Growing a Private Medical Service

Gems from Peter Drucker

2011-01-03T17:20:00.000-08:00

Whilst In Indonesia I thought I should learn from one of the masters what management is REALLY about and what to expect from my team. His work is very solid and fits nicely with the marketing advice of Jay Levinson and the academic research of Professor Sir Michael Marmot (the Whitehall studies). It also helps me re-think the role of Occupational Health within organisations. I hope you enjoy these gems as much as I do and I know I will constantly refer back to them.

Drucker – Management: Tasks, Responsibilities. Practices
Business
‘Every business needs to think through ‘what is our business and what should it be’
‘The first test of any business is not the maximization of profit but the achievement of sufficient profit to cover the risks of economic activity and thus avoid loss.’
There is only one valid definition of business purpose: to create a customer’
‘It is the customer who defines what a business is’
The business enterprise has..only these two..basic functions: marketing and innovation’
“Concern and responsibility for marketing must permeate all areas of the enterprise’
“innovation can be defined as the task of giving human and material resources new and greater wealth-producing capacity’ ‘every managerial unit of business should have responsibility for innovation and definite innovation goals’
‘It is through risk-taking that any business earns its daily bread.’
‘What do we have to do today to deserve the future?’
‘The purpose of an organization is to enable ordinary human beings to do extraordinary things’
‘Every act, every decision, every deliberation of management has economic performance as its first dimension.’
‘Performance is…the consistent ability to produce results over prolonged periods of time and in a variety of assignments.’
‘the test of an organization is the spirit of performance.’
‘The customer never buys a product (or services). By definition the customer buys a satisfaction of a want.’

Management & Performance
‘the ability to organize and lead’
‘Management is tasks. Management is discipline. But management is also people. Every achievement is the achievement of a manager. Every failure is the failure of a manager. People manage rather than ‘forces’ ‘facts’. The vision, dedication, and integrity of managers determine whether there is management or mismanagement.’

‘Managers have responsibilities for specific contributions, part of which is setting objectives, motivating and communicating, planning, organizing, integrating, measuring, and developing people (including him/herself).’
Managers need the following skills:
Effective decision-making
Communication within and outside the organization
The proper use of controls and measurement
Skill in budgeting and in planning work
Skill in using analytical tools
‘Managers must convert society’s needs into opportunities for profitable business.’
The ‘ultimate test of management is performance’.
There are 3 dimensions of Management:
1) Think through and define the specific purpose and mission of the business
2) Make work productive and the worker achieving (I prefer an achiever of goals)
3) Manage social impacts and social responsibilities
“productivity means the balance between all factors of production that will give the greatest output for the smallest effort.’
Focus on Efficacy – are we doing the right things? (ie. reallocating resources to where they can be most productive) as well as Efficiency –are we doing things right?
‘Performance is what counts, and the correlation between promise and performance is not a particularly high one.’
“there is management development tied to the needs of the organisation, and manager development tied to the needs of the individual…the two are different.’
Management development’s ‘purpose is the health, survival and growth of the business’
‘What kind of managers and career professionals will this business need tomorrow in order to achieve its objectives and to perform in a different market, a different economy, a different technology, a different society?’ (very relevant to overseas plans)
A useful tool is a twice yearly manager’s letter to their superior with:
• The manager defines the objectives of their superior’s job and of their own job as they see them
• They set out the performance standards that they believe are being applied to them
• They list the things they must do to attain these goals – and the things within their own units that they regard as the major obstacles
• They list the things that superiors and the company do that help them and the things that hamper them
• They outline what they propose to do during the next year to reach their goals
‘Leadership is lifting a person’s vision to higher sights, the raising of a person’s performance to a higher standard, the building of a personality beyond its normal limitations.’

8 key areas for performance objectives:
• Marketing
• Innovation
• People organisation
• Financial resources
• Physical resources
• Productivity
• Social responsibility
• Profit required
‘the concentration decision is “policy”..in what theatre to fight a war’
Managers always have to manage both work and working….They have to make work productive and the worker achieving.
‘It is responsibility for contributing to the results of the enterprise, not ‘responsibility for the work of others’ that makes a manager.’
‘Managers are the most expensive resource in most businesses – and the one that depreciates the fastest and needs the most constant replenishment.’
Managers taking on a new job should ask ’What specific contribution can my unit and I make which, if done really well, would make a substantial difference in the performance and results of our company?’
‘What information do I need to do my job and where do I get it?’
‘The manager needs to build upward responsibility and upward contribution into the job of subordinates.’
They need to ask: ‘and who depends on information from me, and in what form, upwards, downwards and sideways?

The managers job has 4 key aspects
o The job itself
o The functional definition of the job
o The upwards, downwards and sideways relations
o The information needs and the manager’s position in the information flow

The manager should ask 3 questions:
1) What do I do as your manager, and what does the company do, that helps you most in your job?
2) What do I do as your manager, and what does the company do, that hinders you most in your job?
3) What can you do that will help me, as your manager, do the best job for the company?
Personnel management
“Personnel management is (the) methodical and systematic discharge of all the activities that have to be done where people are employed..their selection and employment; training; medical services, the (health)and safety; the administration of wages, salaries and benefits; and many other.
‘Personnel management has to be done. Otherwise there is serious malfunction. But personnel management activities bear the same relationship to managing people as vacuuming the living room and washing the dishes bear to a happy marriage and the bringing up of children. If too many dirty dishes pile up in the sink, the marriage may come apart. But spotless dishes do not by themselves contribute a great deal to wedded bliss or to close and happy relationships with one’s children. These are hygiene factors. If neglected, they cause trouble. They should be taken for granted.’
‘management means making the strengths of people effective. Neither the welfare approach, nor the personnel management approach, nor the control and fire-fighting approach addresses itself to strengths, however’
‘the purpose of an organisation is to make the strengths of people productive and their weaknesses irrelevant’.
‘an employer has no business with a subordinates personality’ ‘an employee.. owes performance and nothing else.’

Work & working
‘There is ‘work’ and there is ‘working’. They are totally dependent on each other …Yet work and working are quite different. Work is impersonal and objective. .. working is done by a human being, a worker. It is a uniquely human activity. ‘ (Implications for Occupational Health?)
‘Working ..is endowed with distinct physiological, psychological and social needs and characteristics.’
Work is tasks. It needs to be analysed, synthesised, have controls and tools. ‘All work has to be organised into a process of production’
Work must be productive, with feedback and continuous learning.
People work for a living, pride, self-respect, achievement, challenge and stimulation.
The controls are in respect to work’s ..direction; its quality; the quantities turned out; its standard, and its economy.
Control and Controls
“control is a tool of the workers and must not be their master or an impediment to working.’ (fits with Marmot’s work)
Controls = measurement and information vs Control which is direction
Controls are the means, control the needed end (result)
‘People decisions are the ultimate control of an organisation’

Profit
“the concept of profit maximization is, in fact, meaningless’
‘Profit and profitability are…. crucial…Yet profitability is not the purpose of, but a limiting factor on, business enterprise…. Profit is the test of the ..validity’ of ‘the business decisions’
J.B. Say (1767-1832) invented the term entrepreneur as someone who ‘directs resources from less productive into more productive investments and who thereby creates wealth’
‘amongst the most dangerous diseases of an industrial society’ is ‘the misunderstanding of the nature of profit in our society and…the deep-seated hostility to profit’
‘Profit and profit alone can supply the capital for tomorrow’s jobs, both for more jobs and better jobs..profit pays for the economic satisfactions and services of a society, from health care and defense, and from education to the opera. They have all to be paid for out of the surplus of economic production, that is, out of the difference between the value produced by economic activity and its cost.’

