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June/July 2014 www.practicelife.biz

Maternity: A Smooth Return to Work Advice for employees and employers

Getting Back on Track What to do about those poor KPIs

Veterinary Retailing Getting the right mix

Good Mood Foods How diet can help you cope with stress

THE MAGAZINE OF SPVS AND VPMA

In the Spotlight: John Lewis Main Board & HR Director Tracey Killen NEW FEATURE:

The Hot Topic Safeguarding your IT & databases


EDITORS’ LETTERS

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Editors’ Letters

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t is hard to believe that this, the fourth edition of Practice Life, is the last one in the magazine’s first editorial year. It doesn’t seem very long ago that discussions about a joint SPVS and VPMA publication first started and the idea of Practice Life was born. The magazine has evolved with each edition and it’s good to see the regular contributions from organisations like the BVNA, RCVS, and VBF continuing to feature; I hope that you feel we’ve managed to get the balance of news, information and advertising about right. The Wellbeing section which has appeared popular amongst our readers from the first edition, has developed into a larger feature. As a result of this it was suggested that we should enter Practice Life Magazine for the Mind Media Awards which we will be doing; we’ll let you know the outcome!

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ello and welcome to blistering summer! At least there is some respite from the devastating storms and floods which were abound when our last edition was published. I must admit to being a bit blase living in the north of the country in the hills; that is until my car was written off by a slate roof tile crashing through the sunroof just as I was about to climb aboard. Fortunately, my insurance company lived up to the “swift” part of its title and settled in full within a matter of days, leaving me to search for a new vehicle. The thought of trawling around motor dealerships filled me with trepidation somewhat but again, as luck had it, I encountered a very helpful sales person who was not at all pushy and after the usual checks and balances, I returned to the showroom a couple of days later to take delivery. The last time that I went through the process was over a decade ago and I recalled that “delivery” amounted to “sign here, shake hands and take out the complimentary bottle of wine from the dashboard”.

Further to her lectures at SPVS & VPMA Congress in January this year, Tracey Killen from John Lewis kindly made time to give me an interview, albeit by e-mail; you’ll find her comments in our ‘In the Spotlight’ section. Also on the subject of staff management, leading on from the articles about Modern Maternity in the March/April edition, maternity leave and returning to work from the employee’s perspective is discussed and I must thank veterinary surgeon Susie Powell from my own practice for her contribution to this. As always, I hope that you enjoy reading your copy of Practice Life, be it in the confines of the office or staff room at work or perhaps accompanied by a long cool drink in the garden on a warm, sunny afternoon!

Stephanie Writer-Davies, SPVS editor

In 2014 it’s rather more involved and I spent almost an hour being faced with Statements of Demands and Needs, Pre-Contract Agreement, Duty of Care Document, Miscellaneous DMS input Form, Supplementary Order Form etc etc. Curiously, the actual finance paperwork took barely a minute! It did however make me think about our own practice transparency. We have to accept that there are some clients out there who will “try it on” when it comes to what was said, intimated or actually promised and for whatever reason was not delivered. Has the time come for our consent form processes to be tightened or indeed (as was the case with my car) to be coerced into reading three pages of small print before signing that I had and moving onto the next? After all, we are dealing with all things living and breathing (and that beggars the question what happens when they no longer do!) Not just a lump of metal. Enjoy the issue.

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 June/July 2014 z Practice Life


Contents Editors SPVS

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UPDATE: NEWS & VIEWS 5

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VPMA NEWS New member services group launched

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Ian Wolstenholme, Practice Manager ian@practicelife.biz

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SPVS NEWS Snowscene 2014 and Council update

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Publisher

NURSE TALK Findings of the VN Wellbeing survey

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Stephanie Writer-Davies BVSc MRCVS steph@practicelife.biz VPMA

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

© 2014 Practice Life All rights reserved. Practice Life is edited, designed, and published by Mojo Consultancy Ltd. No part of Practice Life Magazine may be reproduced, transmitted, stored electronically, distributed, or copied, in whole or part without the prior written consent of the publisher. A reprint service is available.

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IN THE SPOTLIGHT 18 John Lewis HR & Main Board Director Tracey Killen g

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COLLEGE CORNER The postnoms debate

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HOT TOPIC New feature: How secure is your practice technology...and your people?

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WELL-BEING Vetlife’s Guide to Good Mood Foods

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MANAGING PEOPLE: Maternity: A smooth return to work

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CLIENT CARE AND MARKETING Veterinary retailing: Getting the right mix

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BUSINESS HEALTH AND FINANCE Getting back on track: What to do about those poor KPIs

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PRACTICE DEVELOPMENT Planning for Profitability

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CPD SHARED An attendee shares her experience of the ‘Moving Up’ day

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CPD DIARY Regional CPD

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WHAT’S COMING UP Events listing and a peek at what’s in the next issue

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

Practice Life z June/July 2014 z www.practicelife.biz


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News & Views

VPMA/SPVS CONGRESS 2015 – DATE FOR YOUR DIARY! VPMA and SPVS will be returning to Celtic Manor Resort for the 2015 Congress which will be held on 23rd and 24th January. This follows the success of the 2014 event attended by over 400 vets and managers and 62 sponsors and exhibitors. This is now the largest veterinary management congress in the UK and the very positive feedback from all who attended this year make it likely to sell out early for 2015.

To be sure of your place and to be kept up to date as the programme develops, you can pre-register at www.spvs-vpma-events.co.uk. Join us on facebook and follow us on twitter @SPVSVPMA_Events

Places filling up fast for the Vet Charity Challenge 2014 Organisers of the 2014 Vet Charity Challenge are urging practices to sign up soon for the 2014 event, to take place on Saturday 27th September at St Francis School, Pewsey, in Wiltshire. Over half of the available team places have been snapped up already with over 3 months to go. Last year the event raised over £50,000 for animal charities, with this year’s target being set even higher. Caitrina Harrison from sponsor Vetoquinol is delighted to have 4 teams training hard for this year’s challenge, “We felt so inspired by the camaraderie and competitive spirit shown by participants last year that we decided to up our game even more! We’ve found the training great for team bonding and we are all excited about this year’s event. The VCC is a great fun activity that really helps to pull everyone together.” The event consists of teams of four doing a one-day walking/running, cycling and kayaking challenge in the glorious Wiltshire countryside, together with some problemThe team from Oakfield Veterinary Group solving mental puzzles. The challenge is planned to attract teams of all levels, from get into the spirit those who want to have some fun through to those determined to take the top prize. Competitors decide their own agenda from a flexible format and can make it as hard or as easy as they wish. The charities being supported in 2014 are Hearing Dogs for Deaf People, SPANA and Cats Protection. The Challenge is sponsored by BCF Technology, Kruuse and Vetoquinol and supported by the VMPA, Mojo Consultancy and Veterinary Practice magazine. For more information visit www.vetcharitychallenge.co.uk or Facebook/VetCharityChallenge.

Look out for our new occasional feature ‘The Hot Topic’ on page 22. If there’s an issue you’d like us to look at, let us know! – Ed. www.practicelife.biz z June/July 2014 z Practice Life


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NEWS IN BRIEF

DEBT RECOVERY PARTNERSHIP FOR BVA MEMBERS The British Veterinary Association (BVA) has partnered with Quest Debt Recovery Ltd to help practices deal with bad debts by offering significantly reduced rates for BVA members with over 50% savings on commission.

BVA members receive Quest debt recovery services at a substantial discount:

Quest specialises in the recovery of bad debts, slow paying customers and disputed accounts in the veterinary sector which means it has a good understanding of the relationship between practice and animal owners. It can recover small or large amounts of debt for practices.

• ‘No Trace, No Fee’ tracing service at a fixed fee of £25.00 plus VAT when a debtor is successfully traced – instead of £30-40

• No Collection, No Fee’ debt recovery with a low commission rate fixed at 10% on recovered debt – instead of the standard 25%

• County Court Administration provided for £50 plus VAT where the debt value is less than £600 – instead of the standard £100

To get access to these exclusive rates BVA members should visit www.questdebtrecovery.co.uk or call 01789 207 410 and have their membership number to hand.

Onswitch launches ‘Footsteps’, a new customer experience board game With a refreshing reputation for doing things a little bit differently, it’s not surprising that Onswitch have turned the world of veterinary CPD upside down with the launch of Footsteps – a new board game designed to help practices place the customer experience firmly at the heart of their business. The concept of Footsteps is simple - moving around the board on your ‘customer journey’, you collect clients (or lose them) depending on the kind of customer experience you provide – just like in real life. The number of clients collected determines the funds available for a second ‘revenue journey’ – this time players spend money at every throw of the dice, paying salaries, tax bills, mending equipment and funding bad debts. Playing Footsteps unlocks insight into key concepts such as Key Opinion Leaders, Net Promoter Scores, social media and the 5 steps of great telephone customer care. Which means that a two-hour game delivers great value for money CPD for the whole team. Players have access to an online instructional video and the game can be played as many times as required – ideal for new starters or simply for refreshing the team’s knowledge and motivation. Find out more at www.onswitch.co.uk or call 01476 565343.

EMS CONFIRMED AS ESSENTIAL BUT WITH SOME CONCERNS OVER FINDING SUITABLE PLACEMENTS The RCVS has published the findings of its EMS survey with recent UK graduates. The survey was launched earlier this year to help build up a picture of how placements are currently working and whether graduates felt that they had gained knowledge and experience that they could not have learnt from their core studies. The survey showed that the current system is working well and that there was no need for an immediate review or urgent action. The overwhelming majority of respondents (95.6%) agreed that EMS was essential. However some raised concern on the variable quality of placements with significant numbers of respondents

feeling they were not able to gain as much ‘hands-on’ experience from placements as they would like. Costs of accommodation and travel and a lack of true farm/mixed animal practices also hindered some students from finding the placements they wanted. Other key findings included the fact that the vast majority of students identified and booked their own placements using online searches, recommendations from colleagues and even the Yellow Pages. Some thought that standardisation across practices and a central database of businesses willing to accept students for EMS placements would be of benefit.

Read the full report at www.rcvs.org.uk/news-and-events/news/ems-placements-are-essential-component-of-veterinary-degree/

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 editorial@practicelife.biz

Practice Life z June/July 2014 z www.practicelife.biz


VPMA News VPMA President,

Helen Sanderson

I can’t believe that I am nearly halfway through my second presidential year already. The Council has been busy with regional meetings and attending industry events and our joint CPD is proving very popular. I myself attended BSAVA and Pauline Graham, our Senior Vice President had the honour of presenting the prestigious Petplan Practice Manager of The Year award to Sharon LaneKieltyka from the Shepton Veterinary Group. Sharon was a well-deserved winner, and I would like to congratulate her, the runners up and everyone who received a nomination. To be recognised in this way by the teams they work with day-in, day-out, is a true sign of the value and the esteem they are held in. Judging was not easy… this year we had over 200 nominees, an increase of 40% on the previous year. This is fantastic news and I feel reflects not only the growing numbers of managers in veterinary practice, but welldeserved recognition for their important role. Our focus over the coming months is to review and further improve your member benefits. We aim to make these beneficial not just for the practice, but for members themselves. We have put together a Member Services Group, consisting of practice managers and council representatives Julie Beacham, Angela Andrews and Steve Broomfield. Together, they are reviewing the current member benefits package and negotiating with suppliers to expand the range of support on offer. The planning for our joint VPMA & SPVS Congress is progressing well with a new and exciting line up of speakers which we will announce over the next few months. So save the date in your diary – I can promise you it’s one not to be missed. And finally it was also with great sadness that we learnt of the tragic loss of Lord Ballyedmond OBE founder of Norbrook Pharmaceuticals. Norbrook has always been a fantastic supporter of the VPMA and our condolences go to Edward and the family. Thank you all for your continued support and I wish you all a long, hot and sunny summer. Best wishes,

Helen Sanderson

www.practicelife.biz z June/July 2014 z Practice Life

VPMA NEWS

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Interested in sitting the CVPM Exam?

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he Certificate in Veterinary Practice Management (CVPM) is awarded by the VPMA to individuals who have demonstrated their ability to effectively manage a veterinary practice, hospital or unit. The individual must demonstrate this ability by providing evidence of their managerial skills over six core areas: • General Management • Personnel • Communication ��� Financial Management • Marketing • Strategic Management A detailed CVPM Syllabus is available in printable format on www.vpma.co.uk to enable candidates to ensure they possess knowledge of all areas of veterinary practice management prior to sitting the exam. Candidates are advised to read widely in order to ensure an awareness of any areas not commonly encountered in their own practice, and a suggested reading list is also available. The 2014 exam takes place on the 28th November this year, with an application deadline of 1st August. Applications must be accompanied by a 3,000 word report with the title “How I have used my knowledge to benefit the veterinary environment in which I work”, within which candidates should provide evidence of the practical application of this knowledge in the areas mentioned above. Candidates are also required to give a PowerPoint presentation, based on their report at the examination, and this will be followed by a professional discussion of the report and presentation with the examiners. The exam also includes a written component regarding a fictitious practice, and an oral component involving a series of scenarios reflecting subjects and situations that can occur every day in veterinary management.

The CVPM registration and examination fee for all candidates is £360.00 incl. VAT. A form is available online at www.vpma.co.uk/education/cvpm.html


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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.

The regions again have been busy over the past couple of months. Our new London regional organiser Mark Harwood held his first meeting in April, with plans already in place for his next one in July, so watch out for details coming through. Meetings at regional level have been requested by our London members for some time, so please go along for some relevant CPD and a chance to network with other practice managers. Other meetings that took place were: • Rita Dingwall held the Southern Counties Regional Meeting on the 26th February in Tenterden. • Melvyn Wilkins held the Wales, Shropshire and West Midlands Regional Meeting on the 10th April in Bromsgrove. • Suzanne Headington and I held our joint Avon, Somerset, Devon & Cornwall Regional Meeting on the 11th March in Kilmington. We get some fabulous feedback from our meetings and suggestions for future topics prove very useful to the regional organisers when planning future events. These meetings are arranged solely to meet the needs of our membership so keep that feedback coming. If you have any other suggestions with regards to VPMA membership or member benefits, then let your organisers know to pass it on to me so I can discuss it with your council. You can contact me on ro21@vpma.co.uk Enjoy your summer and I hope that you all get some well-earned time off!

Renay

GILLIAN KIDD Scotland Tel: 01408 622217 ro2@vpma.co.uk

HELEN SANDERSON Oxfordshire/Wiltshire/Berkshire Tel: 07765 338607 ro13@vpma.co.uk

PAULINE GRAHAM Cumbria Tel: 07803 228720 ro3@vpma.co.uk

CLAIRE BAKE Co. Durham Tel: 01388 602707 ro16@vpma.co.uk

DENISE WHITHAM Herts/Beds/Northants Tel: 07837 058155 ro4@vpma.co.uk

SUSAN LUNN Stoke on Trent/South Staffordshire Tel: 01543 424100 ro17@vpma.co.uk

MELVYN WILKINS Gloucestershire/South Wales Tel: 07887 895274 ro5@vpma.co.uk

JULIE BEACHAM Buckinghamshire Tel: 07710 317310 ro18@vpma.co.uk

CATH GRIMSEY & HELEN MANNING East Anglia ro6@vpma.co.uk

SUZANNE HEADINGTON South West Tel: 01242 680000 ro20@vpma.co.uk

MARK HARWOOD London Tel: 01242 680000 ro7@vpma.co.uk

RENAY RICKARD Cornwall/Devon Tel: 01208 872254 ro21@vpma.co.uk

RITA DINGWALL East Sussex Tel: 01435 866058 ro9@vpma.co.uk

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Practice Life z June/July 2014 z www.practicelife.biz


VPMA NEWS

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Congratulations to the Petplan Practice Manager of the Year finalists – all VPMA members!

