Hello everybody, and thank you so much for joining us for today's episode of Vet Chat. So today we are very fortunate to be joined by Gillian Page, who's gonna be speaking to us around how we can achieve business success and gain better profit in practise. Gillian was one of the first RVNs in the UK to own a veterinary practise and was co-founder of Ayrton Veterinary Hospital near Edinburgh.
The business opened from a cold start in 1999, progressing to a purpose-built veterinary hospital in 2006. Gillian was part of the design team for the hospital and co-project managed the year-long build. In December 2017, Gillian led the sale of her practise to Independent Vet Care Limited, and she stayed with the practise as business director until January 2021.
As centre manager for the College of Animal Welfare, she was involved as deputy programme leader in the setting up of Scotland's first Bachelor of Science Honours degree in veterinary nursing. Gillian's interest is in clinical workflow, leadership and practise standards, believing that structure and standardisation in practise can help achieve quality assurance and professional confidence. Gillian is currently senior vice president of the veterinary Management Group.
Of which she was president from 2019 to 2020. So welcome, Gillian, thank you so much for joining us today. Hi Catherine, it's lovely to be with you today.
Hello, so Gillian, could you start, please, obviously you've had such an incredible career. Could you start just by telling us a little bit about your, personal story, and specifically, you know, how the idea of starting, you know, from scratch and building a new practise came about, please? Yeah, sure.
Well, I suppose the first thing to say, Katherine, would be that, apart from having a love of the vet profession, still, I'm someone who has always been energised by being able to affect positive change and development and improvement. I, Very much enjoy creating and implementing improved and more efficient ways of working, especially when those ways of working are for the benefit of patients and the people that are caring for them and in a veterinary environment, . As you say, before I started the practise, I had a very, very career within the profession, so working in a university, private practise, education industry, and then eventually that led towards practise ownership.
But you know, the theme running throughout for me was a motivation and an aim of encouraging a positive change in the work environment. And so whenever I moved position, it was always to, or for want of a new role that allowed me to continue to grow as a person. I suppose that's actually a long-winded way of saying that I feel I had the mindset for ownership, of Ayrton long before it actually materialised.
Something to say here, and it seems almost unbelievable, and I'm now hoping I had the right year, is that until 1999, the year that we opened the practise, non-vets couldn't actually own a veterinary practise. So whilst I might have daydreamed about it, ownership, just wasn't something that I ever thought would be open to me, . So moving on to how it came about, well, following my graduation.
In 1995, . I moved to Derbyshire to be with my vet partner Tony, who I had met whilst I was a locum. So he had already started to formulate a plan of opening his own practise, and we soon realised that we shared a vision of the type of practise that we would both love to have.
So the thought was that we would open a practise, Tony would own it, and I would be employed by it. But in 1999, the rules changed, unbelievable, and it seemed logical, and for me by this time, it was now non-negotiable that we raise the finance together, we share the risk and we become equal partners. So with that decided and with a business plan in hand, we approached the high street banks for funding, and everybody says it's so easy, but it isn't.
I have to say it wasn't. Unfortunately, the answer was no. And so we had the choice of, do we believe the banks that we didn't have the experience to do this, or should we trust ourselves that we can do it and go ahead, so we decided to go ahead, .
We bought land within a year, and the council, the local council agreed to grant us planning permission when we eventually did raise the money to build the hospital. Although it was an expensive way to do it, we took out personal loans to rent a portabin, buy the necessary startup equipment, and Tony's dad kindly helped us with some of that too. I would say here though to anybody that's thinking about it, I really wouldn't recommend personal loans.
It's such a, it's such an expensive way of starting up. But having said that, we did pay it all back within 5 years. So yeah, that's a real positive.
So our initial hope of getting funding after 3 years of hitting our financial targets was not to be, and it wasn't until year 6 actually that we were given the green light to go ahead and build the practise. I know, we had, we had already designed the basic building, and I think the very first drawing of that was actually on a discarded cigarette packet on a BA flight from Gatwick to Edinburgh. So it was a huge risk then back in 1999 with everything that you did.
You know, you, did you feel, did it feel at the time like it was a big risk? No, would be the answer to that, Catherine. No, we didn't, I think, .
