Large Animal & Equine Clinical Director Meeting April 2018
Agenda Welcome & Introductions VetImpress Farm system George Brownlee Business Update Survey results presentation - Peter Edmondson Farm Animal Advisory Board Procurement update - Chris Kingdon/Andy Hardie AMR John Blackwell Pricing strategies in LA practices Francis Sabbe Graduates & CPD - Donald Kingsnorth
Practice Management System Rolling out VetSpace Voyager to all IVC practices temporary pause VetIMPRESS mobile solution intended to be part of the rollout process for Farm and Mixed practices We need to make changes to Voyager to enable Farm and Mixed practices to make best use of the system. Pilot site beginning April 2018
Strategy and Business Update
IVC Group Acquisitions Current surgeries within the group to Feb 782 (560 UK) & to date 782 (539 UK) Number of surgeries already joined this financial year 116 (92 UK) Generally integrating well
Mixed Practices Farm and Equine Scotland & N Ireland England, Wales & IoM 1. Rogart Vets Dornoch 2. Links, Lothian 3. Wards and Bellevue Vets - Elgin 4. Avondale Vets Strathaven 5. Provost, St Andrews 6. Kilbarchan Vets, Kilbarchan 7. Crown, Fort William 8. Seafield, Keith 9. Ardene House, Aberdeen 10. Strathspey, Grantown-on-Spey 11. Kessock Equine, Inverness 12. Castle Vets, Castlewellen 13. MBM, Kilmarnock 14. Abbey Vet Clinics 15. McKenzie Vets, Kilmarnock 16. Crieff Vets, Crieff 1. Three Rivers Beccles, Norfolk 2. Usk Vets Usk, S Wales 3. Robson & Prescott, Morpeth 4. Milan, IoM 5. Vermuyden, Goole 6. Brownlow, Shropshire 7. Chapelfield - Norfolk 8. McPhersons, Worksop 9. Wilton House, Guisborough 10. Blenheim, Ashbourne 11. Portland House, Retford 12. Mearley, Accrington 13. Deane Vets, Taunton 14. Kingswood, Chobham 15. Vine Tree, Ross-on-Wye 16. Delaware, Yeovil 7 in Mixed Practices Due Diligence
Mixed Practice Material Margin Ranking Practice Sum of MTD % Sum of YTD % Group Budget Group Average 1 McPhersons 87.0% 85.0% 83.4% 82.7% 2 Mearley 79.2% 84.8% 83.4% 82.7% 3 Brownlow 85.3% 84.4% 83.4% 82.7% 4 Fort William 83.3% 83.2% 83.4% 82.7% 5 Chapelfield 76.6% 82.9% 83.4% 82.7% 6 Castle Vets 86.9% 82.7% 83.4% 82.7% 7 McKenzie 83.5% 82.6% 83.4% 82.7% 8 Deane Vets 82.1% 82.4% 83.4% 82.7% 9 Wards Vets 79.3% 82.0% 83.4% 82.7% 10 Links Vets 82.1% 81.9% 83.4% 82.7% 11 Wilton 82.0% 81.7% 83.4% 82.7% 12 Milan 80.4% 80.9% 83.4% 82.7% 13 Ardene House 71.3% 80.8% 83.4% 82.7% 14 Crieff Vets 84.1% 80.6% 83.4% 82.7% 15 Kilbarchan 77.6% 80.5% 83.4% 82.7% 16 Vermuyden 76.0% 80.4% 83.4% 82.7% 17 Robson & Presco 77.7% 79.8% 83.4% 82.7% 18 Blenheim 77.8% 78.2% 83.4% 82.7% 19 Three Rivers 68.4% 76.2% 83.4% 82.7% 20 Usk 79.5% 76.1% 83.4% 82.7% 21 Provost 73.8% 75.4% 83.4% 82.7% 22 Portland 75.7% 74.1% 83.4% 82.7% 23 Vine Tree Vets 79.2% 73.2% 83.4% 82.7% 24 Rogart 60.1% 70.0% 83.4% 82.7% 25 MBM 71.7% 66.0% 83.4% 82.7% 26 Avondale 56.2% 65.1% 83.4% 82.7% 27 Strathspey 49.6% 61.6% 83.4% 82.7% 28 Seafield 39.7% 56.0% 83.4% 82.7% 29 Delaware 77.9% 54.7% 83.4% 82.7% Mixed practices ranked on YTD material margin. 6 practices above group average and three above group budget. 13 practices below a margin of 80% YTD, however some of these are relatively new so this could improve as we progress through FY18
Farm Animal and Equine How should we Develop Our Strategy?
Farm Animal and Equine How should we Develop Our Strategy? Some Background We have a well defined small animal strategy, developed with our CDs, PMs and Office Team Small animal practice acquisition was originally at the forefront of our acquisitions, but more mixed practices have joined in the last 2 years as we have become broader in our thinking We now have around 30+ practices in the UK with a reasonable proportion of farm and equine work Our European colleagues in Evidensia have some high profile farm and equine practices. We have had 3 FA/E CD meetings to date An acting Advisory Board helped on pharmaceutical rationalisation Challenges & Opportunities What should our vision be? How do we ensure cohesion and share best practice? Are there similarities between the practices working with farms who's size ranges from larger scale farm production to crofters? Should we be looking at a pan European approach with our colleagues in Evidensia and if yes, how best to facilitate? How do we promote higher levels of organic growth? What can we do to develop our B2B relationships Is there enough similarities between equine and farm for joint meetings? organisations are more likely to succeed if they focus on one thing, and do it well. By doing so, they can beat their competitors and become truly great businesses - Jim Collins, from Good To Great With Large Animal, what should we focus on?
