handling reactions within the teams. Brian Faulkner shared the skills, knowledge and attitudes that staff need for a veterinary practice to be successful. He took the audience through reception, nurses and vets in turn, and how mastering these skills leads to higher revenue and improved client satisfaction. Alison Lambert from Onswitch and Linda Demetriou from Demco Communications spoke about effective telephone training, and how important it is for your bottom line. Lesley Trench from Citation looked at safeguarding practices, with practical advice on how to design and implement a staff health and safety policy that is both practical financially and from a resources perspective.

Engagement and enthusiasm It was great to see the audience so engaged, asking questions and sharing experiences. It’s clear that part of the responsibility falls on individual employees and the choices they make, but managers need to be clear about what is expected of their staff.

Most employees want to succeed at work, but they can fail if there are no systems in place to manage performance.

With the veterinary industry currently facing a recruitment challenge, practices need to be showing their staff that they care, and that they want them to succeed, by giving them clear guidelines and monitoring individual performance. Leaders need to be clear on any agreements they have with their staff, and then when these agreements are broken, have practical tools to deal with getting them back on track.

This was the first Focus on HR day run by SPVS-VPMA Events.

If the enthusiastic reception from those delegates I met and spoke to at the event is anything to go by, it seems likely to become an annual event. I for one will be booking up again for the next event.

At the PSS joint VPMA/SPVS CPD day, veterinary surgeon Dr David Holah BVSc CertZooMed MRCVS of Piddle Valley Vets, not currently involved in PSS, commented “Following the PSS update day in Coventry I am much more interested in joining the scheme. The new computerised record keeping should enable a practice to ensure they are compliant prior to an inspection and should be a useful practice management tool. This hopefully will enable the inspections to become more outcome focussed rather than the current system which appears/feels like an exercise in box ticking or attempting to catch a practice out. Read more about the scheme on page 13.

Practice Life z November/December 2015 z www.practicelife.biz

ADVERTORIAL

41

Watching the pennies HELPS PILE ON THE POUNDS A whole new breed of more profitable veterinary practices are emerging across the country as Zoetis Business Consulting rolls out Profit Solver, a financial analysis tool that significantly boosts practice profits in just 12 months.

P

rofit Solver, a financial analysis tool from Zoetis, can significantly boost practice profits in just 12 months. It uses a practice’s own data to calculate the exact cost for the most commonly performed veterinary services, representing 90% of revenue.

By looking at labour, inventory and equipment costs and combining these with time and motion studies, Profit Solver reveals the variance between cost and price.

It then calculates the correct pricing to both cover costs and deliver a predetermined profit margin.

John Goulding, managing director of St Georges describes the new tool as a complete game changer. “For years I have wanted to know exactly how to price our services and Profit Solver does just that. It showed that if we do the same amount of work as last year we can increase our bottom line by at least £200,000 for our 18 vet practice. We have completely changed our pricing structure moving away from focusing on medicines and the size of the animal to rethink how we charge our clinical care.”

“I have an anecdote from before we piloted Profit Solver, which is the perfect illustration for why it is such a game changer. We had to operate on the cruciate ligament of a dog to insert a metal implant. It took one of our vets two and a half hours and we charged the client £2,500, the standard practice price for an operation of this type. We then had another dog in with Leptospirosis. It was very ill and was hospitalised with us for 13 days. While it didn’t need a metal implant, nursing it back to health involved a lot of time from our vets and nurses, as well as the use of disposable items. Yet we charged £2,500, the same amount as for the ligament operation.”

Cedarmount Veterinary Clinic is a seven vet small animal practice which used Profit Solver as part of its practice growth strategy. Working with Zoetis , the practice analysed 74 procedures and made 25 pricing adjustments with an average increase of £4.56, equating to a 2% rise in profits and an estimated five figure boost in the practice’s value over the next two to three years.

Craig Reilly, veterinary principal at Cedarmount comments: “There were a few eye openers for us. Breaking every process down makes you consider which members of the team Nick Steele

www.practicelife.biz z November/December 2015 z Practice Life

are involved, what their role is and the time spent on each procedure. So, the upshot is you can ensure you are pricing according to time, skill and resource. We implemented the price changes immediately and none of our clients have noticed any difference.”