I'm a very optimistic person. What was not foolishly, but I think excitement and positivity, just took over, and in actual fact, no, we didn't think it would be. The build was a year-long one and we co-project managed it, which saved us a, a fortune in picking up any deviations from architects drawings and things, but it was enjoyable.
Doing that most nights. I, I think, yeah, we were just beyond excited at the thought of it. More excited than anything else.
Yeah, definitely. So did you, so you said you both co-managed the project, did you, from start to finish? Yes, we absolutely did.
I mean, we had hired a very, I'd actually seen a local health centre that I loved the design of, and I contacted that those architects to say, would they build us? And the answer was no. We were too small, but I didn't, I persisted, so I asked them, well, would they not at least come out and meet with us, before saying no, and they were saying, you know, you're really too small, that we don't build anything less than 20 million.
So I thought, well, come and meet with us anyway. So they came out and they were taken by our optimism, I think, and excitement, and they agreed. So it was a year-long build.
And we were keen that costs were kept down and so we definitely asked that we call Project manage it. So the hospital opened on the 15th of May 2006, and we renamed it after our beloved cat, Ayrton, and as people who've heard me chat about it before, he was called after the Formula One racing driver Ayrton Senter, so they share that honour. Oh, that's lovely.
And that was when, sorry, 2006. Yeah, 2006. Wow, that's brilliant.
It's did you ever feel being a woman, did you, did it ever make you doubt that your practise would, you know, be successful or successful? Did you, did you feel that it had sort of no impact on, on the sort of progression of the project and its success? Did I feel, I don't personally feel that my gender's ever negatively impacted my career or or been a barrier to having a leadership position or other opportunities.
And certainly with Ayrton, our team, regardless of gender seem to respond to me as a human, and gender doesn't appear to feature. Having said that, having said that, like most women, I would imagine there have been times where, Although it's not of any consequence, it's more disappointing than anything. I have had to dig deep to shrug off comments or attitudes.
So for example, when we opened Ayrton, although there was an instant, external recognition and an appreciation for Tony's achievement, my own contribution tended to be a little bit glossed over. It was very much a case of that's Tony's practise, although I think his wife gives him a hand. But fortunately though, I'm someone who keeps it light and I tend to focus on the intention and the results because they will eventually be seen.
But you know, I might be about to say something unpopular here, but I think it's important to say, and in my own experience, that on those occasions when there have been some obstacles put in the way, and they haven't been many, I've been incredibly fortunate, but when they have been, it can be by both men and women that create them. I think we should say that, which is the same really, because everybody knows how fabulous we are as women, and so we should be always encouraging, celebrating, supporting each other's progression and any achievements. I think one day gender, gender won't be an obstacle to anything, and that'll be fabulous, but we're not quite there yet.
Yeah, no, I absolutely agree. That's great. Thank you, Gillian.
So what would, what would you say are the main areas that you focused on to ensure that your business will be successful? You know there are there are so many areas, there's so many areas to ensure that we were successful, but I think for today's time on the webinar, I'll I'll pick 3 if that's OK. The first one, a clinical workflow, so we try to Or we worked towards that the right person was doing the right job and in an efficient and resource supported way, so vets were carrying out.
Surgery and diagnostics, RVNs were carrying out an enormous range of tasks that they qualified to do, and animal care assistants were supporting both RVNs and vets in the day to day running tasks, which can, you know, they're often thought of as menial, but without them, a practise just does not run. They're absolutely essential to the smooth running of a practise. We focus on having receptionists from a customer care background who would be a stronger face and a voice representing the business effectively and professionally.
So really, I suppose in short, we were streamlining things, making sure that we weren't employing additional staff that weren't needed, that if we were using the entire vet and support team appropriately, I mean by that. The second thing, fees, so fees. The world is ever changing, isn't it?
And so we wanted our profits or financial success to be based on the confidence of our professional fees and not on a markup for medications or food or retail. So we didn't phone surrounding practises while I say that not more than once or twice. And, and instead, we worked out what our costs were, the running costs, and what profit ideally we would aim to make.
And from those calculations, we worked out what our professional fees should be set at, so important. Third, stock, definitely stock. We made sure as a team that the stock on the shelf reflected the accurate figures that were being given by our business management system.
Something that often amazed our wholesaler whenever they visited us. So I would say that was my, my top 3. Yeah.
