Hello and welcome to the July edition of our newsletter.
he sun is shining and everyone’s getting ready for the first Summer of restriction-free travel, more importantly, business seems to be booming for many of you, which is great to see!
For the last few months, one of the top news stories each day has been related to the increasing cost of living in the UK. In this issue, we are taking a more in-depth look at the cost-of-living crisis and what this means for employers.
Our Managing Director, Jane Braithwaite has also been busy answering Independent Practitioners’ FAQs on how to take advantage of the self-pay boom to increase your profitability and grow your business.
We would like to round up the issue by introducing you to our management team who head up our specialist teams across the business.
We are here to help provide professional services and advice for your business’, if you have any questions please don’t hesitate to contact our friendly team.
For the last few months, one of the top news stories each day relates to the increasing cost of living in the UK. The headline this morning is that inflation has hit the highest rate in 40 years and reached 9% in April 2022. Energy prices are increasing drastically as well as the cost of food, clothing and many other household items. As a result of the increase in inflation, the Bank of England has recently raised the base rate of interest for the first time in many years, putting more pressure on homeowners with higher mortgage payments. With the additional increase in National insurance, this is all putting a significant number of people in the UK under financial pressure.
What does this mean for us as employers? I think it is safe to assume that most employees would like a pay rise in their current job or they will start to look for a new role with a higher salary. As employers, there is a risk that we will lose staff if we do not take action to support our current employees.
Most employees will be demanding a pay increase at least in line with inflation so that they feel they are at least standing still in terms of their financial wellbeing. But for most employers, the prospect of giving every individual within their company an inflation-based increase is simply not a possibility.
Offering every employee, a pay rise in line with inflation is not only difficult for most employers to deliver, but economists would warn us against doing so for other reasons. I am no expert when it comes to economics, but my understanding is that economists caution us against increasing salaries across the board, which will allow spending to continue at current levels, which will cause inflation to continue to rise resulting in a vicious circle. I am happy for anyone to question this of course, as many readers of the IPT will have a far deeper understanding of the issue than I can claim to have.
Research shows us that one of the most common causes of stress for individuals is their financial well-being and this is going to become a major concern for many more in the coming months and potentially years. As employers, we also appreciate that if our teams are feeling stressed in their personal lives, they are not going to be able to perform to the best of their abilities in the workplace and extreme stress can also lead to a higher absence rate from work, due to ill health.
So, what do we do to support our employees through this difficult time?
If increasing salaries in line with inflation are not possible and not advisable, then what do we do as employers? Maybe the answer is to increase salaries where possible by a margin, not in keeping with inflation, but enough to try to alleviate the situation for individuals, especially for those on lower salaries.
There may be other ways in which employers can help by thinking beyond the immediate issue of salaries.
Several schemes may be relevant to our employees including season ticket loan schemes which aim to help employees where the cost of commuting is a major budget item. Research by the company Employee Benefits confirms that this is one of the most common benefits offered by employers, with 59% of employers doing so. The season ticket loan is an interest-free loan for employees to cover the cost of travelling to and from the workplace via modes such as tram, rail, bus, etc. Some schemes can also be used to cover parking costs too. The loan repayments are paid monthly through the employee’s net pay over a set period.
For keen cyclists, the cycle-to-work scheme could be an attractive possibility. It allows employees to save 26 to 40% on their bikes and accessories. The employee has no upfront payment, and the monthly payments are taken tax efficiently from the employee’s salary by their employer.
During the Covid pandemic, when we were all advised to work from home, if possible, the government introduced tax breaks to help alleviate higher energy bills. From April 2022 this tax break has been tightened and whilst some employees can claim, for many this is no longer possible. Without a doubt, heating costs are higher for those working from home and next Winter this will become more of an issue. If the government is not going to provide support for home workers, then employers may need to step up. For companies who have introduced a working from home strategy, there will be cost benefits associated with reducing the need for office space and a proportion of this saving could be passed on to employees to help with the increasing cost of energy.
A different type of approach would be to offer an Employee Discount Scheme to help employees save money on their purchases. These schemes offer employees discounts for products and services that they are likely to buy regularly. For example, one company called PerkBox offers discounts at Sainsbury’s and M& S.