Farm Animal Priorities? This is the rationalised list still to be worked on 1. Recruitment, Retention, Grads, CPD (including exchange visits and rotating staff between practices in the UK and overseas within Evidensia 2. Promoting IVC practices for health, welfare and production (including Position on CIAs (critically important antibiotics) 3. Fee structure options & debt management 4. Marketing - health plans newsletter content, best practice guides, training materials for client meetings, 5. Linking to National organisations
Advisory Board
Advisory Board Members 1. Andrew Rafferty, Strathspey 2. Tim Caldwell, Avondale 3. Andrew Millar, Ardene 4. Kate Matheson, Robson & Prescott 5. Mike Bardsley, Three Rivers 6. Francis Sabbe, Chapelfield 7. Ben George, Usk 8. Martin Fitzpatrick, Castle 9. Alison Burns, Portland 10. John Blackwell, Brownlow 11. Owain Jenkins, Delaware
Advisory Board Agenda Welcome and Introductions Purpose of the Group and Terms of Reference General Discussion on FA Priorities and Strategy Procurement Debt Management with Farm work Practice Management Solution Alignment of dairy sector approach to mastitis control to reduce antimicrobial use Graduates and CPD for FA Large Animal CD meeting agenda Terms of Reference
Practice Management Solution
Update Autumn 2017
IVC Farm Practice Survey Peter Edmondson April 2018
Summary 18/36 replies with variable answers! Many were unable to breakdown financial breakdown Most practices were single site 40% have dedicated TB testers 30% have vet techs/foot trimmers 70% have dedicated farm OOH rota Frequency of farm newsletters 10% monthly 40% every 2 months 10% quarterly 40% whenever!
Number of Farm Vets Number of farm vets
Farm work as % of total practice turnover
Main work ~ Dairy or Beef (10 practices)
How do practices bill? Top 10 practices
Fee income ( k)/vet
Fee and medicine sales per vet
IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh Large animal invoicing and pricing strategies/ policies Dr. Francis SABBE, DVM, (M.Sc.V.M.), M.Sc.Trop.V.M., MRCVS Clinical Director Large Animals Chapelfield Vet
Francis SABBE, CV: IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh 1986: University of Ghent: Masters Degree in Veterinary Medicine 1987: Prince Leopold Tropical Institute: Masters Degree in Tropical Veterinary Medicine 1987-1993: Lecturer Faculty of Veterinary Medicine, University of Zambia 1993 1997: Private Practice, Lusaka, Zambia 1997 2002: Technical & Marketing Director Exports, Vetagro International, France 2002 2008: Partner in Private Practice, LA, Cronat, Burgundy, France 2008 2015: Senior Registrar, Department of Livestock Services, Faculty Veterinary Medicine, University of Sydney 2015 2017: Lecturer, Production Animal Health Clinic, School of Veterinary Medicine, University of Adelaide 2017 - : CD Large Animals, Chapelfield Veterinary Partnership, IVC
IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - The Zambian Model (Consult = a bottle of wine) - The French model (Consult + Double mileage) - The Australian model (Consult + Single mileage, capped to 100 Km, shared mileage if multiple visits in same area) - The Chapelfield model (No mileage charges, apart from far away Consult fee)
IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - Do we need uniformity across IVC - LA practices? - Do we need models, guidelines? - Do we need fixed rules?
- Consult: IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - What does a consult include? - Presenting at farm, without travel (charged separately, or no travel charge) - Travel from practice to farm and return - Travel to farm + 15 minutes of Professional time
- Consult: IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - Different types of consults: - Standard Consult - Consult with extra charge for far away clients - OOH Consult - Routine/ herd health Consult - No charge - Reduced charge - Consult for repeat visit for same patient (Reduced) - Other types of Consult charges (Emergency Consult non OOH)
- Time charges IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - From arrival on farm till departure from farm. - Herd health time charge (per minute) - Surgery time (charged per minute) - Do we charge surgery per unit of time? - Do we charge surgery per procedure? - Time charge for reports, farm health plans, research, analyse farm data, etc.
- Travel charges: - No travel charges IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - Single mileage (from practice to farm, from farm to farm, one way) - Return mileage (from practice to farm and back to practice) - Shared mileage if multiple visits in same area - Capped mileage charge
IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - Other professional charges (after consult) - None - Examination of an animal - Examination and advice - Examination, advice and treatment - Professional acts (PD, AI, ET, Surgery, Regional anaesthesia, Epidural, Paravertebral anaesthesia,. Complete the list) - Injection fees - SC, IM, IV, Fluid therapy,
IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - Charges for pharmaceuticals - Full bottle/ unit/ pack size pricing - Price for detailing, price per ml (same or higher) - Price per ml administered (same or higher) - Price per ml inclusive of needle and syringe????? How is this feasible (standard charge whenever detailing a full unit)
- Additional charges IVC, Large Animal Clinical Directors Meeting, Tuesday, 17 April 2018, Edinburgh - Charge for surgery kit - Charge for disposables - Other charges??????