The need for planned abandonment
“the decision on what new and different things to do is important; just as important is planned, systematic abandonment of the old that no longer fits the purpose and mission of the business, no longer conveys satisfaction to the customer or customers, no longer makes a superior contribution.’
Hospitals, education, welfare etc need to be supported by successful businesses. Where else would the taxation income come from if the only employer was the state? Where the state provides everything it still need to export as if it were a business.

‘An essential step of deciding what our business is, what it will be, and what it should be is systematic analysis of all existing products, services, processes. markets, end uses, and distribution channels. Are they still viable? Are they likely to remain viable? Do they still give value to the customer? And are they likely to do so tomorrow/ Do they still fit the realities of population and markets, of technology and economy? And if not, how can we best abandon them – or at least stop pouring in further resources and efforts.’
Marketing & innovation
‘Any organisation in which marketing is either absent or incidental is not a business and should never be managed as if it were one.’

Decisions & Communication
With any decision ‘understand the problem’ first before you try to seek an answer.
‘Opinions come first’ not facts in decision-making.
‘The first rule in decision-making is that one does not make a decision unless there is disagreement.’
The effective manager ‘uses conflict of opinion as a tool to make sure all aspects of an important matter are looked at carefully.’
An effective decision ‘has to be “sold” after it has been made.’
Communication is perception (it is the recipient who communicates), expectation, is demanding and is different yet interdependent with information (which is logical and impersonal)
Avoid professional ‘workmanship’ that doesn’t fit with the organizations aims – this is the stone polisher who doesn’t or refuses to realise you are trying to build a cathedral on time and with limited resources.

General
‘Krupp provided his workers with housing, schooling, health care, training, small loans at low interest…..The Krupp firm at Essen might be called the first welfare state. The workers.. gave their loyalty to the firm and family for an entire century’ But ‘’it eventually destroys itself, for it creates expectations which, in the long run, no business enterprise – and no institution – can live up to.’

The planned story for 2011: How the NOH team will fight back

2010-12-28T17:22:00.000-08:00

Let’s get in the water and not just dip our toes. Let’s fully engage with existing and prospective customers to ensure we are the best and most profitable medical services company in the world.
We enter 2011 with good news and bad news.
The good news is that we have the most prospects at the start of a New Year then we have ever had in 8 years. That is 9 potential new clients worth more than 1 million pounds per year in revenues. 5 oil and gas, 1 mining, 2 media, 1 sports. We also have prospects with the NHS and private schools.
The bad news is that although we maintained our service standards we had a terrible financial 2010. So the first 3 months of 2011 will be very hard work.
We have taken decisive action to reduce costs by the following actions:
1) Moving admin from the basement of NOH to 126 Harley Street (they do our X-rays). This saves 36K per year.
2) Redundancies/natural leavers – saving over 30K per year
3) Reduced admin hours – saving over 20K per year
4) Salary cuts in admin – saving 40K per year
5) Fixed fees for doctors – saving over 30K per year
6) More work for nurses – saving on doctor’s fees

In total over 170K of cuts to our overhead. We now know our fixed costs per month and can budget for these with much less variation than ever before.
One additional cost is the 10K we will spend on rolling MBA interns (Rotman University/American Intercontinental University), students and Chinese (via Carrie Waley of Mandarin Consulting) support staff. These costs will be much less than full-time staffers and carry no agency/recruitment fees. They come out of the marketing budget.
Almost half our revenues are things we give to our clients: vaccines, medication and kits. So in 2011 we need to do a lot more of that and make it easier for clients to get these things from us: on-site, off-site and via the web.
2011 will see us co-ordinating and managing a LOT more off-site work.
We may also drop some services that don’t add up to decent numbers or profits.
Our breakeven figure for each month of 2011 will be communicated to all the team and we will track this daily, weekly and monthly.

We are improving:
• billing processes and will review all bills within 24 hours of the previous days daily takings
• sending all invoices within 24 hours with purchase orders
• identifying invoice discrepancies within 24 hours
• proper management of cash and the reconciliation
• re-instatement of the weekly stock meetings to ensure adequate but not excess stock
• management of creditors (people we owe money too)
• management of debtors (people who owe is money)

We will undertake regular cash flow projections based on 1) the first 6 months of 2010 and 2) the last 6 months of 2010 both with the 10% price uplift and new 20% VAT.
The new marketing plan will be shared with all. The budget for this will be around 60-80 K (around 5% of turnover). Marketing and innovation are how we will win new customers in 2011 and beyond and increase usage amongst our existing customers.

One of the key elements of marketing costs us nothing. It’s the staff attitude, engagement, commitment and training to ensure excellent customer service. Jay Levinson describes customer service as ‘anything the customer wants it to be.’ We will stick with that!

In 2011 we will do new things, we will do something differently but all with one aim ‘to be the best and most profitable medical services company in the world.’

The Story of 2010: A review

2010-12-28T15:56:00.000-08:00

The year started badly with the loss of Australia visas. This was a random event in that we were acknowledged as a good quality provider but the Australian Government wanted to cull providers. Our main competition in London had a technology advantage over us in that they had for years had in an-house X-ray service. We planned to have an on-site X-ray service but too late!
This loss was 200K of cash revenue per year. That monthly cash income helped us pay our bills on time. What should have happened was a radical, deep cut in our overhead last January. Instead, I only shaved a bit off overhead. The surgery was way too superficial!
It reminds me of the Jack Welch quite about companies seeking to reduce margins by 4-5% when they should be looking to cut 40-50%.
I have to ask myself what led to this false hope (hubris) and lack of action?
We had new work from the NHS, which we expected to grow and not dry up as it did (new government changes).
We also had tenders for:
Oil Company A (9 months later they still have not decided!)
Security Company B (a lot of effort, a whole day to present and then the most annoying thing was that the board had not even agreed any budget for the tender)
Media Company C (possibly postponed because of their own financial issues)
My message to HR Managers is ‘don’t waste people’s time if you don’t have board approval for the budget of your tender!”
Message to self: make the cuts first, and hope for more business later!
Our main costs are rent and people. To be at Number One Harley Street (as Carlsberg might say ‘probably, the best medical address in the world’) we pay a huge premium (80 pounds per square foot). However, for our administration, this premium is too much.
Finally, in 2011 we are moving administration from 1 Harley Street and saving 36K a year in the process. We should have done this some time ago (it was considered but never implemented).
Our other high costs are salaries, admin and medical. On the admin side we had too many people, some of the wrong people, failed to recruit effectively and incurred high agency costs.
The numbers game was complicated in that the most talented person was covering maternal leave and needed to be kept on when the less efficient ‘leaver’ returned. The ‘leaver’ did not work out and eventfully resigned. Along the way we had the classic problems of line management due to under attention and under investment on my part.
Resolving some of the people and organisational issues took up a lot of time. Recruitment failures all carried a price, both financial and organizational. The worst example (now gone) lost in 1 day business that it had taken 9 months to capture! The loss may be as much as 1 million pounds over a 10 year period.
The key message about the right people, in the right seats, doing the right things at the right times is so true.
The other lesson is to recruit for engagement and then with the right team ensure that all employees are both engaged and satisfied. Alongside this communication raises its head. Email doesn’t cut it. So many people claim to know nothing or only a % of the facts despite receiving an in-house email. Nothing can beat regular team, meetings and internal newsletters (which people sign off on when they have read them).
Managing doctor’s hours is complex and trying to maximize fee earning time more so still.
In 2011, I return to more clinical work to keep costs down.
Operational change and efficiency have been slow but in the right direction. It still bugs me that the organisational memory is not as good as it should be and too many staff still do not know, what (by now) I believe they should know.
The challenge for 2011 is: ‘How do we ensure that everyone knows what they need to know and knows where to find the information that they need to best serve our customers?’ Answering these questions will be one of the priorities for 2011.
A Wiki (more later) may be part of the answer.
On the strategic side I think that we have a lot right. It just needs tightening up.
Our strategy is for more work in the following areas:
Oil and gas (5 tenders in 2011)
Mining (I tender)
The NHS (now post White Paper reforms)
Private schools (bursars. Headmasters, nurses)
Media ( 2 tenders)