Gillivervet is a five vet equine practice. Already operating at a 10.7% profit level, Profit Solver was able to move the business to a 15.4% profit level over a 12 month period equating to an additional £40,418 on the bottom line. As well as adding £3,368 per month to the practice’s cash flow the adjustment will have increased the value of the business by £162,000.

Gillivervet veterinary principal, John Gilliver comments: “Historically our price setting had been a mixture of guesswork, previous experience and some arbitrary increases. I was keen to make this a lot more scientific, hence my interest in Profit Solver.

“We had quite a few surprises. There were some areas where we were undercharging – for instance not charging for injection fees or the disposal of surgical waste – but on the other hand we realised the quotes we were giving over the phone were often inaccurate and usually too high! We are implementing the changes at the moment and I am really looking forward to seeing an increase in practice profits!”

Nick Steele, Zoetis national consulting manager sums up: “There is no standard method for pricing veterinary practice services and, as a result, practices are often unable to determine which services make money and which don’t. This hampers the practice’s ability to accurately value the business and, as a result, profit levels tend to be low. Profit Solver can turn this situation around and already has a very successful track record.”

For further information visit www.zoetis.co.uk/businessconsulting.

CONGRESS SPECIAL

SPVS/VPMA CONGRESS 2016 LOOKS SET TO BE THE BIGGEST AND BEST YET

If you haven’t already booked, don’t leave it a minute longer as places are selling out fast!

Alastair Campbell, communications expert, author and son of a Yorkshire vet, will give the opening presentation and join our stream on Mental Health & Wellbeing. He joins a stellar cast of speakers from the UK and USA to make up a lecture programme big on ideas and practical tips you can take back to work on Monday morning. Among these is Professor Noel Fitzpatrick who will be ‘in conversation’ with Martin Whiting, lecturer in ethics at the RVC in the Friday evening discussion slot.

Alastair Campbell

Georgina Hills

Cath Grimsey

Nick Steele

For a full list of lectures and to book your place, visit www.spvs-vpma-events.co.uk Practice Life z November/December 2015 z www.practicelife.biz

CONGRESS SPECIAL

43

CONGRESS NEWS BRAND NEW FOR 2016: New to Management Stream, Sponsored by Mi-Vet This mini ‘Congress within a Congress’ is aimed at two groups; those new to management but who may have worked in veterinary practice, and those more experienced managers who are new to the veterinary profession. It is impossible to cover the all the required information in a day, but our aim is to inspire and inform new managers and send them home with a greater understanding of the bigger picture. New managers will meet others at this stage of their veterinary career and we hope they will stay in touch as an informal group after Congress to share experiences and problems. Brian Faulkner will lead the day, starting with the business basics which will determine whether a practice is profitable or not, moving on through marketing

Professor Noel Fitzpatrick in conversation with Martin Whiting

Professor Noel Fitzpatrick (top left) is both inspirational and controversial in the eyes of many vets. Few would question that his orthopaedic and neurology work has been brilliant and life saving. Anyone close to him will tell you he is a dedicated workaholic who believes passionately in the sanctity of life. By introducing new surgical techniques to move veterinary (and human) medicine forward, he is able to offer more choices to owners.

Programmes like the BBC’s Bionic Vet and Channel 4’s Supervet may, some argue, raise expectations among pet owners as to what the average vet can do.

These areas amongst others will be explored in this hour long ‘conversation’ between Professor Noel Fitzpatrick and Martin Whiting (top right), lecturer in ethics at the RVC. In a format borrowed from literary festivals, Martin will delve into Noel’s biography to describe a career that took him from an Irish childhood to Professor of Orthopaedics, founder of Fitzpatrick Referrals, prodigious author and thought leader.

There will be an opportunity for the audience to submit their questions from the floor.

www.practicelife.biz z November/December 2015 z Practice Life

and team building and then finishing with a whistle stop tour of health and safety and compliance from Citation.Two experienced Practice Managers, Cath Grimsey and Georgina Hills will share with the audience what they wish they’d known when they first became a veterinary practice manager and Nick Steele from Zoetis will contribute to the session on marketing.

The stream with be in the beautiful setting of the Manor House, the original part of Celtic Manor and delegates will have the opportunity to stay there all day, networking over lunch and during breaks as well as during the sessions.

We’ve taken on board your feedback and will have some longer sessions allowing for more in depth learning and discussion. For instance, in a high energy, interactive double session, Rick DeBowes will challenge commonly held beliefs about pet owners, client behaviour and the role of the vet. Your clients are in your waiting room through their own choice.