Runners up Niki Burton and Chris Gudge

Winner of Practice Manager of the Year Sharon Lane-Tieltyka

We’d like to say a huge well-done to the finalists of the Practice Manager of the Year category in the recent Petplan Veterinary Awards. Sharon Lane-Kieltyka from the Shepton Veterinary Group scooped the top prize, while Chris Gudge from Highcroft Vet Group in Bristol and Niki Burton from Eastcott Vet Group in Wiltshire were runners-up. Look out for an interview with the winner Sharon coming up and a chat with Chris and Niki later in the year.

managers and nurses there are working in the profession, I think we can do even better, and I’d like to see nominations next year for both categories being closer to the numbers seen for the Vet of the Year category.” BVNA President Kirstie Shield echoed this, “The public doesn’t see the tremendous amount of work that goes on back-of-house to produce a successful practice and the vet is usually at the forefront of their minds. But the professionalism and expertise of nurses and managers help drive a high standard of service and animal welfare – we’d encourage both of these groups to come forward and nominate their colleagues, and for reception staff to introduce the idea to clients. ”

Surge in practice manager and vet nurse nominations but work still to do Nominations for practice managers and nurses in the Petplan Veterinary Awards were boosted this year by a joint initiative between the Veterinary Practice Management Associations and the British Veterinary Nursing Association. The two presidents, Helen Sanderson and Kirstie Shield, asked association members to nominate practice staff for the other’s award category. Practice manager nominations rose by nearly 40% and nurse nominations by just under 25%. Helen was delighted at the uplift and wanted to encourage even more members to take part next year, “Practice managers and nurses deserve this recognition, as both work very hard to support practice but don’t always get the acknowledgement for it. However, given how many www.practicelife.biz z June/July 2014 z Practice Life

Helen with winner Sharon

BVNA President Kirstie Shield


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VPMA NEWS

VPMA forms Member Services Group Julie Beacham

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e want to hear from you! VPMA council has formed a Member Services Group specifically tasked with optimising member benefits. The group, consisting of council representatives Julie Beacham, Angela Andrews and Steve Broomfield – all managers in private practice – is reviewing the current member benefits package and negotiating with suppliers to expand the range of support on offer. We need you to tell us what things in the current package you value and use, and what you’d like to see added. Under consideration is a legal helpline to help with employment disputes, coaching and personal development support and discounts and assistance from suppliers in management-related services and products. If there’s a company that you’ve received a great service from and you’d like to spread the word to other managers, let us know. If you know a business who’d be willing to offer our members special rates or support, please put them in touch with us. We’ve most recently added utilities broker Full Power Utilities to our affiliated services list. Full Power will assess your current gas and electric utility contracts to check that you’re getting a good rate. Where they can spot potential savings, they will do the hard work of negotiating you a new deal. VPMA will receive a percentage of any new contract commissions that they receive, which are ploughed back into your membership benefits. We’re also looking at other benefits, including CPD and training support. Please feed in your topics that you’d like us to focus on – we will look to include them in our CPD meetings and in Practice Life. So get in touch via the secretariat – give us your views and your ideas, and help us to give you what you need: secretariat@vpma.co.uk

Hazlewoods Accountants have produced a useful guide for us on how long various records should be kept for to meet HMRC and other regulations. Contact the secretariat to be emailed a copy.

feedback Practice Life z June/July 2014 z www.practicelife.biz


SPVS News A few words from SPVS president,

Colin Thomson

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was warned by many that the level of activity would jump considerably in the SPVS President’s role. They were right, and I’ve only just got used to it. There have been many invitations, meetings, requests for comment and information from outside organisations, as well as heading up SPVS’ normal operations – where every decision involves a request for Presidential input, it seems. But it hasn’t been all work and no play. Some invitations come and sound as if they are work, but are really just pleasure. I was invited to be part of the judging team for the Petplan Awards. Another day in London, so a pre- 6.00am start from Yorkshire. Of course we had to choose the winners, but this was bracketed by breakfast and lunch, and the company, atmosphere and food was excellent throughout. Many thanks to Jenny and Howard from Petplan for organising it and inviting me. Some invitations have sounded like pleasure from the start and have been just that to the end. The subsequent invite to the Petplan Awards themselves at BSAVA Congress in Birmingham was such event. Gyles Brandreth compered masterfully. There was real excitement when the prize winners were announced, compounded by the sheer disbelief of the recipient of the final award – Vet of the Year. The winner, Hector Low, hails from the Isle of Lewis, and was only just prised away from his practice (and the lambing) less than 24 hours previously to come to the event. He was due to fly back at 7.00am the following morning. I hope he caught his flight – he was still expressing disbelief at his success in the bar well into the wee small hours. And finally, some invitations have sounded like pleasure, but have involved a lot of work. Snowscene, our annual CPD and skiing event, was in Lech in Austria this year. Although most of the organisation is done by our staff in the office, it’s part of the President’s role to act as trip leader. That involved a remarkable degree of coordinating activity I hadn’t fully appreciated, from handing over tickets to people at the airport, corralling individuals to lectures and meals, to making sure everyone was on the bus home! There were nearly 50 of us. Overall the event went very well, with sunny weather in a beautiful location, excellent CPD and good food in a plush hotel. It was a meeting of both diverse and like-minded vets, where the conversation continued over several days, from the chairlift to the lunchtime restaurant and on into the bar after dinner. This was my first Snowscene, along with 6 or 7 other vets who were also first timers. We all expressed how difficult it was to appreciate the benefits of the extended networking this sort of event provides, until you’ve encountered it first-hand. Although there was some effort on my part, the reward was well worth it, and I’ll be back when it’s someone else’s turn to herd the cats!

www.practicelife.biz z June/July 2014 z Practice Life

SPVS NEWS

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SPVS Dates For Your Diary 2014 June 11th – CPD course ‘Making the Most of Your Nurses’ – Birmingham June 19th – Focus on Digital Technology Day – The Midlands June 24th – SPVS Golf Day at The Oxfordshire – sponsored by Dickinson’s Financial Management Ltd and Hazlewoods Accountants. For details and to secure your place contact Keith Dickinson on Keith.Dickinson@shireinsurance.co.uk or the SPVS Office June 25th – CPD course ‘The Colourful Consultation’ – Surrey July 9th – CPD course ‘Conflict Management’ – Birmingham July 21st and 22nd – SPVS Officers and Council Meetings. If there are any items you’d like discussed or points you’d like to see raised please contact the Hon Sec, Tom Flynn, via the SPVS Office September 24th – CPD course ‘Top 10 Essentials to keep you Legal & Compliant’ – Surrey

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SPVS NEWS

SNOWSCENE 2014 SPVS Hon Editor, Stephanie Writer-Davies reports on a good week of spring skiing and excellent CPD at the Hotel Kristberg, Lech, Austria.

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Charlie Winslade celebrates his success on the slopes

Simon Cartwright, Steve Grove and Tom Flynn

nce again the flights for the Snowscene delegates were unpleasantly early and there were many bleary eyed travellers milling around the departure lounge at Gatwick waiting to board the plane to Innsbruck. However, as last year, the advantage of the early flight became clear when we got to Lech; arriving at lunchtime allowed the keen skiers to have an afternoon on the slopes whilst those of us feeling in need of a more relaxed afternoon had plenty of time both to organise equipment rental and to settle into the hotel, including familiarising ourselves with the lovely Wellness area where there was an array of different saunas and steam rooms as well as a very nice Jacuzzi pool. There were a few newcomers to Snowscene this year, but one of the nicest things about the trip is the friendly atmosphere and at the pre-dinner drinks reception the seasoned delegates did their best to make the first-timers feel welcome. Our first evening meal gave us a taste of things to come with a delicious five course dinner accompanied by a choice of red or white wine and where conversation often centred on what the skiing might be like the following day and for the rest of the week – with the usual differing opinions and weather and snow reports! As it turned out, the first day on the slopes was one of poor visibility and light snow flurries, but for the rest of the week we were treated to clear skies. Lech is part of a large ski area that includes places such as Zurs and St Anton which are linked by a ski-bus; the group I skied with made the most of the different areas, covering the majority of the terrain over the course of the week. The weather was very mild and relatively warm which resulted in those typical spring skiing conditions of hard-packed, somewhat icy, runs early in the morning, then, as the snow softened, perfect skiing for a few hours in the middle of the day and finally a bit of a battle with heavy slush by mid-afternoon. As a result of this, quite a number of the ski groups elected to have rather late, leisurely and frequently indulgent lunches which blended easily into après ski drinks in the sun on the hotel’s terrace from mid-afternoon! There were 15 hours of CPD which started on Sunday evening and followed the traditional pattern of 2 hours in the evenings and 1 hour in the mornings. The clinical CPD lectures on the subject of Veterinary Dentistry were given by Norman Johnston BVM&S, FAVD, Dipl.AVDC, Dipl.EVDC, MRCVS, an RCVS, American & European Specialist in Veterinary Dentistry. I have to confess to being less than keen on dentistry during my time in practice thus far, and that the staff at my surgery laughed when I told them the clinical subject matter for this year’s Snowscene. I had implied that I was only going to take advantage of Practice Life z June/July 2014 z www.practicelife.biz


SPVS NEWS

Cat Arthurs, Rob White-Adams and Kirsty Gwynne

a tax-deductible ski holiday and wouldn’t be attending the lectures! However, although the opportunity to ski with friends had certainly been a big factor in my decision to ‘sign up’ and I was fully expecting to listen to lectures on gum disease and tooth extractions with little, if any, enthusiasm, I couldn’t have been more wrong – I rapidly realised that the teaching of dentistry I had received at college was sadly lacking and our attitudes to and facilities for this important aspect of our patient care at my practice were in need of a complete overhaul. I was absolutely enthralled; Norman’s clear presentations, full

“There were a few newcomers to Snowscene this year, but one of the nicest things about the trip is the friendly atmosphere and atthe pre-dinner drinks reception the seasoned delegates did their best to make the first-timers feel welcome” of helpful advice and guidance inspired me and I know that I wasn’t the only one (in fact, so many of us decided, as a result of what we heard, that a dental x-ray machine was a ‘must have’ for our practices, discussions are ongoing with some suppliers to negotiate a discount for SPVS members – look out for details on the Member Benefits section of the website!). The non-clinical lectures were entitled ‘How to manage yourself and others’ and given by Ben Hardy BVM&S MBA MPhil PhD MRCVS. Having originally qualified as a vet, Ben now lectures in Management at the Open University. His presentations were equally as good as Norman’s and I found them fascinating. They focused on personality and interaction and how these attributes impact on management. We had the www.practicelife.biz z June/July 2014 z Practice Life

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odd bit of ‘homework’ to do in the form of assessing our own behaviour and responses to situations. Some of the sessions were interactive; one involved groups of 6 people having to build a tower from Lego bricks, while complying with requirements that we were each given individually – but we weren’t allowed to speak to each other! I think Ben was less than impressed by our efforts (he told us we were just about the worst group he’d ever seen...) We had one casualty in the group during the week; unfortunately Tammy Gillian who, with her husband, Steve, was one of the newcomers to Snowscene, broke her arm. She had to be taken by helicopter to hospital and have her humerus pinned. Thankfully she didn’t have to remain an in-patient for long and was able to re-join us for the lectures and meals, if not for the snow sports, for the second half of the week. The trip ended with a farewell get-together in the hotel bar on Friday evening where SPVS President Colin Thomson thanked everyone – the speakers for doing a great job, the hotel staff for looking after us so well and the delegates for making the trip a success – and then, since there was a piano available, Kate Kerry provided the accompaniment for a ‘sing song’ which was great fun but failed to discover any potential X-factor contestants... I can’t imagine what the other hotel guests, sitting in the bar, enjoying a quiet drink must have thought! The CPD details for Snowscene 2015 are yet to be finalised but I expect that I’ll be going again – even it doesn’t sound like my usual cup of tea!

STOP PRESS… Snowscene 2015: 8th – 15th March, Corvara, Italy Next year’s Snowscene will be in the beautiful Dolomite Mountains in Northern Italy for the very first time. 1,200km of beautifully maintained runs are linked by 450 lifts on a single ski pass, circling the spectacular Sella Ronda within this World Heritage Site national park. The impressive and rugged mountains are like nowhere you will have skied before and the food in the mountain restaurants is both delicious and, by European ski resort standards, extremely good value. Après-ski is influenced by Austria, just a hop over the border. What’s not to like?! What’s more, our deal with one of the best hotels in Corvara has NO single supplement! CPD to be announced soon, so keep an eye out for details. For more information, or to book your place, visit www.spvs.org.uk


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SPVS NEWS

15

SPVS OFFICERS AND COUNCILLORS CONTINUE TO WORK HARD ON BEHALF OF THE MEMBERSHIP The society is fortunate to have an enthusiastic council and officer team who recognise how important it is that SPVS is represented at all levels within the profession and that the views of the members are heard. To that end, since the beginning of the year, Joint Officer meetings have been held with the RCVS, VPMA and BVA aimed at maintaining the good relationships that SPVS enjoys with these organisations. Additionally several of the SPVS Officers met with the VDS where ongoing support of their Communication Training days and Recent Graduate Reunions was agreed as well as VDS’ involvement in the Lancaster Final Year Seminar; SPVS Council representatives continue to attend the training and reunion events which help to promote the society. As most of SPVS members will be aware, the subject of Out of Hours care continues to cause concerns for veterinary surgeons in practice, both for those offering an ‘in house’ out of hours service as well as for dedicated out of hours service providers, with the issue of house visits being a particular area where clarification of responsibilities and requirements is considered necessary. The RCVS has recently conducted a consultation on the subject and a written response, collated from members’ comments and council opinion was submitted by SPVS President, Colin Thomson, who, along with the Senior Vice President, Adi Nell, took advantage of the opportunity given by the College to attend a meeting regarding the 24-7 consultation in order that SPVS members’ views be made clear. The review of the RCVS Practice Standards Scheme is ongoing, with a decision about how the proposed scheme will look going forward unfortunately having been delayed due to staff changes at

the RCVS. However, SPVS council involvement remains active and feedback continues to be provided to try to ensure that the new scheme is something that will be acceptable to practising veterinary surgeons. The final decision about the scheme will be made at the next Practice Standards Group meeting and the current chair, Jacqui Molyneux, has agreed to provide an article detailing these for the next edition of Practice Life Magazine. The RCVS has also sought the profession’s opinion on the proposal for a new Royal Charter and again SPVS Council responded to this consultation, both directly and by providing comments to BVA for inclusion in its response. Another important area of activity is liaison with the VetXML Consortium which aims to improve compatibility of and links between the different computer programmes that veterinary surgeons rely on for running their Practice Management systems. Regular discussions occur between interested parties, such as PMS providers, drug wholesalers, pet microchip manufacturers, veterinary laboratories and insurance companies; information about different levels of involvement and compatibility of many of the systems is available on the VetXML website. And finally, SPVS Office and Council have continued to support the society’s members by responding to queries and for new and recent graduates, assisting with CV preparation. Thanks must go to all SPVS Council members who give up their time to work on behalf of the membership as well as to the Office staff who not only provide invaluable support for SPVS councillors, but are often the first point of contact for those communicating with the society.