Sports clubs (Rugby Hep B tender)

Our focused marketing plan for 2001 had been developed and will be shared with my team (thanks Jay Levinson!).
The 2011 marketing plan was simple – to upgrade the website, focus on core markets, undertake more tenders (still an area of weakness).
The new website clarifies what we do but came 3 months too late in the year. I have concerns that our Search Engine Optimisation (SEO – how Google and others find us) is sub-optimal and we may need to review the decision not to spend any money on Google ads etc. The second half decline in 2010 revenues is still hard to explain.
The November ‘Medical Innovation’ conference was a success and we will now run this annually.
In 2011 we will hold a promotional evening for Japanese companies.
Finance has been a key problem. The lessons from this:
• Billing needs to be accurate and on time
• We need a constant review of daily, weekly, monthly income
• We need a constant review of daily, weekly, monthly of trends
• We need budget planning and rolling forecast (monthly)
• Appropriate action to reduce costs
• Appropriate marketing to do more of the most profitable things we do
In 2011 I cannot afford to take an eye off the numbers as I did in 2010. I will need to know on a daily basis what we have taken in so far each month in cash, credit cards and what is to be billed. I need to know what our standard overhead is and what exceptional expenditure has occurred during the same period.
I need to regularly review
1) the profit and loss
2) the balance sheet
3) the monthly management accounts
4) the projected cash flow based on rational assumptions of the data.
I need the full facts as to who is owed money at any one time and why this is so.
How much pressure are debtors under themselves! How much pressure are they causing us? All this needs to be recorded.
How soon are our invoices going out (should be within 24 hours)? Are they accurate? Are they associated with the correct purchase orders? Does each customer companies’ accounts department know who we are and why we should be paid on time? Is all this safely documented? Are we emailing or calling prior to the invoice due date, on the date, with appropriate follow up and action (possible suspension of services) if 7 days late? Are we ensuring each relevant invoice to us is billed on to our clients?
If what we owe is rising, have we attempted to make any agreements and if so with whom, when?
In relation to our customers we need a weekly overview of:
1) Who has been in for what?
2) Who has made enquiries and what has been the follow up
3) Review of our VIP and celebrity clients (why did famous comedian, Mr Funny, make his second vaccine appointment at another clinic when he seemed happy with us first time around?)

In the 2011 report to follow I will share the plans for this year and in a separate document the marketing plans for 2011.

Executive summary a New Vision for Health & HR

2010-11-06T03:13:00.001-07:00

Executive Summary: A New Vision for Health and HR

Number One Health

Number One Health is a private medical services provider/consultancy based in London but with the ability to provide services globally through selected partners. The expertise within NOH, since its foundation 7 years ago, has led to the company working with more than 51 companies and includes: Occupational Health, Public Health, Travel Health, Tropical Medicine, Sexual Health, and Private GP services, Pandemic Flu, Health Services Consultancy and Health Screens.

The administration team supports 10 hand-picked doctors and 40 nurses.

Our Value Proposition: The problem we are trying to solve for busy HR managers

Number One Health has observed that the health focus of many companies is too narrow and we believe that significant cost-gains could be achieved with a wider-angle lens used by the HR department for the management of health linked to the business needs. Evidence for the potential cost gains is outlined in the main document in terms of the benefits of Occupational Health, the limitations of insurance and the benefits of a more holistic view of employee health.
Our Number One Solution

Number One Health’s solution is for HR and senior business executives to work together with an assigned medical team or person as part of a 'Health Improvement Team for the business’ (HIT). This team would have as its remit clear aims and objectives which can be measured, costed and scored alongside improved business effectiveness.

We would work with you to measure existing data on your workforce, collect new data, advise on possible health improvements. Keep you up to date with relevant medical advances and technology that could help your workforce. Cost and measure the impact of interventions so that you can see the ‘bottom-line’ short or long-term cost savings.

Potential Cost Savings

Number One Health believes that the narrow focus on employee health represented by current PMI or OH alone is costing companies many £100s per employee per year. Ignoring the general health and welfare of employees is also costly.

Health Improvement teams or activities have been introduced effectively in:
Nestle
Marks and Spencers
Unilever
Tata Industries

Problems with current options in Health
Private Medical Insurance (PMI) – Models vary but the ideal includes self-referral. Models without this have awkward barriers to access. Uninsured costs have been estimated as ‘between 8 and 36 times the scale of costs recoverable through insurance’.
Occupational Health (OH) – depends on the contracted level of cover and may lack capacity to do more. For national companies there is very limited choice in service providers.
Lifestyle – These schemes are to be encouraged and some come with PMI.
Number One Health’s proposition is an overview of all of these with added benefits.
How Number One would engage with your business

Number One Health would charge your company for time spent with the Health Improvement Team (HIT), data analysis and any specific services (ie health screens) undertaken.
The Health Future

Number One Health believe this new vision is part of a new market in health care and should grow steadily achieving benefits for the companies and profitable work for NOH.

The Number One People

The Number One Health Team is led by Dr Charlie Easmon who has experience in all the relevant clinical areas and has assembled an excellent medical team supported by a first-rate administration team.
The Number One aim for 2010

In 2010 NOH seeks to work with at least 2 companies with at least 500 employees between them.
Your Investment

Create a Health Improvement Team with Number One Health and measure the cost and wellness benefits at the end of 12 months.

A New Vision for Health & HR

2010-11-06T03:11:00.000-07:00

Number One Health’s New Vision for Health and Human Resources (HR)

It’s the quality of the relationship that counts, plus the effort you put into making it work

Human Resources: the management and development of people. People who rarely spend a whole life time well. People who may be born with illness or disability or have either or both thrust upon them for short or long periods.

Some health problems may be work-related but whether caused by work or not these problems will have an impact on employee productivity and effectiveness.

In all good businesses HR is strongly linked to the business needs. However, in few businesses is the management of health linked to the business needs. As a simple example, an employee strains an ankle at football and takes time off work. If the employee is waiting to see a physiotherapist it makes some sense for work to pay for early treatment so the employee can get better quicker and get back to work quicker.

My observation is that the traditional links between HR and health are too narrow to truly help the business needs.

Some, but not all, HR managers see their duty on health as covered once they have signed off on a Private Medical Insurance (PMI) scheme. However, by its nature PMI has exclusions and in many cases excludes primary care, pre-existing conditions and rarely gives cover for cancer. The perfect employee in these terms only ever breaks a leg, has no pre-existing conditions and never gets cancer.

Other HR managers feel that their duty on heath is covered by appointing a doctor either full time or ad-hoc. However, few drill down to 'what sort of doctor do I actually need?’ Doctors offer themselves as GPs or Occupational Health (OH). Some try to be both and claim a 'Chinese wall' operates to separate their functions, however this makes no sense. A GP acts on behalf of an individual employee not a company. An occupational health doctor acts as a middle ground between an employee and a company. The role of a GP and an OH are mutually exclusive.