Brilliant, fantastic. So you touched upon the support team. Was there in practise, did you have quite a nice culture and quite a good working environment, would you say?
Have you got any advice around that for our listeners? I'm just just thinking about that one, Catherine, my experience has taught me that this is an ever moving and changing thing, isn't it, and that one that requires continued attention always. My key thoughts though, .
Be kind, be considerate and be respectful to those around you. Take personal responsibility, so that we support those around us and respect our colleagues, and that mix does help people bond, trust and develop a good working relationship, . And in terms of that necessary positive leadership to be open, honest, communicate directly, have those difficult and uncomfortable conversations.
Address any issues that there may be generally in practise or with individual team members quickly before they become bigger than they need to be and even more difficult to resolve, and work to work to keep an equilibrium through the team really. And lastly, to recognise individual and collective strengths and use them. Encourage contribution.
Growth and development with the other people that we work alongside, and particularly for those in a leadership role, obviously we want success for our teams and businesses, But sometimes we also need to look at our environments, and by looking at our environment that we can then decide if we're creating the energy and the motivation that's needed to produce that success. That's brilliant, thank you, that's, that all sounds great. With the practise, how did you make it sort of stand out from the other practises at the time, you know, was there anything that you did to make your practise different from the others, would you say?
Well, we didn't, I suppose I'd say we didn't set out to make it different, so much as we wanted it to be a very personal practise. And one that would work for staff, patients and clients alike. It is a business, obviously it's a business but we wanted to make it a personal one too.
A practise where we could put into place a working culture, a structure, clinical protocols, and working processes that were in line with our values and beliefs as people. So I guess the first thing we looked at was the working environment, which I just mentioned there, that the building itself should be a space that would be. Comfortable and positive and one that promoted wellbeing for those working in it, so that if we were tired at the end of a day, and we often are, aren't we, it wouldn't be due to our surroundings, and I think we did achieve that in terms of the design of the building and also the materials that we used through it, .
Other than the, the environment that we created, there are again, so many things that I could mention today, but I've picked out just a few. And to see that although they would be probably considered quite commonplace now, they certainly weren't at the time when Ayrton opened, . So I said we looked at natural, the environment, we looked at natural light, and it's so important for our wellbeing, isn't it?
And so we wanted it everywhere. So it's a very open and spacious design with loads of windows and skylight, but we also placed doors strategically through it so that there would be a a through pool of air to stop things overheating as as as it not common in Scotland, but you never know. As well as light, we thought about noise through the building, you know, we were keen to minimise that for people and pets.
So in the consulting rooms and the dog wards, we soundproofed those. When you have many people rushing around the building, it can create quite a lot of noise, can't, can't it? And that adds to stress sometimes on the day.
So we wanted to reduce the noise, and so we used acoustic flooring in patient areas and clinical working areas like theatre prep and consulting. And for patients that stayed with us, we had separate waiting rooms, wards, work areas, as I say, all common now, but it wasn't in those days. And we also wanted all of our kennels to be walking ones so that we thought about backs, you know, years of lifting dogs in and out of kennels does leave you with a, an uncomfortable back at times, .
And then in terms of rest areas for for all of us, we fitted them with good quality and comfortable furnishings so that in the years to come, it wouldn't look tired and dated, which it can do sometimes. So these types of things that I've just said, they were more expensive, there's no doubt about it. Like we got eucalyptus woods, shipped over from Portugal.
Because I thought it was such a warm, warm, friendly, thing, and there's so much wood, isn't there? So if you're surrounded by it all day, it's nice for it to be lovely. So we focused on the high quality things, but with a view to that, it would be minimum maintenance, and in 15 years, we would still be in an environment that was uplifting.
Yeah, it sounds it sounds amazing. It sounds like you literally thought of every little detail that went into the, into the bill. Well, with the, the build was one thing, Katherine, and then our next thought was how we would all work within it and how thinking over my many years in practise as well, how chaotic and pressurised general practise can be at times.
So we looked at a vet working. And we introduced, you asked me about how we made it different from other practises. Well, as I say, we were trying to make it personal.
So we were thinking about the often chaotic pressurised environment. So we decided to introduce a few things that might ease that and help people to feel more or have an equilibrium through the day. So we, for vets, we introduced a surgical day and a consulting day.