Veterinary Prescriber Andrea Tarr from independent veterinary treatment information service Veterinary Prescriber highlights a source of help for choosing ectoparasiticide products for cats and dogs Veterinary Prescriber has produced unique product guides to help you to make the most appropriate choice from the dozens of products that are on the market. There is one each for cats and dogs. Products are listed by active ingredient according to parasite coverage and how they can be supplied (POM-V, AVM-GSL, NFAVPS). So, for example, you can easily see which products (active ingredients and available brands) are for the treatment of flea, tick and biting lice infestations and available only on prescription. If a cat or dog has been treated with one product that has proved unsuitable for some reason, you can use these guides to be sure of choosing a product with different active ingredients. The guides are available as laminated posters (A4 size for cat products; A3 for dog products). They have been produced completely independently by Veterinary Prescriber and do not promote any particular product. Visit the Veterinary Prescriber website www.veterinaryprescriber.org to order your set of posters (a charge applies).

Want to know more about stem cell therapy for cats and dogs? Stem cell therapy is now available commercially for use in first-opinion veterinary practice. Veterinary Prescriber has produced an overview of stem cell therapy for the non-specialist vet. As well as summarising evidence on the efficacy and safety of the therapy in cats and dogs, the article includes practical information on the availability, regulatory status and cost of stem cell therapy in the UK. It is an essential read for any veterinary professional wanting a succinct and practical overview of stem cell therapy. The article aims to help vets in first opinion practice keep abreast of this new development, which is now being promoted for the treatment of musculoskeletal problems in cats and dogs. The article can be downloaded from the Veterinary Prescriber website for the introductory price of £10 (usual cost £20).

Visit the website www.veterinaryprescriber.org if you would like to subscribe and receive independent information from Veterinary Prescriber.

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Nurse Talk 16

NURSE TALK

In association with

VN of the Year at Petplan Awards Thank you! A big thank you to everyone who took part in the VN Awareness Month in May! We hope you have all entered the BVNA competition as we love to see what you have been doing to promote the work of the Veterinary Nurse to the public. Meanwhile back at base, a ‘you and your pet selfie’ campaign was started… thanks for sharing your wonderful pics

The BVNA president, Kirstie Shield was honoured to present this award to Tina Wright from Warbreck Veterinary Centre in Liverpool. Tina’s attitude to client communication deserves to be commended; she is always available to answer any queries and remains approachable and friendly at all times. Tina has also set up an ear care clinic in her practice after recognising the need for a support role for clients who have been prescribed ear cleaner or medication for their pets. The BVNA also wanted to congratulate Tina, so we were pleased to present her with a year’s membership and invite her to our Congress in October.

Boost your hours at the BVNA CPD Roadshow! “The entire day was fantastic and passed by far too quickly. The speakers were excellent, all of the talks were fascinating. I learnt loads.” There’s still time to catch some of the BVNA CPD roadshows coming to a town near you! • Saturday 14 June | Harrogate • Saturday 21 June | Telford • Saturday 12 July | Cambridge • Saturday 15 November | Belfast Subjects will cover nursing clinics, clinical governance, emergency & critical care, laboratory skills, behaviour and nutrition. Speakers include Libby Sheridan, Dr Claire Corridan, Pam Mosedale, Nicola Ackerman, Kathleen Tennant, Dr Rachel Casey, Caroline Warnes, Belinda Andrews-Jones and many more. BVNA CPD Days are full day events running from 9.30am to 5.30pm giving you 6 hours worth of quality CPD. The cost is just £110 for members, including refreshments, lunch, course notes and CPD Certificate. Non-members are also welcome, cost £150. Practice Life z June/July 2014 z www.practicelife.biz


NURSE TALK

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VN wellbeing survey The BVNA survey held last year received some thought provoking responses, urging us as the representative body to take a lead on VN mental health. The survey was completed by more than 1,200 nurses. It indicated – unsurprisingly given their high levels of responsibility in practice – that nurses experience stress in many areas, but levels of ‘extreme stress’ appeared relatively low. Low income and the hours worked were noted as causing most stress, along with a fear of making mistakes and being able to manage time effectively. Relatively low income and long hours worked have always been a stress factor in the veterinary nursing profession. A lack of ability to manage finances will of course exacerbate this. Fear of making mistakes is a natural concern for anyone in a profession, and especially one where patients’ lives and well-being are at stake. Client demands and expectations are also high. Registered

veterinary nurses are also now regulated by the RCVS and are culpable for their own actions, which undoubtedly leads to a higher level of concern about making professional errors. Time management and having enough time to nurse cases is difficult in most practices. The time constraints applied to nurse consultations, and the workload within the hospital in terms of inpatients can be difficult to manage successfully, and nurses often do not have the training or possess the skills to put this right. BVNA’s next steps include publication of a series of articles addressing the top five stressors, which will be published in our journal, the VNJ. The support page on the BVNA website will also be updated and a dedicated nurses’ page created on the Vetlife website. BVNA also provide the BVNA Members’ Advisory Service as part of the membership benefit package, which offers confidential telephone advice and support on legal, employment, housing, financial and other issues.

Registration open for BVNA congress 10th-12th October 2014 at Telford International Centre, Shropshire The UK’s best known sole veterinary nursing congress offers delegates unlimited high quality CPD and provides great value for money. The BVNA Congress offers dedicated lectures for practice staff and veterinary nurses of all levels with a tiered lecture stream each day, interactive workshops and an excellent social programme. Delegates can also enjoy a large exhibition open throughout the

event with a vast range of companies offering information and advice on their products and services. There are new product launches, competitions and great networking opportunities. The congress is open to everyone, including non-members. See the BVNA website www.bvna.org.uk for more details and to book!

Here’s a taster of what’s in store:

FRIDAY

SATURDAY

SUNDAY

Lecture streams

• Behaviour

• Advanced surgery

• Diagnostics

• Feline

• Exotics, zoo & wildlife

• Emergency & critical care

• Student

• Anaesthesia and

• Charity/ethics & welfare

• Management advanced anaesthesia

• Equine

• Research

• Current issues

• Laboratory

• Oncology

• A day in the life of...

• Dentistry

• Endocrinology

Workshops

• Practical nutrition

• Ultrasound

• Clicker training

• Working with deaf dogs

• Dental radiography

• A practical approach to

in practice

• Smalls animals with health and substance

• Small animals with Burgess Petcare misuse

Burgess Petcare

• Local anaesthetic

• Physiotherapy techniques

• Dental radiography

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• Skin suturing

• Reiki • Practical nutrition


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IN THE SPOTLIGHT

in the John Lewis Main Board Director and Head of HR Tracey Killen wowed audiences at the recent SPVS-VPMA Congress with her take on what vet practices could learn from the retail giant. SPVS Editor Steph Writer-Davies caught up with her there… Tracey, tell us a little about your role at John Lewis and how you got there? I joined John Lewis in 1982 as an A Level Trainee and worked on the shop floor in a number of selling departments before becoming Staff Manager in 1992. There followed a series of branch management roles and in 1998 the Bristol city centre branch of John Lewis closed and relocated to Cribbs Causeway. Following the move I was promoted to Managing Director. In 2002 I moved to our Head Office in Victoria, Central London to become Personnel Director for the John Lewis department store division and joined the John Lewis Management Board. In my current position, I sit on the Partnership Board where I am responsible for the Partner experience of work across the whole of the

Partnership including its two retailing divisions – John Lewis and Waitrose. My directorate is responsible for defining and shaping a distinctive and competitive employment proposition and setting a policy framework that meets the changing needs of the business in the areas of employment, reward, talent, organisational development and Corporate Social Responsibility. Is there a typical day for you? Can you describe it for us? My days are busy – they start early and finish late! No two days are the same, but there are routine Board and strategy meetings, and steering groups which take up a large chunk of my time. When most people think about personnel they think about people, but I’m not often

dealing with an individual’s issues on a day-to-day basis – my role is about setting a direction for Partners (our employees) and how we as a business can get the best out of them. A lot of time is spent discussing the future and ensuring the approach we have in place keeps us at the forefront of change. What is the best part of your job? And the hardest? Absolutely my favourite part of my job is meetings Partners. They are always inspiring, energetic and they never disappoint. They can be very challenging but they always make me think! A day in any Partnership branch, Waitrose or John Lewis, or meeting any group of Partners at their conferences, meetings, etc is always uplifting and reaffirming. The hardest part of the

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IN THE SPOTLIGHT

“No business has a right to exist, or the people in it the right to do the same job for ever. You need to constantly challenge the way you do business and look for a better way at all times – and listen to your employees, customers and suppliers.”

job is the tough decisions; the choices you make to sustain the business in the future, but which impact individuals. It never gets easier, and nor should it. The Partnership has performed buoyantly in a difficult economic climate. In your opinion what things have contributed to this? The business has been bold. It recognised the level of change in the external environment and instead of denying those changes, it worked out what it meant for the business, made conscious choices and has been courageous in seeing those choices through. In areas like multi-channel shopping, this has given us a market leading position. It helps hugely that the business is not at the mercy of shareholders or the market, and can invest for the long term because it’s not publicly quoted. Was there a strategic shift in direction or mission as a result of the economic downturn or has John Lewis adapted progressively and responsively? A lot of the long term strategic choices the business made did not change as a result of the economic downturn, but no business has a right to exist, or the people in it the right to do the same job for ever. You need to constantly challenge the way you do business and look for a better way at all times – and listen to your employees, customers and suppliers. Being agile and adaptable is increasingly important. John Lewis’ model of employment is a bit different from that of the normal high street. Tell us a little about it. What are its advantages? Any disadvantages?

The John Lewis Partnership comprises two of the most trusted and successful brands in the UK – John Lewis and Waitrose. The business has annual gross sales of over £10bn and is the UK’s largest example of worker co-ownership. We now have 92,000 employees (Partners) and the Partnership is held in trust for the benefit of the people who work there. The Partnership is a democracy and Partners can influence and challenge management through elected representatives on forums and each shop has a forum to hold management to account. The Partnership as a whole has a Council of 80 that holds the Chairman and the Executive to account. It keeps you on your toes! With some large companies or organisations the ‘mission’ can get a bit lost in translation/being disseminated. How does John Lewis avoid this? We have a written Constitution that contains principles – effectively guidelines for how we operate the business. It sets out the purpose of the Partnership. This is central to every aspect of our business and literally not a day goes by without this purpose being touched on somewhere in the business. What are your tips for maintaining a positive culture in a company? Set out a clear purpose for your business and engage your employees with it so that they feel proud of what you are trying to achieve and clear about what they can contribute. The thing I get asked about the most is why the Partnership has such a strong service-

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led culture. It’s because we bring the elements of our purpose to life by ensuring Partners are as well informed as they can be so they know how they link into the business and therefore understand how they are contributing to the success of the business. We put a lot of energy into this. Tell us a little about internal communication at John Lewis; is there a protocol for disseminating new information? How do you manage change? Our Partners want to understand the performance of the business so that they understand how they can improve and influence it. As an employer, the Partnership wants to encourage Partners to do the right things. When you know why and what you’re being asked to do, you will perform better. Every leader in the Partnership has as one of their key responsibilities to share knowledge. No other organisation does this in the same way as the Partnership. We give away sensitive, commercial information to our Partners every week (detailed sales figures – not just headline results or targets) through in-house magazines and time is set aside by managers to communicate directly with their teams as well as through our democracy. Partners are better informed – they know why and when we have to make difficult choices and they are more likely to help us land them really well. It creates a culture of improvement and internal competition – always looking to beat yesterday’s sales, your nearest shop’s sales and to make sure your area of the business is performing the best. What key things do you think veterinary practices can learn from John Lewis? Being distinctive is key to success. Start with your purpose as it is central to every aspect of how you operate and compete. It informs your approach to your people, your customers, your suppliers and how you run your business. Properly developed, it will become the glue that binds your business together. In the veterinary industry, you start with a strong sense of purpose, but make sure you articulate it – don’t assume your staff know. Invest in your people – your investment in


20

IN THE SPOTLIGHT

them will ensure they invest in your customers and their experience, and in turn you will build loyalty and trust and your customers will come back and spend more with you! You’ve been married to Richard, a veterinary surgeon, for 25 years. Have you taken anything gained through Richard’s experiences of running a busy practice back to John Lewis? Richard really grounds me! Whenever I’m getting a bit exercised and I’ve got really locked into an issue at work, Richard does a great job of helping me keep my perspective by reminding me he is facing the same challenges, it’s simply the scale of the business that is different. It always brings me back down to earth. What are your views on bonuses and financial reward for staff? Well, I work in a co-owned business so I believe passionately in sharing knowledge and returning value to those who helped create it in the fairest possible way. In the Partnership we have a market and performance related pay policy to really encourage our Partners to feel motivated about growing their contribution and learning new skills so they can continue to increase their pay. Once a year, the Partnership distributes an equal percentage share of its profits to its members (its ‘Partners’). For me it’s fair: it encourages Partners to work as part of a team, to ensure the business succeeds, not just for individual incentivisation where people chase KPIs irrespective of the risk, which is one of the reasons why the individual bonus system has become so tarnished in recent years. With a pay and progression strategy you have to keep asking yourself what are the behaviours I’m trying to encourage and what are the unintended consequences of my approach? Go in with your eyes wide open. You’re a busy person; how do you manage your time at work? Do you have any hints and tips for vets/ practice managers? The best piece of advice I was ever given by someone I worked for was do those things which only you can do. I try very hard to live by that mantra and not to become involved in an unhelpful way with responsibilities I’ve delegated to other people. Delegate clearly and in trust, but hold people to account for doing a good job. In my experience when managers are struggling to manage their time they are trying to do bits of lots of people’s jobs as well as their own. And finally, how do you relax? Are you disciplined about stopping work and taking time off or does work sometimes go home with you? I am pretty disciplined. I’ve learned through experience that hours at work don’t always equal a quality output! I do think the boundaries between home and work will continue to disappear as technology changes the way we live and work. We should embrace the opportunities. You can choose how and when you work with more freedom than ever before, but always be disciplined and respectful so you don’t impose your choices on others!

in the

extra Mill House shortlisted for people management award Mill House Veterinary Surgery & Hospital in King’s Lynn has been named as a top organisation for people management practice in the UK, having been shortlisted for two categories in the first Investors in People Awards; Employer of the Year (2-49 employees) and Most Innovative People Strategy. The Awards, which received over 500 entries from all over the UK and different sectors, will celebrate the best people management practices amongst Investors in People accredited businesses, with winners being announced at a ceremony held on 23 June. The 15 categories will recognise Excellence in Leadership and Management, Reward and Recognition, Social Responsibility, and Most Improved organisation, amongst others. Mill House Veterinary Surgery & Hospital has been shortlisted alongside 5 other companies in two categories. Carole Clarke, Director, Mill House Veterinary Surgery & Hospital said “We are delighted to have been shortlisted for these awards, the Investors in People framework has been at the core of our activities for almost 20 years. Our main business strategies focus on the best possible care and service, team stability and development, whilst maintaining health and minimising stress. Staff training and motivation is the key to our success. “Through shared purpose and values we have created a culture of mutual growth, and diverse participation which is essential in our knowledge driven profession. We take the health and wellbeing of our team seriously, adjusting our working practices and restructuring the rota based on team feedback. We support our structure with flexible leadership and management systems, to focus on intrinsic motivation to ‘do the right thing’. Our business goals have become indistinguishable from our culture. Over the last 30 years in practice, we have seen the introduction of many new services, our reputation remains excellent and our team is fresh and dynamic, innovative and profitable, so that our staff and clients can have the practice that they want.” Investors in People is the UK’s leading accreditation for business improvement through people management, and provides a wealth of resources for businesses to innovate, improve and grow, with a focus on good people making great business. For more information about Investors in People please visit www.investorsinpeople.co.uk. Donna Northwood or Carole Clarke are happy to speak to anyone interested in finding out more about how they manage their people. They can be contacted on 01553 771457.

