Nurture your staff’s mental well-being.

Nurture your staff’s mental well-being.

Mental Health

From the start of the Covid pandemic, we have been very aware of concerns relating to mental health and the increased number of people suffering from mental health problems.

This has largely been due to lockdown and the impact that has had, and we have heard how it has affected everybody, both young and old. More lately, we are hearing about the enormous toll on healthcare workers and some very concerning discussions relating to this.

As people who work in healthcare, we need to be very aware of the mental health issues employees – and we ourselves – may be experiencing.

It is important that we gain the best understanding so that as leaders, managers and role models, we can help and support our people – and to know what support is available for those who need it.

Before Covid, we knew mental health-related issues were the most common cause of long-term sickness in UK workplaces.

Surveys performed by the Chart­ered Institute of Personnel and Develop­ment (CIPD) in 2019 reported that the impact of stress, in particular, had increased, with 37% of respondents saying that stress-related absence had increased in the last year. They concluded: ‘Work-related stress, depression or anxiety accounts for 44% of work-related ill health and 54% of working days lost in 2018-19.’

As well as sickness absence, poor mental health at work can lead to increased staff turnover, reduced engagement and high absenteeism.

Mental health problems affect around one in four people in the UK in any given year.

As we recover from Covid, there is much evidence to suggest that the pandemic and measures taken to manage it, such as lockdown and social distancing, will have a significant impact upon the mental health of employees and the impact may be felt for months or even years.

How will Covid-19 affect our mental health?
We do not yet know what the exact impacts of the pandemic on our mental health will be. People have been affected in different ways: many feeling isolated, others are fearful about catching the virus themselves and also anxious about their family and friends.

Employees in healthcare have been working long hours with few rest periods in very difficult circumstances throughout the pandemic and have possibly not had the time or opportunity to reflect on their own well-being.

The workload in the healthcare sector is destined to remain high. As Covid numbers have decreased, many individuals have been involved in the vaccine roll-out and are now facing the pressure of addressing long waiting lists of patients requiring non-Covid treatment.

This long-term stress has taken a toll and continues to do so. Our best defence against mental health is resilience, but, to maintain resilience, individuals need time to recuperate and this has not been possible in healthcare and is unlikely to be possible in the near future.

Lockdown’s impact
Mind, the mental health charity, reported that over half of adults and over two-thirds of young people said their mental health declined during lockdown. Young people and those with pre-existing mental health conditions were particularly affected.

The health impacts of lockdown include findings of fatigue, musculoskeletal conditions, poor work-life balance, reduced exercise and increased alcohol consumption. In relation to workplace mental health specifically, employees were reporting reduced motivation, loss of purpose, anxiety and isolation.

Evidence from previous quarantine situations also suggest that there are long-lasting effects on mental health.

Independent Practitioner Today is currently serialising parts of the book called Beneath the White Coat – Doctors, their minds and mental health, edited by Dr Clare Gerada, first published in 2020 (see page 42). In the book, the stress experienced by doctors is examined using supporting evidence and real-life case studies and offers practical steps for doctors to recover and thrive in their roles.

The book also demands policy-makers, government and hospital management ensure doctors are looked after and have access to the resources needed to ensure they remain healthy.

Working from home
Many people have been working from home during the pandemic and while most have found this to be more productive, still one-in-three people have found the opposite, according to research by MetLife UK.

Almost one-in-three (32%) workers admit that their productivity has declined as a result of the shift to home working. Of these employees, two in five (41%) believe that their mental well-being has impacted their productivity levels. The impact is understood to have been more apparent for younger groups aged below 30 and also older women aged 50 plus.

There is also a marked difference between the statistics reported by employees and those reported by employers. Employers believe there has been a greater decline in productivity, with 56% of employers reporting that they perceive their employees’ personal well-being has impacted their productivity levels. This is significantly higher than the 32% of workers who reported their productivity has declined.

Productivity is absolutely key in any business, including healthcare, and therefore it follows that we should be concerned about our employees’ mental health and how this affects the productivity of our teams.

We need to do our best to understand the issues that our teams are facing and support them by implementing management strategies to reduce the impact in the workplace.

Understanding the issue
As mentioned previously, there seems to be a huge amount of information stating the enormity of the mental health problem caused by Covid, but there does not appear to be much research yet giving us useful data to understand the specifics of the issues and indeed how to address them.

One of the greatest challenges is that individuals are often unlikely to ask for help when they need it, and this is perhaps more extreme for those working in healthcare, who feel they should be able to manage their own well-being.

As managers and leaders, we need to work hard to encourage openness and make it easier and more comfortable for people to ask for help.