I've often marvelled through the years how vets go from consulting to surgery and back again without a break, and they've got to maintain this, consistent high performance under a, a time pressure. So we felt if they had the idea of splitting those two functions, what as a surgical vet, they could focus on inpatients and surgical patients. With a very limited two hour consulting in the afternoon.
So basically a limited client facing to take the pressure off some days, and then on a consulting day, the vets would purely focus on consulting, no need to think about surgeries and patients or anything else. We had implemented a 15 minute consultation right from day one in the port cabin, so that was back in '99 and we continued with that. It does give time to do a good clinical job, but it is also despite what some people may say, it is very financially successful.
And just another thing that we put into both those rotas was a time for case management. Watching vets and nurses over the year, it's, it's often that you don't have time during the day to manage cases properly, which makes you feel like you're not doing a good job, which adds to the stress. So we included an hour each day of time that you could just You know, look at diagnostic results, direct the team on patient care, speak to owners, and just time to think, just time to think.
In terms of, in terms of RVNs, just come in here, Catherine, if you, if you'd like to, but there's so many things now coming to mind that we introduced, so for RVNs trying to utilise the whole team from the start, so we looked at clinical. Workflow and the fact that everybody was growing as a person and carrying out test tasks that they'd actually qualified and were more than capable of performing. I think if you listen, value and utilise people to their full potential, gives everyone, all of us, a sense of achievement, growth and fulfilment, and if you do that, people are more likely to remain in the job, aren't they?
And, and lastly, I think on that we employ the animal care assistants to support RVAs, by doing this sort of general husbandry, cleaning of kits, sterilising, packaging things, running tasks through the day, thinking that thought was that that would allow RVNs to better support. To do their own tasks, but also better support vets, and in turn that frees up vets to have more time for better case management, and that can only benefit patients clients, and ultimately, everybody's happier and you get a better business performance. Obviously I'm making that sound quite straightforward and easy, probably and it's not, it's definitely not, it takes energy to maintain it, but it's well worth it.
Yeah, absolutely. No, it sounds incredible. So many great insights there and so much, you know, to consider.
So and did you feel that all these, you know, different factors and things that you introduced, did you feel like they really did have a positive impact on the team and that you saw positive results as well from, from your staff? Yeah, I mean, we were very fortunate from the early years. We had a small but dedicated group of people who've helped make the practise what it is today.
We all have, and several of whom are still with the practise from those earliest days. How, how big a practise is it Gillian? It's we're a medium sized practise, Catherine.
So at the moment, I'd say we've got a staff of about 20. Well, I don't, I don't anymore, but the hospital's 20 so at the moment we're a medium sized practise. And I was just going to say there about people, it comes back to creating that bond, doesn't it?
If you trust one another and you have a bond, then you're just gonna have a better, tighter working environment. And if, is there any, you've given so many great insights already, but is there any advice that you would give people who wanted to start their own practise? Do it.
But buy backs, flower nighttime rescue remedy first. Joking aside though, joking aside, it is a hard road at times. I wouldn't gloss over that, and it's something challenging like no other, definitely, but the hard work, commitment, and any negatives are far outweighed by.
And it is the absolute joy of having dreamt it achieved it and it being successful. Of course, there's, there's all the many important practicalities, not least of all securing finance and then creating a workable systems and processes and putting those in place, but I would say it's. As well as the practicalities, it's equally important to, have confidence in yourself, not shying away from, from a calculated risk and sticking to your personal values and beliefs, no matter who or what tries to shake it, and from experience, people can, even with the best of intention, when you're about to start a new project, there are lots of opinions and suggestions come at you and it can be, You can really have to work hard to keep your confidence, your confidence and your self-belief.
But if you can do that also to, I would say also to push out of your comfort zone, it keeps us growing, doesn't it? And to, lastly, I would say, have fun with it. So in summary, believe in yourself, your vision, the team around you, and just do it.
Yeah, brilliant. No, that sounds wonderful. I think, you know, is there anything more specific around you know, people if they wanted to set their own practise up, how they could, you know, increase profitability within practise and you know, minimise expenses, any sort of financial advice that you could give?
Mm mhm. Well, there's so much to say on this one, so much to say on this one. If we look at the fundamentals, so, I would say being aware of purchases, namely equipment, so if it won't be used in a way that ensures it pays for itself.