Practice Life z June/July 2014 z www.practicelife.biz


COLLEGE CORNER

College Corner

21

Advanced Practitioner status and the postnoms debate… ‘The RCVS is taking away our qualifications!’

You may have heard this shouted from the rooftops lately. We are not, as it happens. But we had planned to no longer publish postgraduate qualifications in our Register – leaving individuals free to use them where they wished. This was not a decision that came out of the blue – and actually related to a consultation that took place in 2011 – but it has recently hit the headlines as we started to publish the context and requirements for Advanced Practitioner status, application for which will open in the autumn. Given the subsequent unhappiness within the profession regarding postnominals, in April the RCVS Operational Board recommended that RCVS Council reviews this decision at its June 5 meeting – the outcome will be reported in the June issue of RCVS News. Meanwhile, it would be a shame if the postnominals issue overshadowed the RCVS commitment to lifelong learning that the Advanced Practitioner status represents. It’s being introduced to give the profession and the public confidence that the holder has not only achieved a postgraduate certificate-level qualification (Masters level 7), but is also committed to keeping his or her skills and knowledge up to date, over and above RCVS minimum CPD requirements. It’s the same model that we have been using for Specialists for many years. The Q&A below outline the requirements for Advanced Practitioner status. For further information, please visit www.rcvs.org.uk/advanced or contact us on 020 7202 0791 or education@ rcvs.org.uk.

How will the list of Advanced Practitioners be published? The AP list, together with the list of Specialists, will be published in the RCVS Register of Members and online, and the relevant status will also be indicated on veterinary surgeons’ records on the online ‘Check the Register’ tool and be searchable via ‘Find a Vet’.

Who can apply for Advanced Practitioner Status? Only MsRCVS may apply to be accredited as Advanced Practitioners. Members who are on the Non-Practising List are not eligible to apply.

• R  CVS Certificate in Advanced Veterinary Practice with a designation • A pre-2012 non-modular RCVS Certificate or b. Postgraduate clinical qualifications awarded by universities/ recognised awarding bodies at Level 7 in the Framework of Higher Education Qualifications (at least 60 credits/30 ECTS (European Credit Transfer and Accumulation System), of which 40 credits are in the clinical area applied for) or c. A relevant postgraduate masters degree. We consider it important that those accredited as Advanced Practitioners have presented evidence of further study in key areas of professional development, such as are covered in the RCVS ‘A’ modules in the CertAVP, or other equivalent modules. If you hold a qualification that does not include such elements, and which was gained before 31 December 2013 (for example, pre-2012 non-modular RCVS Certificates), there will be an initial three-year window during which you could be admitted to the list (subject to approval of other criteria). If admitted, you would then be required to gain 100 hours of CPD (or an equivalent formal qualification/module of at least 10 credits) that cover the same ground as the CertAVP A module. After you have been accredited, you will then have the five-year period up to your next application for re-accreditation to carry out the CPD or complete a professional development module.

What are the CPD requirements? Before you first apply, you will need to have undertaken a minimum of 250 hours of CPD over the previous five years. Of this, around 125 hours should have been in your chosen designated field. Once accepted on to the list, you would need to undertake at least 250 hours of CPD over the five-year period of accreditation, with 125 hours of CPD in your designated field. (For those applying for multiple designations, you will be expected to have undertaken an extra 125 hours per additional designation).

What does it cost?

You must have had at least five years of experience in practice since graduation before applying for the first time.

The fee for those applying for Advanced Practitioner status is £50.00. Advanced Practitioners will also need to pay an annual fee to remain on the list; although this fee is yet to be determined, it is likely to be in-line with fees for accreditation as RCVS Specialists. It is not a money-making scheme and the fees will be set to cover costs.

What qualifications do I need?

When can I apply?

You must hold one of the following qualifications at the date of your application: a. RCVS qualifications:

Applications for the first listings will be taken in autumn 2014.

What experience do I need?

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www.rcvs.org.uk


22

HOT TOPIC

How secure is your practice technology? John Greenshaw, director at Merlin Telecoms looks at the need to safeguard your networks

“It’s imperative to ensure that Every practice that offers freely accessible WiFi to their clients and employees needs to be aware of the potential risks they can expose their business to. The consequences for the business can be both operational, financial and legal. There are 4 key areas of risk that you need to be aware of and proactively managing to protect your business and livelihood: 1) Unsegregated networks – If your clients and colleagues are accessing free WiFi from the same network that you store all of your business critical data on, there is a high risk of infection, hacking and corruption or worse. The advice here is never mix client and business usage. Adherence to this basic rule will help avoid all of these “3rd party” risks. Unfortunately there ARE people who will access unsecured networks to spy, download illegal images and maliciously cause harm. Be aware that an unsecured network with a strong signal may be accessible from 100m away – so you may be blissfully unaware of any activity on your network. 2) Use of Broadband Bandwidth – The more users there are accessing your network the slower your internet speed will be. Practices tend to plan their system requirements based on the number of known users, without factoring in any element of the unknown. This is not an insignificant issue when you consider how many mobile devices can be tapping into your network and slowing its speed. In one audit we completed recently, 120 unknown devices were connected to the network, significantly impacting system performance. Have you got any idea how many additional devices could be accessing your network? 3) BYOD Policies – (Bring Your Own Devices) are becoming commonplace where a mix of home and office working is the norm. The risk here is the introduction of viruses, the migration of data, and information and the security of your commercially sensitive practice documentation and records. There is both responsibility and liability involved in the care and management of 3rd party devices accessing your networks. What consideration have you made and what policies do you have in place? If you

your practice data is protected and there is effective security in place at all times. It’s easy to be complacent about this, but the potential harm is indefinable.” don’t have a BYOD policy, it is essential to consider this as a critical workplace document, as valuable as any other policy documents that protect and govern your business. 4) Introduction of Malware. This is a serious threat, can cripple your business, wipe data and cause untold inconvenience and financial cost. It’s imperative to ensure that your practice data is protected and there is effective security in place at all times. It’s easy to be complacent about this, but the potential harm is indefinable. Regularly updated firewalls and network security is as critical as the lock on the practice door. Check what security you have in place and don’t leave it to chance. These 4 areas are the biggest concerns in practice data use, especially where you manage communications via the internet. The efficacy of the system and security and reliability of your connectivity is paramount. Additionally, you need to consider the use of social media and the interactivity that blurs the lines between business and social use of the internet. Staff have been known to post inappropriate comments about clients on Facebook, Twitter and other social media. What measures and guidelines do you have in place to deal with situations like this? The management of data and the use of the internet is a key part of the future of your practice, so much is dependent upon its effective and responsible management. John is happy to discuss any aspect of this article on 0800 877 8810 or info@merlin-telecom.co.uk Practice Life z June/July 2014 z www.practicelife.biz


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...and how secure are your people? Jeremy Johnson, director of Vetpol and vetmart.net looks at database security and management However secure your Practice Technology is and even if it can be described as state-of-the-art, the database of information on individual people that you hold will only be as secure as the team that is using the technology. Changes to EU legislation either presently being implemented or in the pipeline, driven in part by concerns over the growth of social media and access to data from anywhere in the world via the internet, mean that Personal Data Protection legislation is evolving all the time. Whilst the threats evolve, broadly, data protection principles remain the same and as a reminder, you have t o have permission from individuals: 1) To hold their personal data. 2) To process their personal data for any given purpose. It’s also worth remembering that personal data applies not just to your clients but also your staff. So your first question is, have I got the permissions I need today? If you know that Mrs. Smith at Manypets Cottage has two horses, four cats and a dog, that information, along with everything else you record about her, comes under the heading of personal data. You’ll know many such clients but just because you have permission to send Mrs. Smith a text reminder that her dog’s booster is due, it does not automatically follow that you can process your client database to see which clients have dogs and send them offers for dog food; or that your in-house doggrooming parlour can access your web-enabled database and offer all your dog clients a make-over. You need to check that you have the required permissions to process client data and maximise the benefit of your database to manage and grow your practice. Web and mobile enabled technologies are relatively new and offer fantastic opportunities to provide better service for both clients and patients. They are often used by mixed practitioners roving the countryside and in small animal practices operating across many centres. However, whilst the opportunities for veterinary practice are exciting, despite what practices got away with historically, the rules are evolving to keep up with threats. And the fines the authorities can impose for not at least taking sensible precautions are increasing. The forward-thinking www.practicelife.biz z June/July 2014 z Practice Life

“Just because you have permission to send Mrs. Smith a text reminder that her dog’s booster is due, it does not automatically follow that you can process your client database to see which clients have dogs and send them offers for dog food; ...you need to check that you have the required permissions to process client data and maximise the benefit of your database to manage and grow your practice.”

practice needs to embrace the new technology for the benefit of the business, clients and its patients, but simultaneously it must manage the risk in order to protect those clients and avoid sanctions and loss of reputation. Much information on present requirements is freely available from the Information Commissioner’s Office at www.ico.org.uk. However, the UK Information Commissioner focuses more on what you have to do to comply today rather


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HOT TOPIC

than what’s in the process of coming down the pipeline: Having ensured that your practice has already embraced the basics of data protection (above) it’s worth understanding the principles of what’s coming your way. They provide good guidelines to follow for any practice concerned about its reputation with present and potential clients. It also reduces the risk of you having to make future changes on the hoof or even after a breach has occurred. So: 1) Don’t just sign the annual form from the Information Commissioner’s office: You may now have secured your webenabled database from attack by hackers on distant shores, but review which people in your practice have access to that data and whether they understand what they can do with it. Check who can download data from your database or even print it. Do individuals have access only to the information they need? If in doubt, form a group of people to take overall responsibility for data management in order that data access is appropriate.

your breach notification process; at the very least it will focus the mind of the team on ensuring that a breach doesn’t happen in the first place. 4) It is unlikely that you will be designing your own software and more probable that you will instead be buying it in; when you do so, make sure that privacy is built in to what you are buying by design and that the technologies and processes you are using have client personal information kept private by default. 5) Businesses in the wider world are having to prepare their systems and processes to enable customers to have the right to be forgotten, the right to erasure of their personal data and the right to portability to new organisations. There’s a thought to consider along with traditional practice concerns over succession. It’s a good idea to be thinking about that now.

2) Get your privacy policies, procedures and documentation in order: The data protection authorities can ask for these at any time so you need them, but also make sure that they are written in a language that staff with access to your database can both access and understand when they need them.

So are you that person in the practice who signs off every year as the “Data Controller” on the bit of paper that comes from the Information Commissioner’s office? Do you understand what you are signing? If not, maybe today would be a good day to bump up your CPD hours by going on a personal data protection course and put data protection on the agenda for the next practice meeting.

3) Any data breach is supposed to be notified to relevant data protection authorities: So as you review your policies also review

If you are a VPMA member and would like to discuss this further, log on to the VPMA group at Vetpol.co.uk

Do you let your clients use your practice WiFi? Let us know how you manage it...

feedback

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CASE STUDY: HOW ONE PRACTICE SAFEGUARDS THEIR I.T. Nick Lloyd is a partner at Kingsteignton Veterinary Group in Devon and chairman of the VetXML Consortium. Here, he shares with us how he takes care of his practice I.T.

I.T. is an expensive tool, and if it breaks it can be time consuming and expensive. But like most tools, reading the manual, taking expert advice, and using it appropriately can avoid disaster. At my own practice I set myself a number of tasks to address our IT care. I looked at each piece of equipment, and asked: • How important is this item and what happens if it dies? • In what way is it vulnerable and can it be protected? • How long will it take to repair \ replace and what impact will it have on my business? • If I am not in the practice, will my staff know what to do? • Is my protocol simple and sustainable? • Is the backup off site / vulnerable to the same risk? Then I thought through several scenarios: My practice catches fire/is flooded; My Server is hacked; The Phone System Computer dies. It was important for each scenario that there was a plan, and the staff knew what to do. Your I.T. and telecoms company in my opinion, should have already thought of these possibilities for you and provided you

“My practice catches fire or is flooded; My Server is hacked; The Phone System Computer dies. It was important for each scenario that there was a plan, and the staff knew what to do.” with a solution. Sadly I think they often let small businesses down; many don’t have the I.T. expertise to know what they don’t know, until they are caught unawares by a disaster. I would recommend finding a local I.T. expert; mine has been very useful and significantly cheaper. Within my telecom system I identified that there were no regular backups of my phone system, so if the PC died, it would take a few days before my phone company could get me up and running again, with a call flow that was several months out of date. A backup hadn’t been suggested by my phone company, and when I asked for it, and suggested that

www.practicelife.biz z June/July 2014 z Practice Life

perhaps they should have suggested it for me, I was met with resistance. So my local expert put in place: • Two external hard drives, which are backed up daily, and rotated, so one is off site at all times •A sync process to a second PC, which could be accessed remotely, to bring my phone system back online within 15 minutes Other identified weaknesses included my ISDN phone lines. Apparently they need power, and there was no process in place to divert them. So we set up 3 analogue lines that are mainly used for running my broadband and credit card machines, and ensured I had spare analogue handsets and a protocol for the staff to divert the phones. Some cloud based applications that I have found useful to help my staff work from outside the practice, and to decrease my dependence on any one computer are: • Dropbox – To sync and back up documents for the management team, and allow offsite access. • Evernote – Syncing notes, clinical and managerial, between different staff computers and mobile devices. • Crashplan – Remote offsite back up of key laptops and computers • Logmein / TeamViewer – Setup to allow me remote access to all key computers. Other concerns that should be considered include viruses and hacking. My software provider has a very good firewall, and by making most of my IT equipment Apple Mac based, I have decreased my exposure to viruses. Up to date virus protection on Windows PCs is a must. Passwords are an area I am working on, but I think having a password program (1Password is my program of choice) is an essential – it allows me to have different complex passwords for each login and keeps them secure, as well as allowing me to have a secure place for passwords that the staff use. Practice I.T. seems like a never ending task, but as practices become more dependent on technology, it is well worth investing the time. Most of the vets I talk to hate I.T. However, I don’t think they truly mean that they hate it; they use I.T. all the time at home and at work. What they hate is the hassle when it breaks and when it doesn’t do what they want. When it’s working OK, I think they take it for granted. Ideally try to find someone in the practice who’s keen on I.T. In my practice that person was me when I was an assistant. The partners cleverly delegated I.T. issues to me and saved themselves the headache. Now I am a partner, I am looking forward to passing the metaphorical ball on myself.