Sadly some OH doctors have the same ‘legacy status' as old software. Their views and opinions date from a clubbable era where they were mates with a long departed Chief Executive and their actual interest in helping to manage and improve the health of employees in the business is limited. They take a stand to defend their corner and will not let managers interfere with their role and their lack of collaboration with the business can at times be antagonistic. This is clearly less than ideal.

In the UK the problems for HR managers is made more difficult by an unusual health landscape in which 90% of health care is free and only 10% private. Logically, no company would want to pay for something which is free but is that true? If you were offered a free postal service but that service had long waiting-times, erratic delivery patterns and poor customer service would you make the business decision to stay with the free service or would you pay for a more personable, customer-orientated, timely and efficient service? The NHS is free but with exponentially rising health care costs and only a linear increase in revenues, the quality of what is free has to be variable in both quality and location (postcode lottery).

So what is Number One Health’s New Vision for Health and HR

The new vision, in fact, goes back to core principles adapted in the early days by Unilever, Marks and Spencer’s, Cadburys, Tata of India and many other successful international companies (see quotes at end).

The new vision is based around the fact that the health and well-being of employees can be helped by the company in such ways that it increases the productivity and retention of the employees and these lead to increased profits.

The company that is serious about its business needs to be serious about the health and well-being of its employees. It wants to:
Ensure maximal productivity of all employees
Encourage healthy lifestyles
Reduce and manage stress
Reduce and manage musculo-skeletal injuries
Reduce and manage sickness absence
Efficiently manage return to work after illness or disability
Integrate the disabled into its business

Such a company realises that costs need to be seen in terms of ‘opportunity costs’. In simple terms does it cost me more to do nothing!

This new vision is far wider than the ticking 2 boxes 1) I have PMI 2) I have an assigned doctor (of some sort).

The new vision is for HR and senior business executives to work together with an assigned medical team or person as part of a 'Health Improvement Team for the business’ (HIT). This team would have as its remit clear aims and objectives which can be measured, costed and scored alongside improved business effectiveness.

Areas covered would include all those listed above and amongst other issues:
Toxic Managers (how do we deal with an upstream problem that is causing down stream stress and affecting staff retention?)
Stress audits
Sports injury related return to work
Industrial injury related return to work
Home stress
Carer stress
Chronic disease management
Pandemics
Surgery
Dentistry
Cancer
Vaccines
Duty of care
Travel
Corporate manslaughter

The HIT would help the business manage predictable health problems of employees, react effectively to the unpredictable ones and look across the local health landscape. For example, if local NHS services are excellent in areas A,B,C these would be used, if poor then an alternative would be costed and balanced against the loss of productivity caused by waiting for a ‘free’ service.

Partnering with a health services provider vs contracting for health
(If we are together nothing is impossible. If we are divided all will fail)

Number One Health believe that contracts to cover the required aspects of health care are too complex to be meaningful or manageable. Contracts can cover simple aspects like fee per procedure etc but there needs to be allowance for the health care related problems and questions outside of any such contractual strait-jacket. These items can be covered by a retainer and/or fee per new incident.

A learning organisation is ‘human beings cooperating in dynamic systems that are in a state of continuous adaptation and improvement.’

Number One Health believe in understanding your business and its success factors. We believe in ‘relational dealings …characterised by fewer, longer term contracts that require deeper involvements and cultural adjustments to achieve success. Rather than looking over a defined and often entrenched, boundary at each other, firms have to consider mutual goals, joint performance measures, formal information and communication, system linkages, C3 (cooperation, coordination and collaboration) and softer issues such as building trust and commitment. The task of managing collaborative contracts is more time-consuming, difficult and specialised than the ‘choreography’ of internal, organisation processes….’

We also believe that ‘establishing a regular pattern of inter-firm interactions that support the transfer, recombination or creation of specialised knowledge is likely to bring considerable benefits to both partners.’

Our high relationship model with your company includes:
Proactive relationship management
Joint objectives
High-level commitment
No-blame culture
Avoidance of adversarial practices
Visibility of performance measurements
Joint planning
Open communications

Others who previewed our New Vision for Health and HR

If every business had a health care programme think what a difference it would make in human and economic terms Lord Sieff when Honorary President of Marks and Spencer ‘On Management '

True wealth, which is health
Leonardo Da Vinci

Despite the National Health Service there is much left undone and much scope for medical care at work Marcus Sieff (Marks and Spencer)

....to be lacking in consideration in any way for the life, health and happiness of the employee is the most short-sighted policy a firm can adopt William Lever Founder of Unilever

In order that people may be happy in their work, these three things are needed: they must be fit for it, they must not do too much of it, and they must have a sense of success in it John Ruskin (1851)

It is important to emphasise here that staff health and well-being is more than just the absence of disease. Rather, it puts an emphasis on achieving physical, mental and social contentment. As our Interim Report made clear, there is a strong business case for investing in staff health and well-being. Organisations that prioritised staff health and well-being performed better, with improved patient satisfaction, stronger quality scores, better outcomes, higher levels of staff retention and lower rates of sickness absence.

Staff health and well-being priorities need to be fully aligned with the wider public health priorities of increasing exercise; tackling obesity; reducing smoking and excessive drinking; and improving mental health.

Undertaking such assessments, and shifting the focus of staff health and well-being services towards prevention and health promotion, will require a remodelling of occupational health services............

…. training in health and well-being should be an integral part of management training and leadership development…………….

At the heart of our vision was the concept of a comprehensive, proactive staff health and well-being service, commissioned and delivered to common standards and in consultation with staff and their representatives.

Spending on staff health is sometimes erroneously considered a poor use of scarce resources. As our earlier report made clear, we believe that investment in staff health and well-being services will more than pay for itself through reducing sickness absence and improving productivity.

Dr Steve Boorman (NHS workforce review)

Moving from 15 PCs to 15 Imacs and 2 Ipads!!!

2010-10-04T09:01:00.000-07:00

We are two months in and most of it went well. The actual change for 15 Imacs occurred over a weekend but it took some time for staff to get used to the new aways of working. We are not yet fully Macced as we still used Word and Excel instead of Pages and Numbers but that will come. Look forward to making more use of Ichat.
One early headache was the integration of Sage and I would suggest you make sure your Mac people can do this promptly. Our booking software had some teething problems. we are looking into MacPractice but i cannot say they are user friendly to get started with.
Was it worth it? A resounding YES because we have more efficient machines, with less down time and these will pay for themselves within 2 years. The Apple shop does a good 2 year leased deal which helps keep costs down. More to follow!
Plus i love my Ipad!

My ideal Office Manager

2010-10-04T08:51:00.001-07:00

I have had 7 years to think about this and ma delighted to share this with you. Constructive comments are appreciated.