HR management
Most larger healthcare companies will have in-house HR departments providing expert support and who will be defining organisational strategies to help their managers and leaders deal with mental health issues in the workplace.

For smaller organisations, there is less support available and managers will need to address these issues themselves.

In an attempt to provide a useful guide, our HR managers have provided some input that I hope will be of value.

What is workplace mental health?
Obviously, healthcare professionals have a much greater awareness of mental health illness, but it is still useful to define what we are dealing with in relation to the workplace.

Mental health, like physical health, fluctuates over time and there are degrees of severity. Symptoms include struggling with low mood, anxiety and stress, and we know stress can contribute to other illnesses.

Conditions include depression, anxiety, phobias and bipolar, which tend to continue over a prolonged period.

As employers, one of our objectives should be to help individuals feel comfortable in talking about how they feel. In doing so, we must avoid attempting to diagnose and instead focus on discussing how the issues impact the employee’s work and their work life with a view to agreeing a plan to provide additional support.

A range of measures will need to be introduced and a good starting point for any manager developing their strategy is to understand our legal responsibilities as an employer.

Legal duties
These legal duties set the minimum requirements and must be adhered to, but there is a wealth of evidence arguing that employers who go above and beyond will benefit from improvements in employee engagement, reduced absence, reduction in staff turn-over and improved organisational culture.

Employers have a duty to protect the health, safety and welfare of their employees, including mental health and well-being.

The UK Health and Safety Executive defines work-related stress as a reaction to excessive pressure or other type of demand placed on an individual at work. It is the employer’s duty to assess the risk of stress-related mental health issues arising from work and to take measures to control the risk.

Employees who have a mental health condition may be disabled and will therefore be protected from discrimination during employment as defined by the Equality Act 2010.

Employers are required to make reasonable adjustments for employees with disabilities, which may include amendments to working hours, location of work, changes to duties and the provision of additional equipment.

Prevention is always better than cure, but obviously, in the case of mental health issues, prevention is not necessarily within the employer’s control; however, there are early actions that can be taken.

Supporting the mental health of employees in healthcare, many of whom continue to work under significantly increased pressure making them more vulnerable to stress and other mental health conditions, is vital and it is warranted to take a pro-active approach.

Preventative measures largely relate to improving organisational culture by increased communication so that mental health issues can be more easily addressed and supporting managers by ensuring they are well informed, as they will play a pivotal role in the handling of any issues. (See box below).

Providing support
Managers need to know the typical signs and symptoms of poor or declining mental health exhibited in the working environment.

These can include the following:

  • Workaholic tendencies: Working long hours without breaks;
  • Increased absence due to sickness;
  • Any uncharacteristic behaviour: Emotional responses to situations which could include tearfulness or anger;
  • Withdrawing from others on the team.

Any of these behaviours in isolation clearly do not imply that an individual has a mental health issue, but they do provide an opportunity for a manager to discuss well-being with an individual, which could prove to be valuable in preventing a potential issue.

When a manager holds a one-to-one discussion with an individual, it is important they do not jump to any conclusions. Ideally, the conversation will start with an open discussion about how the employee is feeling, although we know that people are often reluctant to talk openly.

Within an organisation where mental health and well-being are discussed regularly, hopefully the employee will feel more able to be open and honest.

When an individual asks for help, it is important that help and support is made available in a timely manner.

In a large organisation, the HR department may become involved to provide support and potentially the occupational health team, if needed.

In a smaller organisation, it may be relevant to seek advice from outside organisations and there are many suitable providers.

Throughout any discussion of this nature, the manager must be non-judgemental. It is very clear that all people managers have a serious responsibility in their employees’ well-being, and they will also need to be supported and guided through this process.

Support available
The Chartered Institute of Person­nel Directors provides a wealth of information on its website and while it is not specific to healthcare, it is a valuable resource for all managers dealing with HR issues.

Specific to Covid, it is valuable to access the most up-to-date information and Cochrane produced a report, which was updated in January 2021, entitled ‘Supporting resilience and mental well-being in frontline healthcare professionals during and after a pandemic’.

The International Labour Organ­isation has also recently produced a report entitled ‘Protect the mental health of health and care workers in the Covid-19 pandemic’.

Finally, the Academy of Medical Royal Colleges has a page on its website summarising all of the organisations available to provide support in relation to mental health matters for those working in the healthcare sector.

Over the coming months, we will have access to much more data regarding the long-term impacts of the Covid-19 pandemic. As leaders, we will need to learn and evolve to ensure we provide the best support possible so that we can continue to lead successful, high-performing companies and teams.