WELL-BEING

VETLIFE’S GUIDE TO

Good Mood Foods

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esearch exploring the link between diet and mental health “is a very new field; the first papers only came out a few years ago,” says Michael Berk, a professor of psychiatry at the Deakin University School of Medicine in Australia. “But the results are unusually consistent, and they show a link between diet quality and mental health. Traditional diets, the kinds of foods your grandmother would have recognized – have been associated with a lower risk of mental health issues.” It could be that mood disorders change how and what people choose to eat but the relationship may work the other way: certain foods, or their absence, may contribute to poor mental health. “There’s a two-way street between what’s going on in the gut and what’s going on in the brain,” Linda A Lee, director of the John Hopkins Integrative Medicine and Digestive Centre, recently told The Washington Post. Research points to bacteria as possible middlemen in this back-and-forth. “We’re not at the point where we can use diet as therapy, especially when we’re dealing with someone whose mental health issues render them very disabled, because we just don’t know enough, five or ten years from now we’ll know more.” American neurologist Dr David Perlmutter, author of the bestselling book GRAIN BRAIN, has no doubts about the effect of food on the mind. He asserts that all the research points to gluten triggering not just intestinal disorders but headaches, depression, dementia, schizophrenia, epilepsy, ADHD and even decreased libido. He believes that all of our brains are sensitive to gluten and recommends a diet that is 75% healthy fats, 20% protein and 5% carbohydrates. Perlmutter has also collected scientific evidence that supports the theory that even subtle elevations of blood sugar are bad for the brain. In the UK too, Dr Marios Hadjivassiliou in Sheffield has published research showing that gluten sensitivity is significantly associated with neurological problems such as chronic headaches, foggy brain and other cognition difficulties. Research continues but in the meantime UK mental health

charities such as Mind and The Mental Health Foundation make the following recommendations for a diet which should improve your mood and help you to cope with stress: • Eat regular meals & don’t skip breakfast • I f you feel too depressed to eat, eat small amounts of healthy food like soup to steady your blood sugar levels and seek professional help (see VSHSP contact details below). • Avoid refined foods • I nclude protein at every meal. Oats, wholegrains and protein will fill you up and keep your blood sugar steady • Eat a wide variety of foods • I nclude 2-4 portions of fish per week in your diet (limit to 2 if pregnant) • Maintain a healthy weight •M  aintain fluid intake – drink at least 2.5 litres of water per day • Limit alcohol and caffeine intake •B  e realistic – introduce a few changes at a time. Create balance by allowing for the odd indulgence within your health eating plan.

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WELL-BEING

Vetlife’s Good Mood Food Shopping List Seafood Shellfish and molluscs provide selenium found in one study to produce men who are “clearheaded, confident, and composed” and oily fish provides omega-3 DHA which is associated with a decreased risk of dementia. Walnuts A handful a day could make those who indulge feel smarter, more alert, and more focused. Kale, Lettuce Magnesium benefits brain cell receptors and allows more blood & Spinach flow to the brain. Researchers observed that people who got the least folic acid were 67% more likely to suffer from depression than those who got the most (Journal of Nutrition 2003). Turkey Such a potent mood-buster it should be eaten all year round. Loaded with tryptophan which stimulates serotonin production and calms the brain and the protein helps keep you energetic and alert. Vitamin B12 protects against brain shrinkage linked with Alzheimer’s disease. Eggs Perlmutter encourages eating eggs for breakfast because they provide healthy saturated fat, a fundamental building block for brains and are a good for blood-sugar balance. Avocados Avocados are a rich source of brain supportive fat. Blueberries Low-sugar fruit such as lemons, limes and blueberries contain antioxidants which help cognitive function, including memory. Turmeric Turmeric is particularly beneficial because it contains curcumin which can boost memory and stimulate the growth of new brain cells. Variety of Ensuring you have variety in your diet will Vegetables help you to get all the nutrients you need. Peppers, cucumber, tomato, courgettes, squash, pumpkin and aubergine are good sources of antioxidants.

For more about wellbeing see www.vetlife.org.uk/wellbeing. VBF, the registered charity that supports the veterinary profession, offers free, confidential and professional support through the Veterinary Surgeons’ Health Support Programme to anyone in the profession who is struggling with depression. The National Co-ordinator of the programme can be contacted at VSHSP@vetlife.org.uk or 07946 634220.

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MANAGING PEOPLE

SPECIAL FEATURE

Maternity:

a smooth return to work

Carolyne Crowe is a vet and a personal performance coach and mentor for veterinary surgeons and nurses. She specialises in training and support around pregnancy and return to work.

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eturning to work after having children can be a daunting experience. Work moves on, drugs, people and procedures may change and you too may not be the same person that left to go on maternity leave. However, by being prepared, knowing what you want and adapting, you can successfully combine your work and family life. To return to work with confidence and clarity, one needs to focus on both the physical practicalities and the emotional aspects of returning to work.

Know what you want from working

say yes to the request? Think about the drawbacks to your proposal and acknowledge them in your conversation you have with your boss. It’s important to create a solution not a problem. How can your ideal working hours be part of a solution to your practice’s problems? Approaching it proactively, thinking how will this work for ‘me’ as well as how will this work for the team and the practice, will make it more likely to happen. Remain flexible when discussing your preferred working hours. Your conversation should be a collaborative one, looking for that win-win situation.

What motivates you about returning to work? Perspectives and priorities may change after having children so what do you want and need from your career now? Once you know this you will be in a better position to a) Get it b) Be happy with the choices you go on to make.

What are your childcare options?

What’s your ideal work situation? Full-time or part-time? Full days or part days? In the ideal world you would be able to work the hours that suit you, but in reality this may not be the case and compromise/flexibility is often required.

There are several questions to ask yourself to find the option that works best for you: • Work out how much you and your partner can do, be realistic, who is going to drop off and pick up each day? • Does either of you spend time away with work-what happens then? • How will being on call affect your normal arrangements? • Who will take time off when your child is ill? Know what’s important about your childcare provider: is it home-cooked food, flexibility, opening hours, a child sickness policy? Create a list of questions which addresses these points, asking each provider the same set of questions. Be rigorous with them so you can be confident in your choice and have the piece of mind that your child is safe and happy whilst you are at work.

Work out your ideal situation and then consider: • Are you returning to the same role as before? • Can this role be done in the hours you are proposing? • Why does working in this way suit you? • How is working this way suiting the practice? • What have others done before? It’s good to ask others but don’t assume it has to be the same for you. Present your own proposal proactively and positively, so it can be seen for its own merits. • How does the way you want to work impact the rest of your team? If you need to leave earlier than normal e.g. at 5.30pm rather than 6.30pm to pick up your child/ren leaving others having to cover for you, what could you do earlier on in the day that they may not enjoy/would appreciate being taken off them as a trade off? Or could you take a piece of admin and do it from home? • Separate what you need from what you want, highlighting where the flexibility in your plan lies. • What’s in it for the practice? People are more likely to be persuaded to do something if they can see the benefit to them. If the boot were on the other foot, what would make you

Another priority will be arranging your childcare. For many parents this can seem a bewildering experience, but it’s important to make an informed choice about what works for you, your child and your family. The table opposite highlights some of the options.

Keeping In Touch days (KIT days) These are a great way to ease yourself back in to the work environment, to settle your child in childcare and to get yourself thinking and feeling like a vet or nurse again. Neither you nor your employer is obliged to take or offer KIT days, but it’s a great way to smooth your return to work.

Have a meeting with your practice Once you have a clear picture of your ideal situation, have thought about the physical and mental preparation you need to Practice Life z June/July 2014 z www.practicelife.biz


MANAGING PEOPLE

Nursery

Child minder

Nanny/Au Pair

Grandparents

Good social interaction Pros/cons 

Good 1on1 care, child stays in home environment, often more flexible. Some may do some housework.

Benefits of family member looking after child, are they physically capable?

Costs  Average costs are

Average costs are £4.26/hr* £3.93/hr*

Costs vary. A live-out nanny is entitled to the national minimum wage. Can be expensive.

Often None

Majority of staff will have

Not required, only inspected if registered Au Pair-often has no childcare qualifications

None

Good social interaction with other children, with group of other most open all year children, within a round except bank “home” environment. holidays, staff may change around.

Qualifications & Inspections

Registered and

childcare qualifications, inspected by Ofsted

Inspected under Ofsted

Emergency back up if childcare ill/ holidays Flexibility

None needed – nurseries

will arrange staff

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Would need to be arranged, e.g. if your child minder, nanny or grandparent is ill or on holiday

replacements if staff are sick or on holiday Often strict on pick up More flexible on pick up and drop off and drop off times, little flexibility, penalties for over-running

Often very flexible if you are running late, nanny can give child tea and put to bed

Often very flexible

* Childcare costs survey 2013-National Childcare Campaign

do before returning, you can organise a time to have a meeting with your employers to clarify the details. There are several points to discuss: • Your exact working hours. If you are moving from full time to part time ensure all parties are clear on what this entails. • Your pro rata benefits such as CPD, holidays and bank holiday allowance even if your normal working day isn’t going to be a bank holiday day. • CPD: will you receive the full allowance (days and money)? If not what provision is there for fulfilling your RCVS CPD requirements? Frequently, CPD will fall on days that are not your normal workdays, you will need to re-arrange child cover for these days – are you entitled to these days off in lieu? • What happens when your child is ill/childcare provision is suddenly unavailable – does this count as unpaid leave/sick leave/holiday? • Reassurance you can leave on time to pick the children up • Reassurance to be eased back into clinical work – you will be a little slower to start off with • That you remain a conscientious and committed member of staff – you just won’t be there every day and every night! It is very important to have the conversation regarding the above points to ensure a successful return to work. It is also important so that both parties have clarity about what is expected of them to avoid disappointment and disagreements.

The emotional stuff It’s not just about the practicalities of returning to work www.practicelife.biz z June/July 2014 z Practice Life

we need to consider, but also the emotional processes that we will go through. When you return, you will be going through a period of change, frequently experiencing conflicting emotions, feelings of uncertainty and stress. The quicker you’re able to get a hold of these feelings, the smoother the period of change will be. The first step is to recognise and acknowledge the feeling and the reasons behind them, so you can then take action to overcome them. Gaining a grip on feeling guilty • The guilt of leaving your child with someone else • The guilt of feeling you haven’t got the time to commit to work as you want to • The guilt of having to leave the practice before all the work is finished for the day. Mother’s guilt – it can often be overwhelming and stressful! So how can you deal with it? Acknowledge what is making you feel guilty in the first place, be specific, so you can then address it. It’s very easy to go down the road of trying to be the perfect mum, the perfect vet/ nurse, the perfect partner and a domestic goddess. Remember: there is no such thing as ‘perfect’, so make an active decision not to try to be! Become aware of what is truly important to you, concentrate on this and let go of other less important things. Make an active choice to think differently.


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MANAGING PEOPLE

Give yourself a break Remember you are in a period of transition and most likely still sleep deprived! Allow yourself time to adjust, take one step at a time and reflect on the progress as you make it. You will feel tired and maybe a little stressed to start with, and it can seem overwhelming and daunting with all the change and decisions to make. But break it down and work through each step one at a time so you can get the answers that are right for you, your family and your practice. Building confidence It’s not uncommon for confidence levels to be reduced on returning from maternity leave. But the good thing is, people don���t change very much. If you were good at something before you had children, you will still be, and you just need to work on ways to build that confidence. Ask yourself what it is specifically that you aren’t so confident about; is it the clinical work, the childcare, juggling home and work together? Once you know you can then find solutions to build your confidence. Use your KIT days to familiarise yourself with any changes in the team, drugs or procedures. We are often quick to globalise our feelings and once this happens they appear too big, too daunting and overwhelming, so break it down and be specific. One good technique is to look at your strengths, write them down, then ask: What have I learnt or developed since having

children? See the table below for some suggestions and ask yourself: What can I draw upon to make my return to work smoother and easier?

Skills commonly developed/enhanced during parenting Negotiation, Patience, Dealing with frustrations, Communication, Compromise, Adaptability, Direction, Assertiveness, Motivation, Engagement, Flexibility, Dealing with adversity, Dealing with the unknown. Persistence, Prioritising, Compassion, Mediation, Positive thinking, Open mindedness, Delegating, Multi-tasking, Listening, Empathy

Be in control of the time you have, put in place routines and plans to get the most out of the time you do have.

Summary On returning to work, your life is going to be full, it is likely to be fast paced but you can be in control and you can enjoy the balance that works for you. In the competitive jobs market we are in, make yourself invaluable, be proactive, be flexible and make it work for you, your family and your practice.

A Smooth return to work

Advice for Employers Most of us won’t want to lose our valuable employees after maternity leave. So what can we do to encourage and facilitate their return?

Reassurance Reassuring our employee that they are a valued member of the team helps to open up discussions. You should try to be flexible and encourage a working solution that benefits both parties. Remember, they are an experienced member of your team. You have already invested a lot in them and it’s worth making sure this works for them and you. Be flexible in your approach, and think outside the box if necessary, asking the question, ‘How can I make this work for all parties?’ A willing approach will go a long way. Although having lots of part-time staff can make scheduling rotas a challenge, focus on the positives: • By employing part-time working mums you are getting a lot of productivity for your pound. • They are often more engaged and motivated wanting to get on with the job at hand. • Time away from the practice as well as time away from home enables them to have a better work-life balance and often greater sense of perspective than perhaps before they had children. • Good part-time mums are worth their weight in gold but they need to feel appreciated and a valued member of the team.

Understand that although they may have previously stayed for an extra 2 hours most nights, that they now have other commitments, they don’t have the “luxury” to do that. Plans are made around the hours that you want them to work, so if their hours of work are 9-6pm, they will be leaving at 6pm as they are likely to be committed to picking up from childcare at that time – it’s not an option to stay beyond this. As a practice it’s your duty to cover what happens beyond this time - it shouldn’t be left on the shoulders of the individual vet or nurse who needs to leave. Be supportive and understand that some things are outwith their control. If their child is ill, it’s not their fault. Treat your staff as individuals, with their requests being looked at on their own merits. The more flexible you can be, the happier your employees. If you can create a win-win situation, it’s going to be the best for both parties. Try to make their job one that they want to come back to, where you are supportive and understanding, the job is satisfying and small requests to make it easier for them are granted. Fair expectations and mutual respect should be present Practice Life z June/July 2014 z www.practicelife.biz


MANAGING PEOPLE

on both sides with each party being aware of the benefits each brings to the table. Remember your staff are your biggest and most valuable asset. Working mums play an increasingly important role in the growth and development of the veterinary and nursing professions. Recognise their qualities and their strengths. Value them, appreciate them and be the employer who they want to work for. The rewards can be immense.

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CASE STUDY Returning to work after maternity leave; an employee’s perspective...

Carolyne is happy to discuss any aspect of this feature and can be contacted on 01453 833 720 or by email carolyne@carolynecrowe.co.uk

FURTHER TRAINING Webinar: Practicalities of working in a veterinary practice whilst pregnant This webinar gives practical advice about working in practice as a pregnant vet or nurse. It is a useful resource for both employees and employers. • Rights at work • The practicalities – what needs to be done? • Risks involved in being a pregnant vet/nurse – how to keep safe • Working as a vet/nurse whilst pregnant – what to think about • Options around maternity leave • Planning for return • Childcare options • The vet/nurse’s role in the practice

Cost £40 Webinar series: Return to work with confidence and clarity This series of four webinars has been created for vets or nurses who are either on maternity leave, or who have just returned to work. The webinars will boost confidence and enable you to successfully combine life as a mother with a veterinary career. Using a range of practical strategies, tools and techniques, the webinars will help you: • Increase confidence levels • Improve time management • Develop a personal and professional vision • Regain control of your life and career • Find direction • Reduce stress and improve coping mechanisms

Cost of four sessions £147 For further information, to download a webinar or to book a place on a workshop then go to www.carolynecrowe.co.uk

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Susie and her kids, Aaron, Benjamin and Hannah

Susie Powell is a part-time veterinary surgeon at Mimram Veterinary Centre in Welwyn, a 5 vet small animal practice. Her husband is also a vet and they have 3 children, who are 7, 4 and 2.