The final suggestion is to help employees manage their finances more effectively by offering access to support services and financial training. There are lots of organisations and training providers offering such support and these could prove to be very helpful to some employees. This type of approach needs to be handled with extreme care to avoid any suggestion that employees are being judged or criticised. Over the last few days, we have seen numerous politicians slated for their comments regarding individuals being unable to budget and unable to cook. Yesterday it was suggested that individuals solve the issue by taking on extra hours or an extra job. All of these comments appear tone-deaf to individuals who are working hard just to keep their heads above water!
Again, I repeat that I am no economist, but everything I hear and read suggests that the cost-of-living crisis is going to be a long-term issue and so, as employers, we must do what we can to support our employees. One obvious solution for our employees will be to move to a better-paid job and so if we do not take action our biggest issue will be a recruitment crisis, which is time-consuming and expensive. Retaining our employees by supporting them will prove to be the best option for both employer and employee.
If you have any specific questions that you would like answered in coming editions, please do get in touch
MD of Designated Medical
At Designated Medical we believe that with the right professional team to support you, your possibilities are endless. That is why we offer flexible, experienced support for all your private practice needs. An integrated approach allows our carefully selected team members to embed into your practice, allowing you to concentrate on delivering exceptional service and care for your patients. Our experts offer bespoke support across Accountancy, Marketing, Medical PA, HR, and Recruitment and can work to suit your requirements – tailored to your practice, as and when we are needed.
This month: ‘How do I improve staff retention and ensure my team is stable? Recently, I have lost two members of staff and it will take me a long time to recruit and train new team members.
Losing a member of staff is always painful and has a significant impact on team performance and the morale of the remaining team members. When an individual chooses to leave their role, it is natural for their colleagues to feel unsettled and to question their own position within the organisation.
They are also likely to be asked to pick up extra work while a replacement is found and then take responsibility for training and mentoring the new recruit. The whole episode puts immense pressure on the entire team and can have a damaging effect on service delivery. When the Covid pandemic first hit us, many of us suspected that one of the negative outcomes would be high unemployment. But we were wrong and the opposite appears to be true. The majority of jobs survived the end of the Government furlough scheme and the fear of a huge spike in unemployment has not materialised.
Record number of vacancies Vacancies are now at a record high, with some newspapers reporting 1.2m vacancies and a shortage of skilled workers, which is having a drastic impact in many industry sectors, including the healthcare and care sectors. One recruitment specialist has reported ‘fierce competition for talent’ and there are reports of graduate lawyers being offered starting salaries of £150,000 and signing-on bonuses by employers desperate to compete in this shortage market. In general, though, average pay rises are not keeping up with the increase in the cost of living, and while wages are rising, they are not rising as fast as prices. This will lead to more people searching for a new role purely for better remuneration. Currently, it is so much harder to recruit due to a shortage of available candidates and so replacing staff is much harder and more time-consuming. Retention of key staff is vital to protect our organisations in the current climate.
How do we ensure we retain our employees? Most managers assume that salary is the major motivator for their employees. While salary is important, especially with the rising cost of living, for many people there are other more significant factors. Many employees are more highly motivated by other factors such as flexibility, culture, career development opportunities, geographical location and their relationship with their direct manager.The pandemic has led to many people thinking about what they want from their working lives with a new perspective. They have been reminded that life is short, and they want to make the most of their time, both at work and in their social lives. Many are burnt out by the pandemic and desperately in need of a break to regroup and recover. Most have taken fewer holidays over the last couple of years and this has had a cumulative effect on exhaustion. The well-being of employees should be a major concern for all employers. The recruitment firm Randstad UK says that, in a typical year, 11% of workers would move roles, but its recent research in a survey of 6,000 workers found that 69% of those surveyed were feeling confident about moving to a new role in the next six months.