The ideal office manager

High expectations are the key to every thing
Understands and follows NOH mission, vision, action and business plans, sales processes, guides for managers and leaders
To be the MINDER who ensures the Grinders (key operational staff) provide operational and customer excellence for the work identified by the Finder (CEO)
Has a bias for action and no paralysis by analysis
Is able to optimally execute CEO requirements and constantly develops 'know how' to exceed CEO and organizational expectations especially 1) gets the right people together with the right behaviours and the right information to make better, faster decisions and achieve business results 2) calibrates NOH people based on their actions, decisions, and behaviours and matches them to the non-negotiable of the job
Constantly seeks to improve processes and procedures as well as quality
Is able to report on operational functions at any point in time
Has their finger on the pulse of all aspects of the business
Is house proud and ensures the cleanliness, tidiness and organisation of all aspects of the business
Ensures inventory systems are in place for on- site and off- site stuff
Has cold weather strategy
Has warm weather strategy
Ensures and maintains Care Quality Commission compliance
Understands and maintains Investors in People
Ensures seamless interaction with the call centre
Provides CEO with core dashboard data
Has identified the needs for the WIKI for the team
Constantly questions how and what we are doing and how each aspect can and should be improved
Acts in a timely manner to achieve both quick wins and long term goals
Implements and reviews the balanced business score card
Has organisational presence and authority amongst all staff and suppliers
Liaises with other high quality practice managers and brings learning from them into NOH
Is the know how person at NOH
Anticipates the CEOs concerns
Ability to reflect and learn from the past
Fully understand and constantly analyses NOH position in it's markets, compares to competitors and develops maximal distributive channels ( how we get our services and products to market)

Knowledge
As above key NOH policies and day to day parameters of best medical customer service
Attitude
Pro-active, can-do, constant improvement
Decision-making
Timely and linked to appropriate actions
Manual
Hands-on, head-in approach at all times
Communication
Regular updates to CEO based on dashboard and key events, regular updates of team with monitoring of progress in key areas of human, operational, strategic, financial and marketing success/failures

Human
Manages HR with the highest standards for recruitment, retention of the best but also ensures the successful and appropriate removal of poor performers after an acceptable and not too long qualifying period
Engages with all staff to fully understand their day to day processes and makes suggestions and implements change to improve efficiency and efficacy
Understands clients needs and does every thing to ensure the ultimate customer experience
Maintains excellent HR records
Ensures a culture of discipline in all staff
Works to the core ideas of the balanced HR score card
Develops staff health benefit plan
Develops staff charity plan
Canvasses, digests the opinions of the medical staff and listens to their needs
Ensures appropriate discipline of medical staff
Ensures all staff discipline
Collates client delight and complaints for action to constantly improve our customer care offering
Ensures effective induction of new staff and students/interns with all to sign off on the hard version or the virtual version

Operational
Liaises the call centre
Reviews call centre records and makes required changes
Ensures website updates
Ensures iMac folders up to date
Ensures promotional PDFs and templates up to date
Ensures efficient quotes for business and appropriate follow up
Ensures efficient implementation of on site and offsite business
Sets the highest standard for offsite business that ensures the development and maintenance of the maximal reputation for NOH
Ensures client communication is regular and to the highest possible standards
Deals promptly with concerns/incidents and action on any complaints and incidents
Ensures the highest standard of health and safety
Develops the companies green policy
Develops, monitors and reports to CEO on staff engagement and satisfaction
Ensures staff working hours are complied with, optimally used and are not excessive
Ensures phones are answered promptly
Ensures voice mails are dealt with daily
Ensures email enquiries are dealt with daily
Ensures and optimises friendly and collaborative teamwork
Arranges monthly early close with staff tea break
Ensures efficient and timely creation of databases and efficient and timely communication with existing and potential clients
Arranges events to a high pre-agreed standard
A tight dedicated daily process and progress review for induction of new clients with feedback to CEO of how day 1 went, contacts client personnel and client HR or medical on Day 2 &3 to endure delight with process, confirms and feedsback to CEO that Optimal SLA and SOP have been achieved
Ensures data for agreed CEO management dashboard is available in a timely fashion
Ensures effective delegation where the output/outcome of delegated work is regularly reviewed for timely success

Strategic
Thinks ahead for the businesses needs for growth
Anticipates worse case scenarios and how these can be mitigated or avoided
Has contingency plans in place for all emergencies
Develops rolling student programme

Financial
Ensures any lease agreements are efficiently dealt with
Ensures billing is accurate and timely
Ensures pricing in all media is up to date
Constantly Assesses opportunities for cutting costs or making processes more efficient
Reviews competition and pricing structures

Marketing
Works with CEO on growth strategies
Reviews and optimises marketing material
Reviews and optimises staff customer handling training
Reviews and optimises presentation areas within the clinic

JanFeb2010

2010-02-18T10:26:00.001-08:00

Dr Charlie Easmon

Business Blog

People Internal/External

This has been a really busy start to the year. I have been to the European HR Directors meeting (see Blog notes re that) and through that and other issues have really started to appreciate the key value of the right people in the business doing the right things. Things started with my appreciation of needing A talent in A positions. I have since been engaged by the ideas of ‘The Carrot Principal’ around BOTH satisfaction and engagement and the value of reward.

We had to let one staffer go based on a key loss in turnover. Another staffer has set up a job-share which seems to work well.

We had one resignation, which was really sad to see. Some disciplinary issues are on-going. I am reminded of the value I drew from Robert Sutton’s fantastic book ‘The No Asshole policy’.

I have now devised a proper guideline for managers, which covers our key values and expectations of them.

My good friends at ALC Health announced two new appointments this month. I join the company in a newly created post as ALC Health’s Medical Director with immediate effect. and I look forward to working with them and contributing medical information to their clients and to their website etc (www.alchealth.com).

Operations

We may have found the holy grail of data management via Ian and his team at www.zaptag.com. We will upload secure data, which the occupational health team of our client can see remotely hence saving us emails, scans and data capacity issues.

We are undertaking a complete review of processes so that all staffers know what to do for all clients (this has been a long-time coming).

I have been shocked by the sheer obstructiveness of some of the drug companies with regard to H1N1 vaccine. There is a surplus, there are buyers but can we get any……………..?

Strategic

Had a look at our end of year figures for 2009 and thank goodness for our VAT return! We lost way too much in the last quarter of 2009 and the aim for 2010 is to make our profit in the preceding months and make the last quarter at least break-even but not a loss! We will do this by:
Doctors hours reflecting the activity
Minimal stock orders
Minimal agency/recruitment
Minimal entertaining (Xmas do is the exception!)
Minimal repair/computer costs

Had a great meeting with Nitesh who designed our web-site and we will re-configure the site to more clearly focus on what we do and so that companies/individuals can access the information they need about our services.

Financial

The Australian de-listing has had a heavy impact on our cash-flow and so things are tight but we will get through this. Other streams of work, especially vaccinations for Primary Care Trusts are strong.

We are in the process of changing bank. Our current bank has legacy statues from some time ago and is located far enough away that it makes meetings harder than necessary.

We have 2 tenders in at the moment. One for oil major, worth about £400,000 per year and the other for a large security firm. The security firm one was potentially worth over £1 million per year but the latest is that the board rejected it (why are we asked to tender if there is no budget – ho hum!)

Marketing

We have followed up leads after the European HR director’s meeting and hope to confirm some new clients. We hope to get further involved with the retail sector with 2 new clients.
The New Vision for Health and HR has been sent to several HR managers and will feature on the website.
The new processes should help our won staff better understand and sell what we do.

Innovation:

‘MagicWhiteBoard’ was the business at the European HR Director’s meeting.

Best Business Reads this month:

‘Of Interest to Executives’ – A collection of Monthly letters published by the Royal Bank of Canada

Best past business reads:

‘The Richer Way’, Julian Richer ISBN 0-9526730-0-2

Quote of the month:

Matsushita Japan (Panasonic and much more)

‘Treat the people you do business with as if they were a part of your family. Prosperity depends on how much understanding one receives from the people with whom one conducts business…. After-sales service is more important than assistance before sales. It is through such service that one gets permanent customers….Don’t sell customers goods that they are attracted to, sell them goods (or services) that will benefit them………….Any waste, even a sheet of paper, will increase the price of a product by that much……To be out stock is due to carelessness. If this happens, apologise to the customers, ask for their address, and tell them that you will deliver the goods immediately.’