I started working full time at Mimram Vets in 2004, following a short period in first opinion small animal practice and then 2 internships at the RVC and Davies Veterinary Specialists. I really liked the ethos of the practice and the staff and clients, and decided this was somewhere that I would like to work long-term. I became pregnant with my first son just over a year later, and informed my employer following confirmation of the pregnancy at the 12 weeks scan. At the time, standard maternity leave was 6 months paid leave (statutory maternity pay) with the option of taking a further 3 months unpaid. I tried to be as honest as possible with my employer regarding my intentions about taking time off and returning to work, and decided to have 6 months maternity leave, but to come back part-time. We came to an arrangement where I would job-share my full-time hours with my husband, who had been working at the practice on a part-time basis at weekends. I appreciated that maternity leave can be particularly difficult in a small practice, and managed to find a friend and peer of mine who was able to provide locum cover whilst I was away. I worked until I was 38 weeks pregnant, which meant returning to work when my son was 5 ½ months old; I found this quite tough since I was still entirely breastfeeding at that stage and had to express milk during the day at work. It also meant that I might have been up during the night so I sometimes felt quite exhausted. For the first month I worked one short day (6 hours) each week and my husband covered the rest of my rota; thereafter I did 2 short days while my husband did the 2 long days (11 hours).


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MANAGING PEOPLE

When I returned to work I felt quite out of touch, despite only being off for a relatively short time. I found even simple things like the discussion over puppy and kitten vaccinations sometimes hard to remember and I definitely lost some confidence with surgery. This improved as I started carrying out routine procedures again but working part-time meant I had only limited access to these. Additionally, working fewer hours was very different and I found continuity with cases and following up on other colleagues’ cases difficult. Unfortunately, after a few months of the job-sharing arrangement, relationships in the practice between my husband and employer became strained and after an awkward meeting between the 3 of us, it was decided that I would work parttime 2 short and 1 long day per week and my husband would leave. This was without doubt a very difficult time for me at the practice; I was often extremely tired because of looking after a young baby at home and I also felt very let down by my colleagues. I did contemplate leaving the practice at this stage but things eventually settled down into more of a routine pattern at home and work, and I continued to work the 3 days, until my second son was born in June 2009. On this occasion I decided to take a year’s maternity leave (6 months paid and 6 months unpaid) which worked quite well from my employer’s perspective because it coincided with a period of reduced turnover at the practice due to the effects of the recession. I again tried to give my honest intentions both in terms of how much time I wished to take off and that I would prefer to return to work covering 2 short days. I negotiated my change in hours with my employer as early as possible, and she was very helpful in allowing me to be flexible over these hours. Taking a year’s leave allowed me to finish working slightly earlier in the pregnancy, and meant I felt more mentally and physically ready to return to work. I actually found that I felt more confident returning on this second occasion. Perhaps this came from having worked longer in general practice by that stage, though the government had also introduced ‘keeping in

touch’ days and I was able to do (and receive payment for) some Saturday morning consulting sessions during my maternity leave; this also helped the transition back to work. Childcare can be more difficult with 2 children at different stages and I found it quite tough to organise but my Mum was able to help on one day and I had a nanny for the other. The issues over childcare, in terms of both flexibility and cost, means it is often hard for a part-time mother to work overtime or to cover holiday hours, which can sometimes result in feelings of resentment on the part of colleagues and guilt on the mother’s; I feel bad having to leave the practice to collect my children from school if there is still work that remains to be done. My daughter was born in March 2012, and again I took one year’s maternity leave (now 9 months statutory and 3 months unpaid). Luckily, by the time I returned to work, my husband was in the fortunate position that he was able to take time off work to look after the children when I worked. My employer was again very helpful in allowing me to be flexible and fit my shifts round my husband’s working hours and I now work one evening consulting and a short day operating. I feel very strongly that employees should be completely honest with their employer over how long they wish to take on maternity leave as well as their intentions for returning to work. I realise the choices are heavily weighted in favour of the employee nowadays, but this should not mean that employees abuse the system and leave their decisions to the last minute. Communication in a practice definitely works best when both parties are completely open. There’s no doubt that it’s difficult to get the right work-life balance, particularly where children are involved; I can’t help feeling that I am short-changing someone, either my colleagues at work when I can’t give the same level of commitment as them, or my children when I miss their special events because I am working. However, overall, I feel I am very lucky to have a job that I love, where I can work flexible and part-time hours, in a fantastic practice with caring and supportive staff.

The Law Mike Woolnough Business Development Manager at Peninsula Business Services, looks at the law governing return to work after maternity leave.

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urrent legislation governing maternity leave gives employees certain rights in relation to their job both during and after maternity leave. Failure to comply with these entitlements can leave practices in a tricky situation so keeping up to date with developments is key to retaining good staff and keeping yourself out of tribunal. An employee returning after maternity leave has an outright entitlement to return to the same job that they performed before they started their leave. This, however, is only the case when the employee returns during or at the end of the ‘ordinary maternity leave’ (the first 6 months of leave). If the employee takes any ‘additional maternity leave’ (the second 6 months of

leave), then the employee is entitled to return to her previous role where it is ‘reasonably practicable’. Where it is not, then the employee must be given a role which is suitable and appropriate for her in the circumstances where her seniority, pension and other rights are as though she had not been absent. Usually, however, it is not the actual role that the employee is returning to that is problematic, but her hours or days of work. Frequently, employees want to reduce their hours so that they can balance their job with their new family commitments. Currently, employees have the right to request flexible working when they have at least 26 weeks service with the practice; have a child under the age of 17 and have not made Practice Life z June/July 2014 z www.practicelife.biz


MANAGING PEOPLE

another statutory request for flexible working within the last 12 months. The request can take several forms, including a reduction of hours per day; or a reduction in days per week; or condensed hours. Practices are not required to consent to the request, as long as the reason for refusal falls into one of those permitted by law. Reasons include a detrimental effect on ability to meet customer demand; insufficiency of work during periods the employee proposes to work; or the inability to organise work. It’s important to base your decision on true facts because an employee may bring a claim to tribunal if they do not believe that this was the case. You may suggest an alternative to the proposal put forward if you can agree an alteration in principle but not exactly in the way that the employee has suggested. An employee also has a right to take time off for dependants. This can be taken when an employee needs to leave work in an emergency situation if their normal childcare arrangements have broken down or their child falls ill, for example.

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The employee is entitled to take ‘reasonable’ time off for each occurrence. ‘Reasonable’ will depend heavily on the circumstances but one or two days will usually be sufficient. An employee needs to inform you, at the time they tell you that they need time off, how long they think they will need. If this is more than a couple of days, it may be best to deal with it by means other than time off for dependants, e.g. annual leave or parental leave. Time off for dependants is unpaid. Sickness absence, including pregnancy related sickness absence, that occurs once the employee has returned to work e.g. due to post-natal depression, should be dealt with in line with normal sickness procedures, although consideration should be given to whether the illness constitutes a disability. Dismissal due to this kind of absence will not be pregnancy/ maternity related discrimination because the absence falls outside of the protected period i.e. from the start of pregnancy to the end of maternity leave. www.peninsulagrouplimited.com

CASE STUDY One employer’s perspective on part-time return to work

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e have found many benefits of employing part-time women vets who are also mothers:

• They are experienced and as you’ve already spent time training them (prior to them going on maternity leave) it’s a great shame to lose them. It makes more financial sense to us to keep them rather than having to train a new employee up. • There is familiarity on both sides, you know and trust them (and hopefully that is reciprocated too!) This also goes for the clients; there is already a bond and trust between the vet and our clients, so there is continuity and stability. • We find it can be an advantage having more vets working fewer hours – it gives us greater flexibility in the system. • The working mums we employ are highly motivated and when at work they are very productive – they actually turn over more than the full time staff for the hours they work. • They’re more settled in the job, and tend to stay longer, reducing staff turnover However we’ve found there are some downsides. Providing out of hours cover can be difficult to manage especially if your employee is the one who needs to pick up the children at the end of the day. Our practice timetable is frequently dictated by our clients and not the staff – it can be hard to have staff leave at a certain time. We understand that they are contracted to a certain time and that time has to be stuck to as they need to go and pick their child up, but it can be frustrating when cover is left to other members of our team.

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However, we believe that the future of veterinary practice will involve many more part time women, so we have to accommodate this change. We look at each individual on a case by case basis. If someone wants to come back just mornings, or full days, then as long as this remains a productive way of working (depending on their individual case load and any specialty) then we try and accommodate it. We try to be flexible and understanding when there is a problem with childcare or illness and believe that this understanding is appreciated by our employees and builds good will. In return we ask our part-time assistants to remember we are a small business, that their actions have a ripple effect and for them to work towards the win-win situation for us both. So far this approach has worked well!


CLIENT CARE & MARKETING

VETERINARY RETAILING:

The right mix Libby Sheridan takes a look at the pet retail market and whether vets can compete in the digital age of shopping

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recent article in Pet Product Marketing magazine urged pet shops to ‘take back their share’ of sales of worming and flea products from vet practices. The phrase stuck with me I guess because of the many times I’ve heard vet practices bemoan the opening of a pet store nearby, concerned at the potential loss of business. Reading this, it’s suggested that the ‘boot is sometimes on the other foot’. Reported sales figures for the pet market suggest there may be room for both. Sales of pet products have remained buoyant through the recent economic downturn, with the European market thought to be worth about e8.5 billion in 2013 and the UK market still growing. A recent IRI report highlighted that the growth was driven by increased prices rather than increased sales, but that cat products – primarily food – were performing very well¹. Smaller packs of dry food and singleserve portions seem to be the order of the day. Given this leaning of pet owners towards buying small SKUs, it begs the question why vet practices, who often struggle for retail space, shouldn’t capitalise on the trend? That said, many vet practices are put off retailing by comparatively low margins (vs drug sales and fees) and the hassle factor. And it’s compounded by the reticence of vets to be seen as salespeople. Add to the mix the burgeoning success of superstore chains such as Pets at Home, and huge online competition, why bother?

Brendan Robinson of Village Vets is of the view that we shouldn’t, “This is a subject I try to analyse daily. It is such a changing world and we have to adapt. My feeling at this moment is that we should be developing our services and decrease retail. It is impossible to compete directly with online shops. I do think a mix of in-clinic and online (retailing) works for us, but we are lucky to have our own pet portal/online shop which we developed 5 years ago. The best way (for vets) to compete would be to raise service fees and decrease retail fees.” However, there is a line of thought that retailing, despite the lower margins, provides an ideal opportunity to get the pet owner into the vet clinic, and helps with client bonding. With so many others – pet shops, agri-merchants, groomers and trainers – keen to give advice to knowledge-hungry pet owners, why would vets want to turn down an opportunity to engage? In practices that do it well, retailing provides a good source of income. Where the income is more marginal, many believe it provides an opportunity to strengthen client relationships with a positive knock-on on loyalty and transaction value. Jane Fletcher from Smartkits believes that retailing provides an opportunity for practices to shine, “The primary focus of a practice is on the health of a pet and the knowledge, skills and experience of the vets, nurses and others are the ultimate strengths. Products which help the pet and owner and fit with the practice’s positioning and approach can work well. Keys Practice Life z June/July 2014 z www.practicelife.biz


CLIENT CARE & MARKETING

to success are in selecting the right products and then actively recommending them, for example, products which are only available to vets and are the best for the pet (e.g. flea control, diet). Products can provide a great opportunity for practices to demonstrate their expertise and point of difference. Customers want this level of service and advice from a practice and it will help to stop them shopping around or just buying online. Buy into the products and the customer will too.” George Christopherson from Ashdown Vet Services agrees, but thinks that to be able to get the footfall and bonded clients, practices need to be prepared to sacrifice margins. He’s done this in his own practice, selling pet food at 10-15% margin, for example (historically 40-50%). “We want the footfall and bonded clients, even if on an activity-based costing it is not a profitable exercise – like neutering fees. The vet industry subsidises routine vet care by undercharging for vaccinations and neutering and over charging in other areas to get an acceptable average.” Mr Christopherson thinks that vets have a wealth of information that they can capitalise on, and new vet technology focusing on compliance will give vets an edge. “Over 5 million people’s data is in vet surgery databases. 10% of clients are new every year and the vet will have all their details very early in the pet owning life (giving approx. £15-17K expenditure in a lifetime). Manufacturers want vets to endorse and recommend their products. New free technology being developed (by manufacturers) and given to vets to improve compliance will give them a competitive advantage in also retailing to their clients.” The global phenomenon of Click & Collect, championed successfully by the likes of John Lewis, may present practices tight on space with another opportunity. Customers are increasingly buying online across a huge range of markets, driven by the desire to capitalise on reduced costs. Avoiding delivery charges through the ability to complete the transaction online and then pick up in store, is the main reason behind this emerging trend. Data from research agency Planet Retail shows that 47% of consumers would be encouraged to choose a retailer offering in store collection². And of course, it has the advantage that less stock needs to be carried, as well as providing the opportunity to engage with customers and cross-sell. Mr Christopherson is a keen advocate of online sales and Click & Collect. He has moved all his high volume or specialised product sales online. With this he has reduced his stock of unsold food in the surgery by 70%, and at the same time increased sales by 25%. He finds other [more profitable sic] uses for the spare space once occupied by food, “We offer local delivery (for online sales) and from our 150 orders a month, we get a request for delivery approximately once every 3-4 months, so once every 500-600 orders. People historically buy online because it’s cheaper. Remove the price difference (due to delivery charges) and it’s not nearly as attractive. Hence click and collect is expected to be 3 times the size of home delivery internet retailing. “Because the phone rings less (all bought online) stock is down 70%. The customers pay for the product before it is ordered or delivered, and so are much more efficient in using reception time when collecting the product as it’s already www.practicelife.biz z June/July 2014 z Practice Life

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“Products can provide a great opportunity for practices to demonstrate their expertise and point of difference. Customers want this level of service and advice from a practice and it will help to stop them shopping around or just buying online. Buy into the products and the customer will too.” bought and paid for. Plus the product is automatically reordered into the correct wholesaler account – the efficiency improvement to the business is substantial. Even on a 10-15% margin, it may well still be a profitable activity.” Jane Fletcher agrees with the concept of convenience, “If practices want customers to buy from them online, then they need to let them know it’s available through all the practice’s communication channels. The benefits should be made clear. Think about how you can make it as convenient as possible re deliveries, Click & Collect, rewards schemes etc.” Advocates of online retailing emphasise the importance of seamless and excellent customer experience. However, when it comes to creating greater brand advocacy (to your clinic), face-to-face interaction may still have the edge. Engaging customers in relevant conversations at the right time and in the right place, and providing a tailored experience is easier in an offline environment. Jane reinforces that at the end of the day, successful retailing in a practice environment is all about having a team with a positive mind set to actively recommend the right products. Everything else (display, space, location, technology, economic climate, competition) is secondary to this. Alison Lambert from Onswitch goes one step further, “Everything needs to be looked at from the customer’s point of view. The vet’s USP is that they have the right to provide veterinary medicine. They should concentrate on nailing this part – excellent medicine and excellent customer experience in vet service delivery. If this part is not cracked they cannot move on. If vets can do retailing as well as they do it at Pets at Home then yes, go for it, but most practices have a long way to go with perfecting the essentials of customer experience before they can even begin to think about retail”. 1. www.iriworldwide.co.uk/tabid/253/ItemID/1170/View/Details/default.aspx 2. www1.planetretail.net/stepnews-and-events/press-release/six-elements-achievingomnichannel-nirvana


BUSINESS HEALTH & FINANCE

Getting back on track: WHAT TO DO ABOUT THOSE POOR KPIS James Barnes is the General Manager EMEA at Rx Works, a PMS provider

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o-one needs reminding that the veterinary practice business is getting tougher each and every year. This is reflected in Bayer’s study of practices in 2011 which showed a downward trend in veterinary client visits and revenue. • 51% of vets reported a decrease in patient visits. • 42% reported a decrease in revenue. •O  n average, only 61.7% of available client appointments are filled each week. Not surprisingly, for those vets that saw increased visits, 88% reported that they also saw more revenue.