If you would like any further information in relation to this article, please do get in touch. I am always very happy to help and I am sure that my team of HR professionals will also be able to help with most workplace well-being questions.

 

 

Furlough going forward, what you have to pay from July 1st, 2021.

Furlough going forward, what you have to pay from July 1st, 2021.

Furlough doctors july

Furlough has been somewhat of a saving grace to both employers and employees since the beginning of the pandemic. Now as coronavirus cases begin to ease, with the help of the nationwide vaccination programme, the UK government has announced changes to the scheme which come into effect July 1st, 2021, with subsequent changes also from August 1st, 2021.

The current scheme: The Furlough funds that are currently available to businesses in the UK allow for a grant of up to 80% to cover an employees pay, up to a maximum of £2,500 per month. Employers can choose to top up to 100% if they wish.

Flexible Furlough is also an option. An employee will work only some hours, which their employer will pay them for in full, the grant will cover 80% of pay for the employees unworked hours subject to a cap of £2,500.

What will change for employers as of 1st July 2021?
From the 1st of July 2021, the Government’s grant will reduce to pay 70% of a Furloughed employees wages instead of 80%. However, monthly pay for Furloughed staff must remain at 80%, (at a cap of £2,500) so employers must contribute 10%, up to £312.50 each month.

What will change for employers as of 1st August 2021? From 1 August 2021 until the scheme ends, the Government’s grant will reduce a final time to 60% of Furloughed employees’ wages for their unworked hours (capped at £1,875 per month).

With the 80% pay still required for employees, the employer’s contributions will increase to 20% (up to £625.)

So from July until September employers will need to plan to be able to cover the cost of 10% – 20% of their employees’ wages, national insurance and pension contributions.

If you would like any assistance as we move into this next phase, the Accountancy team at Designated Medical would be more than happy to work with you to ensure you are meeting new requirements and responsibilities as an employer.

Our Head of Accountancy services Vicky, would be more than happy to discuss this in more detail with you, get in touch: vicky.garbett@designatedgroup.com.

 

 

 

 

 

Did you know your team can claim up to £250 for working from home in 2020/2021?

Did you know your team can claim up to £250 for working from home in 2020/2021?

working from home

If like many private practices you have had to take some work online, remotely with your staff from home during 2020 and 2021, they can submit a tax claim of up to £125.00 for 2021/22 tax year. If they also worked from home last year (tax year 2020/21) then they could be eligible for up to £250.00 tax relief for both years.

Are they eligible?

  • They will need to have started working from home during the pandemic.
  • Encountered higher costs due to home working.
  • Working from home costs not already been covered by you, the employer.

How can they claim?

With so many of the UK population still working from home to some degree, the government set up an easy to use website making It easier than before to claim back tax relief: https://www.gov.uk/tax-relief-for-employees/working-at-home

If their application is successful their PAYE tax code will be changed and they will be able to take home more of your income tax.

The tax relief they will receive depends on their income tax band. All taxpayers can get a flat-rate of tax relief on £6 a week; basic-rate taxpayers will gain £1.20 a week (20% of £6), which equates to £60 a year. Higher-rate taxpayers can gain £2.40 a week, which is 40% of £6. This equates to £125 a year.

They can claim more and submit evidence if they have incurred more costs working from home.

 

Business owners and self-employed.

Self-employed workers can claim for more costs when working from home, such as a proportion of the costs when lighting, heating, cleaning, insurance, mortgage interest, water rates and general maintenance are used for work.

To work out the proportion, you’ll need to account for the amount of time you’re using your home for work, and in some cases the size of the area within the home that’s used for work purposes.

For example, if you work in a study you’d only be able to claim for the costs of heating that room while you work.

2021 Budget Announcement

Earlier this year Rishi Sunak announced a number of schemes and support plans for small businesses, these include:

• Restart Grant
• Help to Grow scheme
• Self-Employment Income Support Scheme
• Recovery Loan Scheme
• Super-deduction tax break for investment
• Business rates holiday
• Reduced VAT for tourism and hospitality
• Relief as no increase to Capital Gains Tax

You can find out more about these schemes and how they could apply to you and your business here.

https://smallbusiness.co.uk/budget-2021-and-what-it-means-for-small-business-2552090/

 

 

 

 

 

 

 

 

 

 

Credit control and how to ensure you get paid

Credit control and how to ensure you get paid

chasing-money-large

 

TopTips2Invoicing and credit control is a time-consuming task in private practice, but it is essential for obvious reasons. Yet it is the area of practice management that is most often overlooked. Jane Braithwaite reports.