Charity of the month:

Have sponsored Mrs Eileen Barrett via http://www.justgiving.com/runningforhaiti - as it says she is running for Haiti!

Special Blog: HR Directors meeting

2010-02-18T10:01:00.001-08:00

I’m glad I am doing only 2 stands this year (both happen to be in Birmingham!). In the past I have wasted time, money and effort on promotional stands. Often it is best that you do it yourself or not at all. In the past, ‘helpers’ have used half the time to promote themselves or not been very helpful. Another lesson I have learned is ‘’don’t take trunk-loads of promotional material, only to return with (you guessed it!) trunk-loads of promotional material! The recession helped here in that I could not justify huge print costs and had to think innovatively. So I decided to offer simple health screens (height, weight, body mass index, blood pressure) and to collect cards by the offer of a Free Health Screen. I also took information on our New Vision for Health and HR. I also needed a ‘stand-bribe’ and whereas most people would use chocolate to attract the crowds I decided on something healthier (tasty sticks of liquorice – total cost under £20!).

The recession also meant I booked late and cheap and found a fantastic capsule hotel. The price was half that of the other hotels, it was really cosy and I had one of the best hotel sleeps I have ever had (www.Nitenite.com)

Pre-preparation

Ideally for these exhibitions one should spend time setting up appointments but I was genuinely too busy to do so. I was glad with my plan to keep the information and the stand simple.

Getting there

I was taking up 2 banners, 2 chairs, a table and various other bits and so car was the only solution. I hired my good friend MJ to take me up and bring me back the next day. We had a 5 am start and a healthy Fast-Food-Chain breakfast (more of that later)!

On Day One

On arrival I was stunned by the unhelpfulness of the event organisers. When I finally found my stand, I realised that a cat would have had difficulty standing let alone swinging! Fortunately 2 others did not turn up and so I had enough space for my table, chairs and one banner. Once set up I gradually realised that my location was like Siberia (no-one was heading our way) and so with entrepreneurial chutzpah I visited other stands and got the lie of the land. I was advised to go to some talks since then I would also meet a few more of the delegates.

‘MagicWhiteBoard’ came to the rescue in that the venue did not allow blue tack in its walls – no problem put up white board first and then blue tack on that – brilliant!

The day ended with some drinks followed by more drinks with a wine-tasting. I met the delightful HR manager of Loch Ffyne restaurants and was privileged to hear everyone gush as they say who he was – ‘I got engaged at an LF’, ‘I had my most romantic meal at an LF’ ‘My taste buds are still recovering from an LF’ etc . I turned to him and said ‘My Goodness you would never get this reaction from people if you were the HR Manager for a Fast-Food-Chain!’ There was a tap on my shoulder ‘ Charlie, let me introduce you to Mr XY, the HR Manager for a Fast-Food-Chain!’ What can you say?

On Day Two

I attended two talks. One, about managing HR in the Met police. One, about strategic HR. I missed the ‘Carrot Principle’ but saw how delighted the crowd where with the speaker (Chester Elton) and got the book (an excellent read with some fantastic suggestions). It was clear from a LOT of delegates that they were unhappy with their occupational health or general health providers and from this I derive a new and simple aim ’To be the best medical services provider in the World!’

Follow up

The best value from the whole thing for me was meeting other suppliers who can enhance our offering. Some of these were in areas of:
Counselling and Employee Assistance Programmes
Sickness Absence Management and a 24/7 365 nurse call centre
OH providers across the UK

Hopefully Number One Health will also get new clients and we have spread our message!

March is the next and final show for the year.

Business Blog - India Special

2009-12-16T07:19:00.000-08:00

My exploratory visit to India was a great learning experience both for my UK company and the plans for international expansion. One of the great benefits of going away is it gives you time to think and some perspective. I also read two excellent books:
Re-inventing the CFO and
The Workforce Scorecard .
In the first there was an excellent view on what has always frustrated me about finance and it fits with a clear and urgent need for us to have a CFO so it helped me think about the sort of person we would want.

The second book opened my eyes to some simple facts about the people in work – they are at least 60% of costs so the investment in them is a no brainier. I also love the quote this message:

Anthony J Rucci, Steven P Kirn and Richard T Quinn: “The Employee-Customer-Profit Chain at Sears” – Harvard Business Review

The measure of workforce climate is a very broad concept and includes employee perceptions of a company’s strategy execution and leadership practices. Based on data collected from 1997 to 2003, they find that workforce climate is a good predictor of future customer satisfaction, which is a good predictor of future market share. If measures are answers to questions, how much more compelling would those “answers” be if we could determine the relationship between the measures of strategic performance behaviours and customer buying experience? Both the line managers and the HR Manager would be able to get more specific answers, like

“A 15 percent improvement in performance behaviours has increased customer buying experience by 25 percent, which in turn has increased sales growth by 6 percent.”

The other key idea is of people in A strategic positions needing to be A performers really appeals to me and Ms ABW in HR has some clear goals that will help me define her KPIs and MBOs (call me a convert – HR is exciting once you appreciate the link to business strategy and its implementation!).

A few lessons from India

1. Choose the right consultant and agree fees in writing before hand

I choose SK and she did a great job, achieving high-level access to companies, insurers and doctors. One minor error is that we should have agreed and signed off on a fix-fee contract but all is well.

2. Caution re drivers etc

Traffic in Indian metropolitan cities is terrible. You need a driver and a good one with an air-conditioned car.

Customer service stories from India

2 bad

Nehru jacket story

SK the Indian consultant and I have finished seeing a doctor and weak past a clothes shop, which has a Nehru jacket in the window. We go inside and enquire after said Nehru jacket, about four people look a bit bewildered and then send us upstairs. The elderly man upstairs looks even more confused about a Nehru jacket and first shows me a normal jacket and then a jerkin. SK is surprised and we start to leave. On the way down the stairs the accountant says in perfect English ‘Did you not find what you were looking for?’. I reply ‘No, all we wanted was a Nehru jacket!.’ He says ‘Like this one here and pulls one out. Finally I but the jacket and trousers and he proudly tells me that guess who they used to make jackets for – Nehru! Now, the lesson there is dead obvious – Make sure your staff know your product line, especially if it is in the window!

Ram Charan story

I am a great admirer of Ram Charan and think any educated Indian should be proud of their countryman. At a small bookshop I notice they have a business section. I ask the hapless man on the desk if he has anything by Ram Charan. He looks lost and eventually decides to look at his database. He shakes his head but as he does so I notice that behind him is a book by Ram Charan! Again, staff should know their product lines! By the way, ‘Know How’ is a great book.

2 good

Insurance medical market

At a meeting with Kotak Insurance this was estimated for us as worth over $54 million and at NM Medical they explained that do the number of medical insurers required they would need 5000 clinics not 5!

The UKTI team in Mumbai

Anjali and her team were really helpful and speedily provided useful data and advice.

People meetings in India

The incomprehensible

One doctor in his 70’s was a delight but was like a ‘Carry On@ character as he rambled away in his version of English but a great guy and he showed us proudly round his hospital.

The asshole

One doctor was rude and denied we had an appointment and denied knowing who had made it despite him trying to get that person on his board! Well, he blew that one. Cross-referencing confirmed his local status as an ‘asshole’ and the doubtful reputation of his facilities.