The Great Resignation
This trend is often referred to by the press as ‘The Great Resignation’ and is going to be hard for industries like healthcare, where the prediction is that some employees are looking to leave the sector completely, resulting in a reduced pool of available workers. If you have had resignations within your organisation, one valuable way to learn why your employees are unhappy is to hold exit interviews with employees before they leave. An exit interview should be hosted by an individual who is not directly working with the employee so that the meeting can be credibly viewed as confidential to encourage honesty and transparency. The interview offers an opportunity for the employee to express their reasons for leaving and to suggest ways in which the organisation can improve to retain valuable workers in the future. A similar approach should also be adopted with all employees to understand what motivates them most about their work, what they are happy about currently and where your organisation is able to improve. Asking questions like what additional support would benefit them will give you valuable insight into options to improve. An HR expert will wisely advise you to create the Employment Value Proposition (EVP) for your organisation, to help you with the retention of employees and the recruitment of new team members.
As business owners, we spend much time thinking about patients and clients and how we want them to perceive our organisation, but, to create an EVP, we need to think about our organisation through the eyes of our employees. An EVP states what employees receive in return for the talent, enthusiasm, loyalty and contribution they deliver to our organisations. Your EVP will give you a competitive advantage in retaining your employees and attracting the best employees to join your organisation. This is especially relevant to organisations that do not have the budget to compete with the remuneration offered by larger competitors. You can promote other unique qualities that differentiate your business from your competitors, thus attracting the right talent.
An EVP should provide incentives that reward hard work and create a supportive, inclusive working environment. Start by identifying all the benefits of working at your company and the unique strengths of the organisation versus its competitors in terms of remuneration, working environment, career progression, learning and development and culture. This could be done as a team exercise at a workshop-style meeting or through the use of a simple questionnaire sent to all employees. Covid has changed the face of the working environment and more companies are adopting a hybrid working solution. Where this is not possible – for example, in many healthcare settings – businesses are providing more flexible working solutions such as job sharing and condensed hours to attract target audiences who value flexibility and a healthier work-life balance. Opportunities for career progression are also an attractive proposition for high potential individuals who are looking for challenge and growth. Many employers like to showcase success stories of people who have risen through the ranks and who have been encouraged and supported throughout their career journey from entry-level positions to senior-level roles.
Examining the company’s policies on training, performance development and promotions will give clarity on the company’s attitude towards career progression and growth and how the company supports this by providing opportunities for learning and development and rewarding good performance management and development practices. The culture reflects everything from human, social and even political issues. Identifying with the corporate culture can help candidates determine whether or not their values and beliefs are aligned with those of the company. If candidates share the same beliefs, attitudes, and behaviours as those identified by the company, this gives them some reassurance of a harmonious working environment which could lead to a longer-term working relationship. Other benefits can also cover aspects such as financial strength and constant growth, unique services and a strong commercial footing, and reassuring candidates in terms of security, stability and longevity. In each stage of the EVP definition process, consider how the company fares against its competitors in terms of remuneration, working environment, culture, and career progression. This will help to establish the company’s unique selling points against the competition and promote aspects that are more generous or attractive than your competitors. Creating your EVP will help you identify areas where you need to improve in your organisation and this will lead to increased employee retention. According to research from Gartner: ‘Organisations that effectively deliver on their EVP can decrease annual employee turnover by just under 70% and increase new hire commitment by nearly 30%.’
‘Should I charge patients for phone calls and answering their questions sent by email? These take up a lot of my time
The traditional model of seeing patients face to face has been challenged over the last couple of years and patients have become more accustomed to talking to their doctor by video, phone and emailing questions.Many private GPs and consultants were challenged by the number of patient phone calls and emails prior to Covid, but we have definitely seen a marked increase.Being able to provide patient care in a number of different manners brings advantages, and a mix of approaches can be adopted to improve the patient experience.But in private healthcare, we need to be mindful of how we charge for these different interactions, what the insurance companies allow and also how patients react to different fees.Pre-covid, most private doctors charged for face-to-face consultations and accepted there might be a couple of phone calls or emails as follow-up, especially if surgery were needed, and there would be no charge for these follow-ups.
At no cost
I recently met a consultant who had seen a patient for one face-to-face consultation and had received 28 follow-up emails from them in the following 12 months and had replied to each one at no cost. Taking into account the amount of time invested in the care of this patient, the one-off consultation fee did not nearly cover the cost of care provided. So how do we charge patients appropriately for these new interactions? There is a convincing argument to charge the same fee for a virtual/video consultation as for a face-to-face one. The length of discussion is the same, as is the nature of the discussion, and so it follows that the fee should be equal. Some patients may prefer to meet via video either due to time or geographical constraints and see this option as advantageous to them.