Many doctors and medical secretaries are highly focused on patient care, as they should be of course, and therefore billing and collecting the money becomes the lowest priority.

It is not natural for a doctor to switch conversation with a patient from their symptoms and care plan to payment.

Likewise, a medical secretary has often chosen to work in the field of healthcare due to a desire to care for patients and is less comfortable handling the billing side.

Private consultants can sometimes struggle with the contrast between private practice and working for the NHS. It can be difficult to feel comfortable charging for your medical services after years of NHS work, which is ‘free’ to patients.

Robust credit control

But managing payments and debts is crucial for any business and you will not thrive or grow as a private consultant without a robust credit control strategy from the outset.

In a bigger clinic or hospital, there is often a department that handles invoicing and billing. This team will often be more aligned with the finance team and this makes total sense. But in a smaller practice, billing must be handled by the secretarial team.

It is well reported in the business world that cash flow is king, especially in the first years of a new business. This is just as true for a consultant working in the private world as it is for a clinic or hospital.

Delays in receiving payment can put a great deal of strain on cash flow in a private medical practice and we need to ensure this is avoided.

Using good systems will help alleviate and automate much of the process relating to invoicing and collection. It is also key to define good processes and ensure the system is set up to support these processes.

Most private clinics will be invoicing both insurance companies and self-pay patients. They may also be invoicing embassies and legal companies.

You may already have a practice management software system in place, which could also handle billings, reminders and management accounts.

This could also make it much easier to comply with increasing requests from insurers to send billing information electronically using electronic data interchange.

Submitting invoices electronically will also speed up payment settlement, which should greatly help with credit control.

Electronic billing

chasing-moneyThe use of technology is imperative, particularly for invoicing insurance companies.

A good practice management system will link to Healthcode and allow electronic billing. All private doctors should be using this technology, as it ensures that insurance invoices are dealt with very quickly and smoothly.

A good practice management system will also ensure that invoicing self-pay patients is simple and easy.

Invoice templates can be created with pick lists of the most commonly used items. Invoices can be sent to patients via email or by post, if preferred, but I would use email as widely as possible to reduce costs and eliminate delays.

Insurance shortfalls

Shortfalls from insurance payments will need to be dealt with in the same way as self-pay patients. It seems that many aged debts are due to lack of transparency over insurance shortfalls.

Patients simply are not aware that their insurance will not cover the entire cost of the consultation, treatment or procedure. This could be remedied by improving communications with patients.

It might mean incorporating a short discussion about payment in the consultation itself, reworking the written information given to patients afterwards or even following up appointments with a short email to clarify information.

If you are sending invoices to embassies and law firms for medico-legal work, these will be created in the same way as for self-pay patients, but a greater focus on chasing for payment will be needed, as these invoices often take much longer to be paid.

My advice would be to attempt to build relationships with key contacts within the organisation to smooth the way.

Reconciliation

The next step in the invoicing process is to reconcile payments received against the invoices issued. If you are using electronic billing for insurance patients, this process will be easier for you.

Insurance companies will regularly send you remittance advice notes that need to be checked against the invoices on the system.

If self-pay patients are paying by credit card, the payments should be marked as paid on the day payment is made. There is nothing worse than chasing a patient for payment when they have already paid.

chasing-moneyBankers’ Automated Clearing Services (BACS) payments will need to be reconciled with bank statements and that is a harder task than it sounds.

Encourage patients to quote their invoice number when making a payment to ease the process.

Payments should be reconciled regularly so that you have an accurate picture of your current debt. I would suggest that a reconciliation is done at least weekly.

At the end of each month, a report of current debt should be produced and reviewed by key members of the team to identify and address issues early and therefore avoid that debt growing into a mountain of unpaid dues.

Credit control process

Each practice needs to define their credit control process. An invoice sent to an insurance company or self-pay patient may be paid promptly, but quite often this is not the case and the debt will need to be chased.

There will always be patients who do not pay on time and standard protocols to collect payment owed will need to be followed.

A robust monitoring system must be in place so that you can keep track of reminders sent. This can be managed within your practice management system.

A good practice management system will allow you to set up a process for chasing debt, but you will need to define the parameters. You can set up standard template letters to be sent after certain periods of time.

The time allowed may differ depending on your practice. You may feel that patients should be allowed a month to pay before receiving their first reminder.

This might be the case in a practice where you are seeing the patients regularly and have every confidence that they will pay at their next appointment. In another practice, you may want the reminder to be sent seven days after the initial invoice.

Reminder letters

You can set up a series of reminder letters to be sent by email to patients chasing their payment.