In an acceptable time frame and you decide what that is personally, but if we say 3 years, or if it doesn't offer a new service and it's not going to generate revenue or a profit, then don't buy it. That's the first thing I would say. So be conscious of what we buy and the profitability of it.
I know I mentioned this before, but I'm gonna come back to it, so ensuring accurate stock levels, so. You know, if we query our business management systems and it accurately tells us that the practise sells 10 Meta 32 per day, then keep 10 or 1132 Metacam on the shelf, don't keep 20. And for the people who will go ahead and order 20 because in their mind that's what the practise sells, make people accountable.
So. So I would say that one, without doubt, though, the one that we focused mostly on, other than fees and stock levels and obviously, purchases was the structure of the team and how we set the team up, so the clinical workflow. I'm repeating that again, but I just find it so fundamental to the successful working of a practise.
So by that, I mean, to utilise the skill set that we all have and do it wisely. So appreciate qualification and experience and skills that each individual person has, and that when they're utilised to the full potential, the valuable contribution that they make to the success of that business. So the correct role carrying out the correct task appropriate for the level of qualification, ability and competence, thinking about, you know, if you bring it right back to the basics, if we consider the varying salary range for clinical staff, so vets, nurses, ACAs.
Perhaps a question to give people those answers might be, do we employ a vet surgeon to perform tasks that a competent RVN can easily carry out? Are we employing an RVN to carry out tasks that a capable animal care assistant is more than competent to do. So for example, again, animal husbandry, laundry, cleaning, packing, sterilising, instrumentation.
If you focus on the costs of working in that way. That there can be considerable differences, both good and bad, and we found, not that I'm trying to do people out of a job here, you understand, but we found very often that the need for an additional vet was negated due to our using the enormous skill set of our RVNs and likewise the need sometimes for an additional RVN, . Wasn't there if we were using our veterinary nursing assistants or animal care assistance appropriately, something that's particularly relevant now with recruitment being and recruitment and retention being so problematic, but there's, you know, apart from the financial aspect that I've, that I've been mentioning there, I'm just thinking that.
It's a very real positive for people development and growing in confidence and skills, and that undoubtedly adds to a sense of professional confidence and a wish to stay in a job that they find challenging and fulfilling, and one where they're, where they're being used to their full potential, . And that they've carried out years of study to be able to do. And, and lastly just to say, in terms of ACCAs with an HNC or an HND, you know, we've employed those right from the beginning of Ayrton, and these young people, and sometimes not so young people, are more than capable of carrying out many tasks that are often performed by people who are overqualified for them.
So RVNs, all the tasks I've just mentioned . They're on reception, they're doing animal husbandry. Would it not be more fulfilling for an RVN and more profitable for the practise if they were in a consulting room with clients?
And, and lastly, you can tell I'm passionate about this kind of thing. Lastly, there are so many people that perhaps aren't able to or don't want to work with what don't want to be RVNs, but they do want to work with animals and to do that in a veterinary setting. So maybe the bigger consideration for us is that we need to be considering and encouraging younger people into this profession, it can only be a good thing.
Yeah, absolutely. Thank you, Gillian, that's great. I know we're getting close to running out of time and I know we've touched upon it earlier, but I think it's such a great question to finish with.
I think it's, you know, critical on achieving business success. And do you have any final advice on how you can encourage a healthy working environment in practise? I think I, I think I mostly covered that one earlier, Catherine, but, but just, yeah, just to see, I think it's about being, being kind, being considerate, taking personal responsibility so that you're supporting other people around you, and that that mix of .
Behaviours helps people to bond trust, develop and a good working relationship. So I think it's just about those behaviours of being, being open with people, being honest, being supportive, communicating directly. And recognising individual and collective strengths and encouraging people to contribute to the practise and grow and develop themselves.
Brilliant. That's great, Gillian, thank you, thank you so much. That's a great, great note to end our podcast on today.
So much, so much great information there and so many insights from your experience and lots to consider. I'm already looking forward to listening to you back and making lots of notes. So thank you again.
Thank you so much for joining us, and also really looking forward to the VMG leadership and management webinars which we'll be running with you this year. Absolutely, so looking forward to that. Thanks Catherine.
You too, bye bye.