Major insurance companies allow consultants to charge for consultations that are not face to face and they describe them as ‘remote’. Initially, the amount allowed was capped to a maximum limit, but this was challenged and it is now possible to charge the same fee for a virtual consultation as a face-to-face one.
Bupa themselves run a virtual GP service where the fees are based on the meeting time. A 15-minute call with a GP will cost £49 and a 30-minute call will cost £89. A remote consultation can also cover a consultation via phone call rather than video, and some patients prefer this, as they don’t like the perceived intrusion of video or they see no added benefit in being able to see their consultant’s face. I make no comment! The big question is how will patients react to being charged for a phone call when they have come to expect these ad hoc calls as part of the overall service and thus free? Some patients will feel that introducing a fee for these calls is too much and will object strongly. This is obviously less of an issue for insured patients, although many of them may incur an excess fee. For self-pay patients, we need to think very carefully about how these fees are introduced.
One tip I would offer is to ensure that phone calls are positioned as appointments rather than ad hoc interactions. I would set up a process with your medical PA whereby phone calls are scheduled into your clinic even if your preference is to add them at the end of your face-to-face clinics. The message your medical PA delivers to the patient will feel different. The patient will understand that they have a scheduled appointment within your clinic rather than a perception that you will call on a slightly ad hoc basis at the end of your clinic.
But how do patients feel about paying for emails and prescriptions? Replying to patients’ emails can be very time-consuming, especially if the patient is asking lots of detailed medical questions. Most doctors I know do not charge for these responses, but maybe they should? It is far more common to see a charge for prescriptions, though. To the best of my knowledge, most insurance companies do not cover costs for emails or prescriptions. As with all fees, it is essential that the patient knows in advance the cost of their care. When a patient books an appointment, they must receive confirmation of the likely cost of treatment. Most medical PAs have a standard email they send to confirm an appointment, which also details the likely cost of treatment, and this should also be used when confirming a video consultation. If you are charging for email responses and prescriptions, these costs must be provided in advance too.
The ability to charge appropriately for the services offered in private healthcare will continue to be a challenge and it is important to continually review the actual cost of providing the care to our patients and attempt to recover these costs.
There are so many patients on NHS waiting lists and many of these are considering self-pay private treatment. How do I attract them to my practice?
A deeply concerning impact of Covid has been the increase in NHS waiting lists for healthcare treatment and this is generating growth in the number of patients in the UK opting for self-pay private treatment. Reports suggest a 30% increase in self-pay treatment in April 2020 compared to pre-Covid levels. It was reported in Independent Practitioner Today in October 2021 that self-pay patients amounted to one-third of all private hospital activity for the first time. When planning to access private care, a self-pay patient needs advice from a knowledgeable and responsible source, regarding which hospital and which consultant to see and this advice would often be offered by their GP.
But a significant impact of Covid has been the increased pressure on GP services throughout the UK. And one of the most worrying impacts for patients has been their inability to make an appointment with their GP, either face to face or online. In recent months, the Government has been pushing GPs to make more face-to-face appointments available and, in October, they announced a major NHS drive to improve access for patients.
The Government has promised an additional £250m extra for GP practices to enable these improvements. GPs will need to extend their opening hours and offer walk-in appointments to access these additional funds. In the short term, though, we can assume that there are an increasing number of individuals in the UK who are looking for private healthcare. If you are a consultant in private practice who is keen to provide support to self-pay patients, then you will want to ensure they are able to find out about you and the services and treatments you offer. I know a lot of doctors feel uncomfortable with the concept of marketing and, to overcome this concern, I prefer to talk about communications. Your communications with existing and potential patients and potential referrers will increase your opportunities to see additional private patients.
The starting point for any marketing plan is to clarify your target audience. Think about:
The treatments you offer;
Who is your audience;
Who is your ideal patient.
Think about age, sex, geography and lifestyle. By having a clear definition of your audience, you can make good decisions about how to reach your target patients.
How do patients find a doctor to treat them?