These letter templates must be created and while the first might be a very gentle reminder, the third reminder needs to be a little sterner.

Eventually, someone will need to pick up the phone to chase payment and that is not a task liked by most. If a patient is ignoring your letters, then a phone call may be just what is needed to prompt payment.

Again, you need to decide at what stage this occurs. Do you wait one month or three months before taking such a step? What feels right in your practice?

Debt collection

chasing-moneyThankfully, most patients do pay what is owed, but there will be a small percentage who ignore emails, letters and phone calls.

You need to be clear on how you will handle this. Are you happy to accept a certain percentage of non-payment and simply write this off? Or do you want to take this further and involve a debt collection agency. Obviously, this is a last resort, but one you will need to consider.

Whether you are running a large hospital or a small clinic, you have a choice whether to handle invoicing and credit management in-house or to outsource.

In-house billing and collection

Many consultants choose to handle credit control themselves when they first start out in private practice, in partnership with their medical secretary. This can be a workable solution while the practice builds, and needs to be scal­able once the practice becomes busier.

You may need to employ additional members of staff to manage the workload. You may employ a medical secretary and a billing specialist who are able to work closely together but have defined roles. As always, effective and clear procedures need to be in place from the very start.

It is imperative that administrative and financial processes are reviewed regularly and documented to avoid key person dependency. You do not want to find yourself in a situation where someone is sick and no one else knows how the systems and processes work.

There are a number of accountants who specialise in the private medical sector who could help with reviewing and recording your clinic procedures. And while this may seem expensive, it may turn out out to be a cost which repays the investment many times over.

Consultants and their secretaries often find chasing debts to be an uncomfortable task and not one that fits easily with the medical ethos.

You will need to ensure that you and your team stay informed about technological advances so that you and your patients can benefit from them.

On the positive side, handling invoicing in-house means that you have complete control and can feel comfortable that every communication with your patients is made by a member of your team.

Outsourcing invoicing

chasing-moneyMany consultants move their entire invoicing work to an external company, which will send invoices, liaise with insurers and chase payments.

Most of these companies charge a percentage fee for the invoices they process and collect on behalf of your practice.

They can also chase aged debts and provide a variety of management reports such as insurance breakdowns and bank reconciliation information.

Some firms have their own custom software for this, while others integrate with industry-standard practice management software.

The primary advantage to outsourcing billing and collection is that consultants can spend more time concentrating on developing the medical side of the business.

The downside is the additional cost, although this should be weighed against the potential savings outsourcing may provide. Consultants should also consider whether relationships with patients could be negatively impacted by moving invoicing to an external company. As always, communicating regularly with patients may help offset any problems.

Following the tips provided in this article may hopefully mean fewer debts are left to chase.

 

Jane Braithwaite is Managing Director at Designated Medical and regularly contributes to the Independent Practitioner Today publication.

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What is a bookkeeper?  and why you should hire one.

What is a bookkeeper? and why you should hire one.

That pile of receipts and invoices is getting bigger AND you haven’t updated your cash flow spreadsheet in 2 months!  You know roughly where you are financially with your business but how do you get a clearer, accurate and more up-to-date picture? Most SME’s live and die by their cash flow so employing effective bookkeeping and accountants is invaluable to the overall growth and stability of your business. What is the difference between a bookkeeper and an accountant and which one is the right one for you?

Accountant vs Bookkeeper

An accountant will generally look at your ‘books’ on a quarterly basis and advise on VAT, Corporation Tax owed and other such legal requirements for your business.  As well as classifying, reporting and summarising financial data. A bookkeeper will work on day-by-day basis recording financial transactions chronologically and advise on any cashflow problems or late payment invoices and in some cases, can help with classification and financial reporting.

Most business will really need both services, but often they only engage an accountant largely because they feel they can handle the day to day activity themselves but also to help reduce costs. But is this a sensible decision?

Business owners are so busy running their business, that the task of recording of financial transactions and performing a reconciliation get left to the end of the quarter when the VAT return is due. That also means that for much of the time their view of their company’s finances is several weeks out of date. Some business owners get so behind that their accountant is brought into clear the backlog and this can be a significant expense as it’s not the core business of an accountant to handle this type of work.

At Designated Bookkeeping, we would strongly recommend that all business owners employ a highly trained bookkeeper as soon as they are able to afford to do so. A good bookkeeper brings two distinct advantages: –

  1. Relieves the pressure on the business owner to manage the day to day finances freeing him/ her up to grow their business
  2. Ensures financial control with accurate up to date data.

For more information on our bookkeeping services please visit: designatedbookkeeping.com/ or call us on 02079521460.

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