The dude

We saw a fantastic hospital with fantastic staff and were then, as a bonus, invited to see the Chief Executive. He was a handsome, trendy young man with long hair and a photo of himself with Miss India on the wall. Beat that!

Summary

India is an opportunity and I really look forward to working with local partners to set up our first clinics there.

Lack of commercial availability of Swine Flu (H1N1) Vaccine

2009-11-12T10:18:00.000-08:00

This is a special post

Dr Charlie Easmon MBBS MRCP MSc Public Health DTM&H DOccMed
Medical Director www.numberonehealth.co.uk
Email cahrlie@numberonehealth.co.uk

When is a customer not a customer? When is a pound not a pound? A dollar not a dollar? When a drug company says so?
When I first became aware that drug companies were producing a pandemic vaccine, I was excited. When I heard, on the grapevine, that pandemic vaccine was only available to government I, at first, accepted that.
However, on reflection, the decision by the drug companies to make no stocks of pandemic available commercially seems to me absurd, anti-competitive and unfair.
Does Ferrari only sell to Arabs? (no offence intended to Arabs)
My anger and frustration comes on behalf of my staff, friends, colleagues and clients.
Private health care in the UK is at least 10% of all healthcare. The private sector are efficient deliverers of vaccine services for both private and the National Health Service (NHS). The private sector can facilitate the access of pandemic vaccine to vulnerable groups such as pregnant women and those with pre-existing conditions. The private sector can administer vaccines in the workplace and so help 1) the UK economy by staff not having to take time off work and 2) General Practitioners by reducing the burden on them.
I tried to assess the rationale of the drug companies for not selling to the private sector.

1) Had the UK government banned them from selling it to the private sector?
Email exchanges with the Department of Health (DH) confirmed that this is not the case.

2) Lack of production capacity?

Possible, but in my view not an acceptable excuse for lack of communication on such an important issue. If you can produce several million doses for a key client (government), you can still make provision of a few thousand or tens of thousands for the private sector.

3) Legal issues

I struggle to see what these would be. The vaccine is safe and has European medical regulatory licensing. Private practitioners have appropriate levels of risk insurance.

4) An internal policy decision

This seems to be the likely reason but by whom and with what decision matrix? There is no transparency about this. In my experience the drug company staff themselves are confused by the policy and some do not understand or support it.

My message to the drug companies on this issue is that such an important policy decision should be transparent and communicated to private clients in a way that they can at least respond.

There is a real risk, in my view, of damaged customer relations and life has been made more difficult for the field force (reps) of the drug companies. These reps normally spend the whole year trying to SELL products to us. Suddenly for the one pandemic in world history for which there is a vaccine, the private sector is no longer a customer!

I hope that colleagues will take up this cause whether they agree with me or not.

Incidentally, I was amused by one incident. The drug company mantra is ‘we only sell to government’. I then got a call from a government asking for 400 doses for their UK-based embassy staff. The response – nothing!

So, how do I feel that the drug companies could have handled this better? They could have communicated early to private providers along the following lines:
Re pandemic flu vaccines, the vast majority of our stock will go to government. We believe that this is the right thing for us to do. However, we have not forgotten our private clients and have made a small allocation of X doses available. Clearly, demand will outstrip supply for these few doses and we will allocate on rationed basis (for example, usage of our other vaccine products in the private sector).

Finally, as a private practitioner I respect the NHS and believe that the vast majority of the vaccine should be administered from that source with help form the private sector where necessary. However, I also believe in choice, and it grates to have that choice taken away with no proper redress.

October 2009

2009-10-18T02:14:00.000-07:00

October 2009

Dr Charlie Easmon
Business Blog

People Internal/External:

We have welcomed back Ms KE after extended maternity leave. K’s key current project is re-organisation of office space as we have grown. I am reviewing the long-term plan in terms of space and the options are 1) 100% move 2) 100% stay and 3) partial stay (i.e. clinical services at 1 Harley Street and admin functions local bit at a lower cost per square foot). Ms ABW now works on HR and special projects as planned and has a main task of cutting our transport costs by half for a Primary Care Trust (PCT) project in which we would otherwise loose money.

Sadly 2 nurses have had to be disciplined. One suspended but we do suspect a serious medical problem and await confirmation of that.

Operations:

I have spoken to bursars, GPs and Travel underwrites on swine flu H1N1 and I must say I learn something new every time. I spoke again to the Diploma in Occupational Medicine students on ‘Caring for Employees Overseas’ and made some useful medical contacts in Qatar, Bahrain and Nigeria.

Mr LL has excellently demonstrated that as we have grown the need for a specific stock-controller has increased – this cannot be the job of one busy clinical nurse. So post-office reorganisation, Ms KE will sort this one (I am excited by the possibilities and can see how it will make the lives’ of the clinical staff easier and ensure good stock control!).

KE has set up my appointments for the November-December clinical audits and appraisal of the medical team. We also have a visit from the Australians in November appraising our visa medical processes.

We have had a big review of future IT needs (I still dream of a Mac office!).

Ms KE and ABW have set up our future Management Team and whole team meetings.

Strategic:

Our biggest challenge has related to providing cervical cancer vaccines for NHS Primary Care Trusts, especially after the death of the unfortunate girl. Some of the press were very one-sided but common sense seems to have prevailed overall and things swung back into action surprisingly quickly.

The visit to India (Delhi/Mumbai) is all set for November 14-22. My good friend Dr John Llewellyn of the FCO will host me in Delhi and Ms Sheela Kennan is acting a consultant and has set up the relevant meetings.

Our Objectives are as follows:
To meet potential Indian Medical Partners
To identify a property lawyer
To identify a suitable location for a clinic in each city
To meet with 1-2- Indian companies in each location that might use our services
To discuss our plans with the British Commercial attaché

Have discussed with Dr MS a new role as Deputy MD since I will be travelling more and this will become increasingly important.

Financial: A unique opportunity has arisen to buy back 40% of my shares. I must say I am disappointed with one bank where we had several meetings and in the end ‘the computer says no’. Why lead business people up the garden path? Let the computer do the talking first and help us all save loads of time and effort.

Marketing: The YouTube channel has 6 new videos.
• Travel Health Basics
• Occupational Health: The Basics
• A simple guide to what NHS GP services can and cannot provide v
• Mole in One: Mole Screening
• The Pill Cam: Coming soon to NOH
• My response to anti-vaccination questions Flu and Seasonal Flu
Previously uploaded
• Flu and Seasonal Flu and HPV2009

This information will be emailed to our key contacts and we will need to work on the search engine optimisations to make these more popular.

Dr JB spoke at the World Youth and Student Travel conference. I made some good contacts and found a suitable location for Manchester clinic.

Innovation: Once again I sing the delights of the Flip camera (best £100 spent on marketing).

Best business reads this month: Harvard Business Review – they review a book that I have not read but it sounds really interesting: Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America by Barbara Ehrenreich (Metropolitan Books 2009)

Best past business reads: Six Thinking Hats by Edward de Bono (a must for managing meetings)

Quote of the month: ‘Profits in their true sense are simply the reward of foresight and courage - the foresight to see where opportunities exist to meet mankind's needs more adequately and cheaply than before; and the courage to risk one's energies and one's savings in exploiting these opportunities’ Deterding Royal Dutch Shell

Charity of the month: Transplant Links
www.transplantlinks.org and Kids Company www.kidso.org.uk

July-September

2009-09-09T07:28:00.000-07:00

July-September 2009

Dr Charlie Easmon
Business Blog

People Internal/External:

We have recruited 2 excellent new team members. Welcome Vanessa Hallick and Gemma Cannon! Vanessa heads up our outside vaccines for Primary Care Trusts and Flu vaccines on business sites. Gemma currently is in reception. Both came from the agency May and Stephens and we are really impressed with the candidates. Ms Kristina Evangelou returns on 1st October from extended maternity leave as Practice Manager. The excellent Ms Avril Bunton-Williams stays on with an HR and a Project management role to cover our increasing NHS Primary Care Trust work and other items.