Some might be there for the first time through a recommendation, others will be long standing clients.

The role of you and your team is to ensure that while they are there, they make the right decision for themselves, their pet and for you. Crucially, your role is also to ensure the experience they have means they will come back and recommend you to others. This session will be followed by complementary sessions, for instance from Michael Pagnotta who will explain how to persuade guests in a 5 star hotel to behave the way you want them to without them realising that’s what’s happening!

44

CONGRESS SPECIAL

Make a beeline for the exhibition SPVS-VPMA’s Congress exhibition has grown in stature over the years, and is a must-do for any congress attendee.

The exhibition runs in parallel with lectures over the two full congress days; all tea and lunchtime breaks take place here, and Celtic Manor’s catering is second to none. With coffee on tap, and a broad range of exhibiting companies to visit, it’s not unusual for attendees to spend a good deal of their congress time seeing what’s on offer; this year, we are delighted to have an excellent line-up of suppliers on hand to welcome you.

Because SPVS-VPMA congress is dedicated to business and management, the exhibition reflects this, with exhibiting

companies having a real business bias. From the larger pharmaceutical companies, many with offerings of added-value support packages to smaller companies dedicated to services of every description, finding several hours to work your way round the exhibition is a must. With over 60 business-focused exhibitors on hand to help you, SPVS-VPMA Congress ensures that you spend your time wisely. A full list of exhibitors is shown opposite, along with a floor map to help you plan your journey in advance.

Make sure you leave plenty of time to work your way around!

PRIZES GALORE FOR DELEGATES IN EXHIBITION COMPETITION Our exhibition competition has grown and grown, with many exhibiting companies offering fantastic prizes. All you have to do is find the competition entry form in your delegate bag (you will have one of two competition forms inserted already), and make your way around the participating stands, finding out the answer to a short question at each one. Simply hand your completed form into the Exhibitor Helpdesk when you’ve finished and you’ll be put in the draw to win one of the many prizes on offer. If you have time, why not have a go at completing the second competition form – pick one up when you hand in the first, and double your chances to win!

BEST OF BOTH WORLDS Can’t bear to tear yourself away from the exhibition? Don’t worry, we will be relaying Martin Whiting’s Friday afternoon discussion with Professor Noel Fitzpatrick down to the exhibition on screen, so you don’t have to miss out on what promises to be one of the congress highlights.

What’s New? If you run out of time to make your way around all the 60+ congress exhibition stands, you can get a flavour of what’s on offer with our What’s New? boards.

We’ll be posting information on business and management-related products and services to update you on exciting new and interesting developments.

“Innovative, challenging, inspiring with a novel and engaging conversational style” Congress delegate, 2015 Practice Life z November/December 2015 z www.practicelife.biz

ENTRANCE FROM LECTURES

13

12

14

11

15

9

10

8 7

16

17

WHAT”S NEW BOARD

EXHIBITORS 2016 REGISTRATION DESK

1

2

18

19

3a

3

4

6

5

21

20

54

SCREEN

22

28

23

29

24

30

25

31

26

32

27

33

34 43

44 53

35 42

45 52

36 41

46 51

37 40

47 50

38 39

48 49

55 56 57 58

PLENARY SESSION AND BANQUET

59 POSEUR TABLES

60

BUFFET

EXHIBITOR’S QUIET MEETING AREA

TEA COFFEE DESSERT

61

NOTE : This layout is schematic and not necessarily to scale. We reserve the right to make minor amendments to the layout before the event.