So how do you buck the trend? First, you should follow the advice of Peter Drucker, the man that BusinessWeek called “the inventor of management”. He said “What’s measured is improved”. Another of his opinions was “you cannot manage what you cannot measure”. There are no points for guessing his focus when it came to how to manage. Next and perhaps the most difficult step, is to decide what to measure.

What to Measure Traditionally practice managers have relied on measuring gross revenue and other metrics based on gross revenue such as average client transaction. But, both are results of other activities and are a blend of several revenue sources – as such they are not sufficient to provide the performance metrics you need in today’s business environment. In fact the road to bankruptcy is littered with businesses that had good gross revenues. The main drivers of your business revenues can be simplistically defined as the number of patient visits and their associated fees. However, to manage the drivers you need to measure the factors that affect them. Examples are: • Are you charging for everything you do? – for surgery, percentages of procedures without expected charges (such as hospitalisation, anaesthesia, medication, etc.). For preventative care, the number of visits without exam charge, etc. • Are you retaining enough clients? – number of clients last year who haven’t been back for another visit this year • Are you recruiting new clients to replace those you lose? – number of new clients compared with number of clients lost, in the last twelve months • How successful are you in getting clients to accept your care recommendations? – compliance rates for preventative care • How many times does each patient visit you every year? • Do you know how frequently you provide individual procedures? • Etc.

Each of these factors is also controlled by other activities. Let’s look at client retention: We know that clients respond very well to being reminded of needed care for the patient. So, a very useful KPI is how many clients don’t have any reminders on their records? Our experience is that the extent of missing reminders is roughly the same in all the countries in which we have users. They show up to 40% of clients without reminders. The outcome is that practices end up with a client retention rate between 50 and 75%. No reminder means no proactive contact – and probably a lost client. A common cause of missing reminders is that the patient was first seen for a problem that didn’t require any product that has a reminder attached. There’s a simple solution and that’s to ensure that a patient visit cannot be completed unless there’s a reminder on their record. Our software has a safety net that automatically checks and adds an annual exam reminder if no other reminder is present. Other areas that will benefit from measuring with KPIs are: • Source of revenues – both by type of activity (preventative care, chronic, surgery, etc.) and type of client (bonded, new, returning). • Number of visits by type of activity and client. • Number of procedures by type of activity. • Ratio of professional services to product revenue. • Sales by type of product. That’s a small example of KPIs that can be useful in a veterinary practice. There’s a multitude of possible KPIs that can be used. The strategy for your practice will dictate those that are the most important. If you want your main activity to be preventative care, one element you will look at increasing is the number of bonded clients, which means concentrating on client retention. Another is the client compliance rate for each of the areas in preventative care. If surgery is your main focus, making sure that you charge for each component in a surgical procedure is paramount. It’s important to recognise that none of the KPIs function very well in isolation. There’s often a set of complementary KPIs needed to give you the full picture. Here’s an example. If I’m looking to grow my preventative care business, I would monitor the following KPIs. • Number of bonded clients – they are the bedrock of preventative care business • Client retention rate – a measure of the quality of your client service Practice Life z June/July 2014 z www.practicelife.biz


BUSINESS HEALTH & FINANCE

• Number of visits for preventative care – indicates the success of your client communication and education processes • Preventative care compliance rates – how well you are explaining the value of your care • Preventative care revenue – the end result of strategy

Measuring Effect of Changes It’s essential to continue with KPIs so as you can establish trends and measure the effect of any changes in process. A one-time snapshot is of little value in managing. Once you’ve identified an under-performing area in your practice, you need to change the process in that area. The process doesn’t often need a major overhaul – an additional audit step or changes in some function in your software are normally sufficient. You must monitor the KPIs before, during and after the change is made, so you can determine its effect.

Obviously there will be variations in KPIs, month to month. It’s important that when comparing results that you look at trends over a year or preferably 3 years. Use a rolling twelve month average, so you are comparing to the same month and twelve months to date in previous years. Another tool to help you quickly identify unusual results is to set a threshold over which your KPI report will highlight the offending items. Use something like 5% over or below last month or year. There is one other very important consideration. All of your KPIs should be automatically calculated from data currently held in your practice management system. That sounds easier than it actually is. It depends on the coding structure provided in your software to help categorise clients, patients, visits, services, products and financial transactions. Make sure your codes can be used by the software calculating your KPIs. www.rxworks.com

CASE STUDY A real-life example of results of measurement and a change in process

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his practice recognised that they were missing charges in their surgery area – which is not unusual when the process depends on medical staff selecting several items to charge from a large list of options. In early 2010 we suggested that we calculate KPIs for their surgery procedures going back to 2002. The KPIs measured how many of the service categories, shown on the chart, that are normally part of surgery procedures but were missing from surgery visits. You can see that the percentage of surgery visits with charges for the various categories didn’t change much between 2002 and early 2010. They range from a high of around 90% to a low of less than 10%. The high values were reasonable, even though around 10% were missed. However, the low rates for consumables, hospitalisation and medical waste disposal were unexpected and totally unacceptable. In 2010, the practice added a new software and content database function that was designed to reduce the number of manual entries needed to record a procedure. It’s based on

the principle that fewer entries result in fewer errors. It’s also dependent on the fact that the majority of components for the procedures which are provided by the practice can be pre-defined and stored in a database. To facilitate implementation that content database was included as part of our function. The chart clearly shows the effect of the change. Charges for all categories increased to between 90% and 100%. All of the increased revenue from recovery of charges previously missed went straight to the bottom line – as the costs of missed items were being borne by the practice before, just not billed. A by-product was that the invoices were more understandable and educational for the client, reducing their focus on cost and more on the value of the care – as well as being more consistent and accurate. The practice continues to monitor the KPIs to make sure there’s no U-turn in their process.

The effect of Performance Pack capturing missed chances in surgery

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Once upon a time, information was stored in your practice as if on a desert island.

Even when the message was received, it was often in a language that couldn't be read.

And the only way to exchange information

was through a message in a bottle. Enter a universal language that – together with a veterinary data delivery service and they all lived happily ever after

– facilitates electronic dialogues between your PMS and veterinary suppliers.

... THE END

Ask your supplier and PMS provider if they use VetXML, and start making your practice more efficient today! For more information on benefits to your practice and for a list of PMS providers currently speaking the language: visit: www.vetxml.org call: +44 (0)3332 407 636 or email: secretariat@vetxml.org Live services currently using VetXML: Insurance Claims | Microchip Registration | Lab Reports | Lab Requests | Benchmarking | Dietary Advice


PRACTICE DEVELOPMENT

PLANNING for Profitability Riz Akhtar is a partner at RA Accountants, He regularly presents on tax specialism across England, Scotland and Wales.

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ost business owners will have come across the notion of ‘Turnover is Vanity, Profit is Sanity but Cash is King.’ Understanding that profitability is not just about the total income you receive but the total net income you are left with, after all costs are deducted, is key to a healthy and profitable business. There are many methods to increase your top line. This article will focus on a few elementary techniques to set your feet in the right direction. 1. Increase your profit by decreasing your costs margin In order for any business owner to reduce their costs, you must firstly identify all your costs; only then will you be able to consider alleviating excessive costs. There are two types of costs: fixed and variable. Fixed costs are those that a company pays out but does not change, such as rent, rates and staff salaries. Variable costs are generally directly associated with the business activity, with the amount varying. Examples of varying costs are medicines, other medical supplies and potentially locums’ costs. In an independent veterinary practice, the owners usually are fully aware of their own costs; if that’s the case, increasing profitability by reducing costs may not be something they see as a priority. This is an argument that is common amongst business owners; however a specialist external perspective can alter your profitability drastically. A fundamental question you must ask yourself is “what do you do, how do you do it and why do you do it?” Looking into and understanding these points can provide clarity in what needs to be done in order to increase productivity and profitability. In most cases, resources are not utilised entirely or efficiently and there is often waste. As a practice owner or manager, you are responsible for judging waste and therefore the reduction and elimination of non-value adding activity. All veterinary businesses have two major costs associated with them: those that are ‘man’ related and those that are ‘land’ related. Looking into the economics and efficiencies of both is vital to the profitability of the business. For example, you might ask “why is the stock room full of www.practicelife.biz z June/July 2014 z Practice Life

non-sellable stock?”, “why do staff feel so over-worked?” and “why is turnover below the industry average?” Asking yourself such questions will enable you to identify areas to improve productivity or reduce costs. An answer to some of the questions could simply be that clients are taking up too much of the staffs’ time, which is not then being reflected in the price you are charging. 2. Increase your profitability via your trusted staff Creating systems to link staff performance with your top line will allow you to identify and measure the level of service your staff provide to your clients. How do you appraise your staff? The first step would be to set staff targets with a financial reward. They will then be mindful of the financial reward in achieving what is expected of them. You need to keep in mind the concept of ‘fee-earners’. Within a veterinary practice, your vets and your support staff are just that. Training is needed in how to earn fees as opposed to simply conducting administrative and other duties on a day to day basis. The furniture, fixtures and premises are there to facilitate the provision of a service, which in turn will generate revenue for the practice. The service is provided by a vet (a ‘fee-earner’) to a client, and thus must be accounted for. Other concepts to consider are profit by clinician, and profit by treatment type. Many veterinary practices do make a profit, however during the analysis of profit and loss sheets, the two aforementioned areas tend to just break even or make a loss. The justification of a veterinary practice making a profit is generally due to not incorporating the principal or the partners’ time as a cost into the profit and loss account. It is critical that the time costs are identified, as the principal brings the greatest volume of profit into the veterinary practice. 3. Increase your profitability through your purchase order value One way of increasing revenue into the vet practice is through increasing the value of each purchase order. In other words, increasing the amount your clients spend with you. Amongst veterinary practices prices based on value rather than on a consultation are yet to be comprehended, this is predominantly due to the perceived loss to the client, and thus generating a decline in rightful margins. On the other hand the cost of providing a veterinary service has risen and is continuing to surge, making it increasingly difficult for vets to attain reasonable profit margins. Veterinary practices should


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PRACTICE DEVELOPMENT

be encouraged to increase their prices every six months, as opposed to the favoured increase at Christmas time. A suggestion, that will minimally impact your clients, is to increase your prices by 2% in January and 2% in June, giving you an increase of almost 5% over the year and accelerating the cash inflow into your business. 4. Increase your profitability by enhancing your buying skills There is an old saying that in trading, no matter what kind of business you run, a profit is made at the point of purchase, not at the point of sale. The point of sale is a mere transaction which converts a service or stock into cash value. Sales prices, as seen in everyday life, are dictated by market forces, in other words, competition. You can only ensure you make a profit at a subsequent sale, by buying at reduced or low prices in the first instance. Yes – it is suggested that you buy your materials, as well as supplies and services that you require, at competitive market prices. An argument could be made that staff salaries, (which are compared to local market prices) are perceived to be fixed. However, if staff salaries are linked to performance indicators, such as

revenue and profit, then there is scope for negotiation, to help generate an overall profit, rather than being a fixed cost to the business. Cost reduction and improvement of profitability is a scary thought, but you must ask yourself “which type of business manager do you wish to be? One who makes it happen, one who watches it happen or one that wonders what happened”. A good business manager knows what is expected of them and understands what they can achieve through business planning for the foreseeable future. A good business manager will be able to make their surroundings effective and efficient, by utilising the resources available and ultimately creating added value activity for the veterinary practice. Running a business is not an exact science, it is a numbers game. This is a phrase used in the wider business community. Some people are good at it and become life’s Sir Richard Branson, Sir Alan Sugar; and others are not so good at it. But veterinary practices are veterinary businesses at the end of the day, and vets will often have to double up as good business people too. www.raaccountants.com

Disclaimer: These notes are for guidance only and professional advice should be obtained before acting on any information contained in them. No responsibility can be accepted for loss occasioned to any person as a result of action taken or refrained from as a result of reading these notes

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PRACTICE DEVELOPMENT

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6 Tips for Success Many practices are unsure where to begin when tackling the thorny subject of monitoring profitability and how to achieve their goals. It can pay to apply a simple format. Bobbie Flight, Training & Business Development Manager at St Francis, shares six quick tips:

1. Know where you are now The best place to start is really understanding where you are now. Knowing what your strengths and weaknesses are as a business, where the opportunities may lie and what potential threats may await you. I would encourage you to do a SWOT analysis of your business, preferably with your whole team to get a balanced unbiased view and once you have identified your goals look at the gaps in the business from your SWOT and identify what steps and resources you need to take to fill those gaps and get you closer to achieving your objectives. 2. Set bite-sized goals When looking at your objectives only have a few and make sure they are SMART (Specific, Measurable, Action orientated, Realistic and Timely). Always be clear as to exactly what your goals are, otherwise when you communicate them to your team they will be unsure of the direction you are wishing to go, and will fall short in delivering success. When setting your objectives make sure you have a combination of financial and motivational goals. It is very hard to motivate a team with purely financially driven objectives and you will often lose colleagues if they only see pound signs in what you are trying to achieve. Start with some easy wins first and get your team used to the process keeping them informed regularly of progress and celebrating their success on achievement. Once you have a few victories under your belt and team confidence is high you can look to tackling more difficult goals. 3. Small changes make big differences Don’t forget you are working in a largely fixed cost business and very small changes can make a huge contribution to the bottom line. So set yourself bold targets, but make small changes, and you will be surprised by how slightly adjusting what you are doing now can translate into a marked increase in profit. 4. Have a plan and measure it One of the things practices are inherently poor at is having a plan of action. Few have a formal business plan and many will know what they want to do in their own mind but not tell their team members and expect them to deliver results without knowing why. www.practicelife.biz z June/July 2014 z Practice Life

Do a simple outline of what you are hoping to achieve, detailing your smart objectives, a broad strategy and your tactics (action steps) on how you are to achieve your objectives. Share these with the entire team. This will really help to focus your efforts and give a greater understanding of where and how you want the business to develop. Measuring progress is essential if you really want to understand the impact of any initiatives you have implemented and is often a step which is missed. Use your PMS system to track results or set up manual means of identifying progress. Communicate advances to everybody involved no matter how small the achievement; it can really motivate a team who are working hard towards achieving goals. Set regular review dates and continue to be flexible in your approach, amending and adjusting targets if necessary, but ensuring communication is strong throughout the process. 5. Share the plan with your team Don’t be nervous about sharing your plan with your team members. Frequently they will come up with ideas and suggestions that you may not have even thought of and you will learn much about the skill set of your colleagues that may previously have gone unnoticed and untapped. Often your team members will be delighted to take on extra responsibility and really work with you to help achieve your goals. Try to create a ‘solution culture’ so that colleagues will come to you with answers to challenges they are facing, and then give them responsibility for implementation whilst keeping accountability yourself. However, remember if you are empowering people you need to ensure that you have provided all the right tools, training, resources and time to enable them to achieve their tasks. 6. Finally, celebrate your successes I cannot stress enough the importance of recognising team members’ contribution towards achieving your goals. So many times I have worked with practice staff who have been crying out for a thank you or just a little recognition of a job well done. This is your ultimate motivational tool and it is often so underused and undervalued. If your guys have done well, let them know how much they are appreciated and let others know too. It will instil confidence, heighten morale and go a long way to creating a winning culture. www.st-francis.co.uk


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PRACTICE DEVELOPMENT

CASE STUDY: PLANNING FOR PROFIT Penbode Equine is a 4.5 FTE ‘equine only’ department within Penbode Vets based on the Devon / Cornwall border. Director David Rowlands describes the journey that the department has made since its establishment in February 2005.