As the pressure on GPs is currently significant, patients may be using other routes to find their treatment: asking friends and family. Word-of-mouth referrals and recommendations are hugely valuable to all doctors working in private practice and a positive way to increase the number of patients that you treat. Every patient you have seen in the past is a potential source of referrals for you. We also know that potential patients will do their due diligence before booking an appointment with you to validate the recommendation they have been offered and to check that you are the right doctor for them. The easiest way for them to do so is performing a Google search on your name and the results of this search are what we refer to as your ‘online reputation’. Your potential patients will be checking out your ‘online reputation’ prior to booking an appointment with you, so I recommend you regularly check your online profile and ensure it provides an accurate and positive representation of you and your practice. A very basic, but often overlooked, starting point is to ensure that your contact details are correct on all websites where your profile is published. Ideally, you should include the name of your medical PA – as this reassures patients that your practice is professionally set-up – a phone number that is not a mobile and an email address with your own domain and not a Gmail address.
Appropriate content. It is also important to check that the content on each website is appropriate, considering who the audience will be. Most profiles are aimed at potential patients and yet many doctors write their profiles with their medical colleagues in mind, listing their CV and medical education.
A patient wants to know if you are the right doctor for them.
Do you treat their condition?
Do you understand their symptoms?
Do you offer the right type of care?
So your profile needs to be written to reassure the patient that you are the right doctor and ensure they follow through to book an appointment to see you.
Personal profile One great asset that is totally free is your own personal profile on private hospital websites where you practise. Each private hospital group has a directory of consultants on its website and your profile will be featured here for potential patients to review. It is really important to ensure that your profile is up to date and accurate. You should also make sure you list all treatments that you offer. When a patient visits the hospital website, they will be looking for a particular treatment and you want to make sure your name comes up as a potential consultant in the search results. The word ‘branding’ may sound like marketing jargon and so we encourage you to think about it in terms of your identity. You want to create a consistent online identity and ideally every mention of your name and your practice should have that same identity. This should also extend to your stationery, business cards, email signature and letterheads. All your photos must also be professional and should look consistent.
First impressions count
Your website is the most important and valuable aspect of your online profile, as you are completely in control of the content and the look and feel. Visitors to your website will decide in the first 30 seconds whether your website is relevant to them and so first impressions are important. The look and feel of your website, the branding, your logo and the colour palette will have a significant impact on your visitor’s decision to stay or leave. Once you have convinced the visitor to stay on your website, you need to ensure it is easy for them to find the information they are looking for and, most importantly, you need a strong call to action. Your ideal call to action is to encourage your visitor to book an appointment with you either via phone, email or ideally online. Online booking is common in many industries and is growing in popularity in private healthcare. In the next couple of years, we expect to see this become the norm and it is important that you implement an online booking system to avoid being left behind. An alternative call to action is to ask your website visitors to sign up to receive your regular newsletter.
A patient newsletter on a monthly or quarterly basis is an effective way to stay connected with your growing community of patients and doing so is likely to increase word-of-mouth referrals, as patients will remember to mention you to friends and family. Please ensure that your newsletters are managed in a manner that complies with the General Data Protection Regulations, though. All doctors should be encouraging patients to leave reviews about their practice, as these are incredibly powerful to prospective patients looking to book with you. It is human nature to be influenced by others and reading your previous patients reviews are very reassuring. There are several platforms for gathering reviews that you can choose to use and you may decide to use more than one, but it is certainly vital to be using at least one. You should also promote your patient reviews on your own website.
Social media gives you the opportunity to communicate regularly with your patients and potential patients and, as with your website, you are completely in control of the content. Ideally, your social media will create engagement with your patients and so as well as posting relevant content, it is important that you respond and engage with your community. The choice of social media platform you use should depend on your target audience and the type of content that will appeal to them. Whichever platforms you choose, you should ensure consistent branding across your social media presence and plan regular updates to avoid a social media graveyard where nothing has been posted for several months. Finally, if you are willing to invest in your marketing, you may be interested in using Google AdWords and Pay Per Click (PPC). This is paid advertising that you can set up to target your potential patients when they search on your chosen search terms. These campaigns can deliver remarkably successful results.