1

Virbac

21

Nestlé Purina

42

Burgess Diagnostics Ltd

2

Bayer Plc

22

Centaur Services

43

Norbrook Laboratories

3

Merial Animal Health Ltd

23

Protexin Veterinary

44

Vetsolutions

3a

The Vet Channel

24

Veterinary Instrumentation

45

Henry Schein Animal Health

4

MSD Animal Health

25

Lloyd & White

46

Vet Inflow

5

St Francis Group

26

VetHelpDirect.com

47

Vetsec

6

IDEXX Animana

27

Teleos Systems Ltd

48

Elanco Animal Health

7

Vetstoria Ltd

28

AVID Plc

49

National Veterinary Services

8

Citation Ltd

29

Full Power Utilities Ltd

50

Eight Legal Ltd

9

Pet Health Plans from Denplan

30

CSL/Pet Tags

51

Carefree Credit Ltd

10

VetShare Buying Group

31

Vetspace

52

Hazlewoods

11

Moore Scarrott

32

Veterinary Insights

53

The College of Animal Welfare

12

Natures Menu

33

Vetswest Ltd

54

Veterinary Business Journal

13

Lease UK Ltd

34

Woodley Equipment Co Ltd

55

Pet-ID Microchips

14

Summerleaze Pet Crematorium

35

Royal College of Veterinary Surgeons

56

Virtual Recall

15

RxWorks

36

Braemar Finance

57

Axiom Veterinary Laboratories

16

MiVetClub

37

Connected Vet

58

Training-Progress Ltd

17

Pet Cremation Services

38

MAI Animal Health

59

Independent Vetcare Ltd

18

Petplan

39

Hill’s Pet Nutrition

60

Onswitch

19

Zoetis UK Ltd

40

iM3 Dental Limited

61

Vetlife/Henley Business School

20

Royal Canin

41

AT Veterinary Systems

46

WHAT’S COMING UP

As our 2015 CPD Events draw to a close, we’d like to share some feedback from this year’s attendees... we hope you can join us in 2016. Look out for the new programme being announced very soon!

“Very enga ging, relev ant inform ation.

Well prese nted, easy to relate to thorough , in working through co ntent”

and “Well organisedented” brilliantly pres

“Good to have questions answered by fellow delegates as well as the excellent speaker”

to other delegates and “Talking and listening y of the same issues” empathising with man

“Great ideas, tips an d take home messages; practical information to put to use straight away”

“Straight talking speaker”

resting” a ‘difficult’ subject inte e ad m rs te en es pr he “T d “Quality speakers who gave goo feedback on a vast subject”

“The speakers were well-versed and knowledg eable.

Ice breakers / activities were good”

“Best training course I’ve been on – ever!!”

“Good for brainstormin g and exchanging expe riences with like minded peop le and learning what other progressive prac tices are doing”

“Innovative, challenging, inspiring with a novel and engaging conversational style” “A wide range of people in different areas of the profession, interesting to hear other people’s situations and issues”

Look out for the Spring issue of Practice Life Out early March 2016

SPECIAL FEATURES: Harnessing Your Database The Bootstock Challenge Encouraging RVNs to Stay in the Profession Practice Life z November/December 2015 z www.practicelife.biz

INNOVATIVE PATENTED TECHNOLOGY THAT IS TRANSFORMING THE TREATMENT OF TICKS AND FLEAS – PROVIDING PROTECTION LIKE NEVER BEFORE Unique 12-week duration of efficacy against ticks* AND fleas makes compliance easy.

Chewable flavoured formulation puts the ‘treat’ back into treatment.

Available only on prescription, bringing business back to your practice.

BRAVECTO® contains fluralaner POM-V Use medicines responsibly. Further information is available from MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ. *12-week immediate and persistent tick-killing activity against Ixodes ricinus, Dermacentor reticulatus and D. variabilis and 8-week immediate and persistent killing activity against Rhipicephalus sanguineus.

Please refer to the BRAVECTO® Summary of Product Characteristics for further information.

National Veterinary Specialists

moore scarrott

Representing in excess of 550 practices all across the UK, our benchmarking and comparative data allows us to provide a unique service to our Veterinary clients.

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 • Taxation planning, advice and strategies • Full outsourcing service and payroll bureau • Computerisation and Sage® supply & support • Full Benchmarking service & KPI reporting • Forensic services including practice valuations and resolution of partnership issues or disputes Veterinary team partners:

Andy Moore andy.moore@moore-scarrott.co.uk Marcus Longbottom cmsl@moore-scarrott.co.uk

Steve Headon steve.headon@moore-scarrott.co.uk Nick Lawrence nick.lawrence@moore-scarrott.co.uk

www.moore-scarrott.co.uk Head Office: Calyx House, South Road, Taunton, Somerset, TA1 3DU Wolverhampton Office: 4 Compton Road, Wolverhampton, West Middlands, WV3 9PH

moore moore scarrott scarrott

Telephone: 01823 282100 Fax: 01823 254396 Regulated by the Institute of Chartered Accountants in England and Wales for a range of investment business activities.

Incorporating:

Bertram Kidson & Co

Accounts, Taxation & Business Development Specialists

Our Service is completely flexible which enables us to fit within the practice management team at any level in a cost effective way.