I

joined Penbode Vets 9 years ago with a clear brief from the directors – build us a successful equine department and you can become a director. This was a challenge that I relished and threw myself into. At the time I had 8 years of experience having worked in equine practice in Ireland, New Zealand and with Rossdales in Newmarket. Being born and brought up in Cornwall, with strong family links to Penbode, I had quietly always hoped to settle there. Penbode Vets (formerly Penhale and Partners) had been established for over 160 years. On my arrival the practice had a well-respected farm animal department with 15 FTE and an up and coming small animal department with 7 FTE. The equine work was being covered by farm vets and equated to 0.5 FTE. Penbode Vets is a practice that has traditionally strived to provide a high level of clinical standards and client care and achieve a good work life balance. My aim was to generate enough clinical work and hence turnover and profit to justify an equine team large enough to achieve a reasonable ‘equine only’ out of hours rota. This approach of starting with a rota that you want to achieve and finding enough work to justify it is quite alien to most accountants. From the outset it was imperative that there was a clear message to all potential clients – our department was ‘equine only’. Penbode had dedicated equine vets – not farm vets doing horse work. The next key step was appointing the right staff. We employed two equine specific receptionists who job shared. Karen Easterbrook and Caroline Barnes had many years of horse experience and could talk to horse owners in their own language. This was vital. In September 2005 I was joined by Gemma Hearn, a talented and extremely personable vet with, at the time, just over a year’s experience. Other people worked with us for periods of time, but it was Gemma, Karen, Caroline and me that consistently drove the department forward. I was very open about what we were trying to achieve. Vets and receptionists were aware that in order to be able to invest in new equipment and sustain a good work life balance that the department needed to gain more clients and work profitably. I involved all team members in many business discussions and decisions. This was their practice. I believe that the fact that we remained together as a tight unit for

over 8 years was instrumental in the growth that the practice has seen. In October 2008, with Penbode Equine running at 3 FTE, I became a director. In 2010 Penbode Vets joined XL Vets. This has proved to be a very worthwhile move. In recent years Penbode Equine has become far more involved with XL Equine. The structured approach of a group of pro-active, progressive practices working together for a common good has aided our department growth. Initiatives such as the recent award winning ‘Old Friends’ campaign has been particularly successful. In the last 3 years Penbode Equine has utilised an external marketing resource in the form of David Burnard of agatheasolutions. David has guided us along the principle of understanding our clients’ needs and expectations, and ensuring that we are seen as the best option for meeting those needs. This in turn has driven enduring profitable growth. The target of double digit growth was set and has been achieved. I view our relationship with David as being similar to that of a sports team with their coach. He keeps us focused on what we ‘should do’ rather than what we ‘could do’. In May 2014 we increased to 4.5 equine FTE. In summary, I believe that our profitable growth is the result of clear vision and leadership, a consistent focused team and working with a marketer who has helped us see the wood for the trees and to communicate our message. www.penbodevets.co.uk/equine-vets-devon.php David Burnard is an independent Chartered Marketer and can be contacted on david@agathea.co.uk or 07516 974 849

Practice Life z June/July 2014 z www.practicelife.biz


HEADING

CPD SHARED

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We certainly struck a note with our first CPD course aimed directly at nurses moving up into a management role. SPVS/VPMA Events ran this day in partnership with the BVNA, offering their members the same discount as our members. The response was overwhelming and we finally closed registration at 65 with a waiting list. As a result, we will be repeating this course in Leeds in November. See www.spvs-vpma-events.co.uk for details of this and our other CPD courses... don’t hang about as they are all selling out fast!

My day at ‘Moving Up’ (A SPVS/VMPA CPD day hosted by Fiona Sims and Claire Stewart from Zoetis)

Kate Ellis RVN, Vale Vets and Vale Referrals An offer to attend a course aimed at the progression from a clinical to leadership role, seemed not only a gratifying recognition of my new position as Deputy Head Nurse, but also an opportunity to give me some tools to help me overcome my lack of leadership experience. My clinical role as RVN at a large referral hospital has developed over the past 6 months and I’ve seen my responsibilities grow to include staff training, clinical coaching, management of the nursing rota, stock control and first aid certification. So I arrived at the workshop in Milton Keynes hoping that by the end of the day I’d be better equipped to successfully introduce new ideas, gain acceptance from my colleagues/ friends, assign tasks and deliver constructive feedback when required. I’ve always found it easy and rewarding to give positive feedback, but I’ve found assertiveness and delegation less easy. Fiona Simms and Claire Stewart from Zoetis were our two course leaders, backed up by their boss, Nick Steele. Learning commenced with a look at the differences between leadership and management, with an analysis of our own leadership styles and the supportive styles needed to cope in a range of scenarios. We then moved on to the process of diagnosing performance via a selection of working models including the competency ladder, ‘horns and halos effect’ and the ‘skill vs. will’ matrix. Understanding performance followed, using tools such as the ‘BECKS’ model and methods for providing feedback such as the ‘STAR’ and ‘Johari feedback’ window. It sounds like a lot of jargon but in context and with lots of case study examples, it all made perfect sense! I met a range of people from within the profession, including senior nurses, head nurses, head receptionists, veterinary surgeons, practice managers, clinical managers and nurse managers. It was really useful and interesting to share experience with delegates who had years of experience, having worked their way up from auxiliary to head nurse and

to compare their experience to others who had entered their practice at a management level. Pebbles, from Ivy Lodge Vets who has the combined role of practice manager and head nurse, said she found the provision of frameworks and models very useful for dealing with staff performance, and said she would take back the idea of measuring ‘skill vs. Will’ levels. Discussing the day over lunch with Leanne, a head nurse, and Anne, a deputy head nurse both at Cromwell Veterinary Group, we agreed it was really good to hear from course leaders who obviously understood veterinary practice. Both said it had been an excellent refresher on management theory they’d been taught or read elsewhere, but what made it particularly good was the insight into how to adapt conventional leadership skills into a small business like a vet practice, which may not have the framework and structure of other larger organisations. Rachel, a head nurse for Vets4Pets, had travelled all the way from Liverpool for the course. It sounded as though she felt the trip was worthwhile as she described it as ‘a first of its kind’. She, like me, found it refreshing to know she is not the only one facing these challenges. Jon, a practice manager at Manor Veterinary Clinic, and one of the few men in the room, agreed that it was really valuable to get time out of practice to chat with other colleagues doing the same job. So did I achieve my objectives? I certainly feel more prepared to manage my new leadership role and feel more confident in my position as a veterinary nursing clinical coach. Identifying different models for providing feedback has helped me to understand the importance of providing clarity and structure. Recognising my own leadership style allowed me to relate to scenarios which I have already faced and hopefully I’ll be much better equipped to face similar challenges next time. To be honest, I had been expecting a day of daunting role-play scenarios but instead was pleasantly surprised by supportive and informative learning in a relaxed atmosphere. Jaqui from SPVS/VPMA Events told me that the course had sold out and I can see why - varied teaching styles, great speakers, group discussion, case studies, lunch and lots of tea, coffee and cookies would not be difficult to sell! But if you missed the first one, don’t despair, it will be repeated in Leeds on 5th November. Remember remember!

For more details and to book, visit www.spvs-vpma-events.co.uk or call Jaqui on 01453 872731. This course will again be run in partnership with BVNA offering their members the SPVS/VPMA discount. www.practicelife.biz z June/July 2014 z Practice Life


CPD DIARY

2014 REGIONAL CPD SPONSORED BY THE COLOURFUL CONSULTATION Wednesday 25th June, Hartsfield Manor, Surrey (10:00-16:30) Contributor: Brian Faulkner, VetPsych

The consultation room is the engine house of the practice, where clinical resolution strategies are set in place (or not!), client bonds are built (or weakened) and profit is generated (or missed!). In this, the second of Brian Faulkner’s very popular Colourful Consultation courses, he identifies 4 specific outcomes of an effective consultation; clinical resolution, client satisfaction, financial resolution and team harmony’n’happiness. Brian breaks the consultation up into five crucial stages, each of which is necessary to help vets deal with the inherent tension that comes

with trying to keep colleagues, clients, bosses and yourself happy all at the same time. The theory is brought to life with examples from Brian’s own experience of running a successful practice as well as his one to one training sessions with other vets. You will learn about how to apply the psychology of client satisfaction as well as how to measure the effectiveness of consultations plus top tips on how to work effectively with receptionists, nurses and other vets… and keep to time!

Who will benefit: Any vet who wants to improve their own consultation technique or any manager or practice owner wanting a better understanding of the inconsistencies in how their vets perform.

CONFLICT MANAGEMENT Wednesday 9th July, Village Hotel Solihull (10:00-16:30) Wednesday 23rd July, Preston Marriott (10:00-16:30) Contributors: Nick Steele, Zoetis plus Practice Case Studies Managing conflict in the workplace can be one of the biggest challenges a manager faces. This might be conflict directed at you from a colleague or client, or conflict between two members of staff. In this brand new course, from one of our most popular speakers, Nick Steele and his Zoetis colleagues will take you through some simple techniques that can be learnt starting with how to listen to the angry person and work backwards to the source of the anger. Once these techniques have been learnt they

can be applied to managing difficult situations with clients OR with colleagues. The day will include role play and case study scenarios together with interactive sessions to allow you to share experiences with other colleagues and you will leave with the tools to help you tackle difficult situations together with simple tips to help you train your reception team.

Who will benefit: Managers, head nurses or head receptionists.

TRAINING THE VETERINARY RECEPTIONIST Thursday 11th September, Norton House Hotel (10:00-16:30) Contributor: Brian Faulkner, VetPsych

Veterinary receptionists are critical, not only to client satisfaction, but to achieving clinical resolution and optimising profit. Veterinary receptionists need a spectrum of skills, but all too often veterinary receptionist training is ad hoc and ‘on the job’ and can be one of the biggest challenges to running a practice. Poorly trained receptionists will have a knock on to the whole team resulting in inconsistent client experiences.

You will be shown how veterinary receptionists are pivotal in ensuring pets, owners, nurses and vets work together to achieve optimum clinical resolution. And how, by getting this right, they contribute to optimum financial resolution. It goes without saying that happy, effective receptionists are key to a positive and productive practice culture. The day will include case studies of practices with such successful embedded reception training programmes.

Who will benefit: Practice managers, owners, head nurses or head receptionists whose job description includes training the reception team. Practice Life z June/July 2014 z www.practicelife.biz


WHAT’S COMING UP

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TOP 10 ESSENTIALS TO KEEP YOU LEGAL AND COMPLIANT Wednesday 24th September, Hartsfield Manor, Surrey (10:00-16:30) Contributors: Samantha Deakin, Citation; John Ingram, LS Fire Group

This day offers a practical update, refresher or introduction to current H&S requirements and legislation, including radiation, waste regulation, COSHH and Risk Assessments, fire safety, staff safety protocols and medicine legislation compliance. You will leave knowing what you need to know and what you need to do to ensure your practice is legal and compliant.

Includes a practical workshop in completing Risk Assessments and a question and answer session in which Citation will share the most commonly asked questions to their helpline. There will be a practical demonstration on fire safety, tailored to vet practice, with the chance to try out fire extinguishers and fire blankets and including a separate certificate.

Who will benefit: Anyone new to H&S or feeling in need of a refresher.

GOOGLE MASTERCLASS Wednesday 8th October, Hartsfield Manor, Surrey (10:00-16:30) Contributor: Susie Samuel, vethelpdirect.com

Social Networking and the internet can be powerful marketing tools, but in a rapidly changing world, do you have a grip on how to control the message? This one day course will give you the tools to ensure you optimise your online presence and make sure people can find you first.

You will leave with key tips on how to manage what others are saying about you and how your practice looks online. If you have attended our Websites, Facebook, Twitter and Tweets course last year, this is the logical next step. If you haven’t, but are reasonably familiar with social media and want to take your knowledge to the next level, then this day is not to be missed.

FACEBOOK MASTERCLASS Wednesday 22nd October, Village Hotel Solihull (10:00-16:30) Contributor: Susie Samuel, vethelpdirect.com

A practice’s Facebook page is becoming almost as important as their website in attracting new clients and bonding with existing ones. It is the human face of your practice where you can exchange photographs and tips and keep your followers up to date with practice news.

It will also cover promoting your page, pinning, tabs and highlighting, scheduling, and social network aggregating. It will also consider how to deal effectively with negative comments and guard your online reputation, and what to include in your social media policy.

This one day course is aimed at practices who already have a facebook page that they would like to take to a new level. It will look at techniques to make it look good and how to maximise your hits and likes.

This is a brand new course from Susie Samuel and the Vet Help Direct team, put together exclusively for SPVS/VPMA and building on the success of her sell out social media events and Google Masterclass.

All CPD courses can be booked online at at www.vpma-spvs-events.co.uk or by telephoning 01453 872731

www.practicelife.biz z June/July 2014 z Practice Life


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HEADING

WHAT’S COMING UP... FOCUS ON DIGITAL TECHNOLOGY Thursday 19th June, Staverton Park (10:00-17:00)

This one day mix of workshops and exhibition is your annual refresher on everything from Practice Management Systems, image storage and digital phones to the latest smartphone apps. We’ll give you the latest on how to measure your online performance or how to track your Facebook profile alongside the case for tablets in the consult room (not the kind you swallow!). All the leading PMS providers will be there so you can spend some quality time with your technical support or, if you are in the market for a new system, compare and contrast what’s on offer from the others.

Thinking of upgrading your digital storage systems for your x-rays and imaging? This is a complicated area and it is worth comparing and contrasting what’s on offer. Or maybe you want a new website and are looking for inspiration from other practices. Exhibitors will include PMS providers, website designers, social media consultants, and digital imagery and telecommunication system suppliers all under one roof.

There’s still time to book! Tel 01453 872731

FOCUS ON DIAGNOSTICS Thursday 16th October, Staverton Park (10:00-17:00) Workshop streams chaired by Brian Faulkner, VetPysch and Peter Southerden, Eastcott Referrals

If you are trying to decide what equipment or skills to invest in and how to ensure a return on your investment, then this is the day for you. Expert-led workshops will offer tips from suppliers and practising vets on everything from making money from dentistry to deciding between in house or external labs. And once you’ve decided what you want to buy, we’ll help you plot a finance model to pay for it.

Exhibitors will include laboratory and diagnostic imaging companies, suppliers of specialist equipment such as laser therapy, dental and laparoscopes and providers of financial packages.

Book online at www.spvs-vpma-events.co.uk or by telephoning 01453 872731

‘About the best day’s CPD I’ve been to in 10 years!’ ‘Excellent lectures.... good environ ment to talk to suppliers.’

Don’t miss the Autumn Issue (out 12th September...) Special features: In the spotlight with Ernie Ward Setting up nurse clinics Let’s talk! Avoiding disciplinary through conflict management Top tips for interviewers and interviewees

Practice Life z June/July 2014 z www.practicelife.biz


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www.moore-scarrott.co.uk Head Office: Calyx House, South Road, Taunton, Somerset, TA1 3DU Wolverhampton Office: 4 Compton Road, Wolverhampton, West Midlands, W V3 9PH Telephone: 01823 282100 Fax: 01823 254396


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Practice Life Magazine Issue 4 June/July 2014