I have done 2 team appraisals in the last month and found the experience very rewarding. It is great to have such a fantastic team.

Operations:

I was amazed a few weeks ago to realise that for Swine flu/H1N1 Yahoo is more up to date than both WHO and the Health Protection Agency! I worked with City HR and Simmons and Simmons on a breakfast seminar for HR managers on the subject and this went well – we do another event on 10th of September.

I have had 2 trips to Africa since the last blog.

One week in Rwanda in July

Dr Jane Hill works with Rwanda Aid and works for free in Rwanda and pays the salary of a doctor Chris from the Congo. Jane was the host for myself and UK nurse Uma Fernandes. She was a great host and we visited 3 clinics. At first, Uma and I did wonder what we could contribute but over time we realised we could help train local medical staff (doctor/nurse) on basic primary care issues.

The Rwanda clinics had very good record keeping and most basic drugs but patients were not examined as often as I thought they should be (the least a medical can do in a resource poor area is look at and examine the patient!). It was also a shame that they do not have access to the latest simple diagnostic tests for HIV and malaria and so many patients are over-treated and no-one every knows what was really wrong with them!

Day 1 Nkombo Island (in the Congo. 16000 inhabitants – very poor!)
Day 2 Bugarama (the most ill people we saw)
Day 3 Banda in the forest

The pathology seen included:
HIV and associated nervous system destruction
Filariasis
Possible Tuberculosis
Probable Trachoma conjunctivitis
Balinitis
Parkinson’s (I donated some money for this guy to get new clothes)
Warts, herpes, Chlamydia (all in the same man!)
Malaria
Dental abscess
Thyroglossal cyst
Burn
Pleurisy of unknown cause

I donated my Optylse for opthalmoscopy and sphygmomanometer.

Rwanda reminded me that as I see it:
Quality in primary care is made up of:
Dignity and respect for patients
Physician listens examines and uses best available laboratory resources
Has essential drug kit
Has optimal equipment
Explains diseases and treatment
Hands out patient information
Gets feedback from peers and from patients
Physician has Continuing Professional Development Programme
Integrates with best of local health and welfare systems
Uses Education, Information and communication in public health

Have a look at the Rwanda video which will soon be uploaded to www.youtube.com/numberonehealth

My next trip to Africa was for the British Council in Botswana and Mozambique. I have not been to Botswana sine Raleigh International in 1994 and then I was 3 months in the gorgeous Okovango Delta (JP and Clive are still great mates from that period). Gabarone is now more famous since Jill Scott acts as the Number One lady detective. Rasina met me at the airport and the man is a star. He had me featured in 2 local papers, interviewed for a third and a slot on Botswana National TV. My subject matter was management and occupational health with the core message that HIV should now be treated as any other chronic illness. The audience of 50 plus were superb and we had some great discussion and I think I made some new friends.
Then off to Mozambique where Liz McManus treated me to a delightful supper in the naval club. The seminar had not been prompted as well here bit the quality audience of only 7 included 4 people from Rio Tinto whom I had done medicals on last time I was in Maputo in September last year!! Definitely need to consider setting up Occupational health services in Maputo.

Strategic: Based on the HR meeting with is now published in the magazine HR Director, I have designed with Phil Dias of Karma Creative a new promotional PDF – based on the idea of Number one as a Health Navigator. In next few weeks we will have a top team meeting to review our Balanced Business Scorecard.

Financial: Favourable result from Inland Revenue with a rebate! Well done Usman and Cartwright’s. Have plugged a key financial gap by getting us work during our quiet periods (October to December) vaccinating school girls for Ealing and Wandsworth Primary Trusts.
Marketing: Have learned can do loads more with Linked In and need to find the time to do this.
Innovation: Our Facebook sites and Twitter are now within the website. We have launched our You Tube channel with its first video. www.youtube.com/numberonehealth. I love the Flip Video device.
Best Business Reads this month: Robert Heller downloads and I finally got around to reading ‘In Search Of Excellence’ (Peters and Waterman) and that has inspired me with a book idea (more later).
Best past business reads:
Jack Welch ‘Straight from the Gut’ and with Suzy Welch on Winning. First, Break all the rules by Marcus Buckingham and Curt Coffman of Gallup ISBN-13 978-0-684-85286-7
Quote of the month: 'Marketing is an approach to business rather than a specialist discipline. It is no more the exclusive responsibility of the marketing department than profitability is the sole charge of the finance department.'

'There is no such thing as a marketing skill by itself. For a company to be good at marketing, it must be good at everything else from R&D to manufacturing, from quality controls to financial controls.'
Howard Morganis, past chairman of Procter and Gamble
Charity of the month: Rwanda Survivors www.equityforafrica.org and KIVA www.kiva.org but this has no health projects – why?

June 2009

2009-07-03T08:29:00.001-07:00

June 2009

Dr Charlie Easmon
Business Blog

People Internal/External: Our new admin assistant is now helping email and mail out databases and this should see an increase in new business enquiries.
At lunch the other day I took the chance to give my card to one of the key hedge fund players and would love to be involved with his charity, ARK. Mid-week we closed clinic for a whole morning and had team-building day based on some of the lessons I learned from Peter Kennedy on his Business Leadership Course (www.theleadershipchallenge.co.uk) – went really well and we all got to know each other better as well as appreciating attitudes that supported each other versus those that do not.

Operations: Planning for my talks to HIV clinic managers in Botswana and Rwanda end August/start July. Had brief meeting Monday 8th June about my one week stint in Rwanda at the end of July, followed by an excellent briefing where staff form the Rwanda Embassy explained how much they appreciated the programme and the amazing Mary K Blewitt OBE told us about her charity and investigative journalist Linda Melvern (www.lindamelvern.co.uk) clarified how well planned the genocide was (shocking now and forever!). In July we also have meets with Centrica and AXA PPP OHS and other existing clients.

Strategic: To Mac or not to Mac! Changing the whole office will cost a lot of money but I am convinced save money over time on maintenance costs. Watch this space. Monday 25th June key event with HR Director went really well – it was a roundtable hosted by myself and Dentist Simon Darfoor (also in 1 Harley Street). We all learned loads about the gap between NHS provision and PMI and many companies could benefit form a sensible ‘medical broker’. It has also become clear that the case should be made for ad-hoc health spending as a business cost versus time saved.

Financial: Ticking along nicely despite the recession. We are winning back some of our market share on the visa medicals. Have another enquiry from a PCT re the cervical cancer vaccine programme in girls 12-18. This is government funded but we as a private provider give the vaccinations and charge accordingly.

Marketing: Mail outs to doctors and engineering firms all in one week. The key event was the HR Roundtable. Have followed up several prospects this week and received some encouraging replies. Am surprised by the lack of interest in anti-virals. Am considering promotional activity with www.circa-club.co.uk , www.velvet-club.co.uk two of the UK’s biggest gay sites and off to an event tonight.

Innovation: Before the end of the year we will host an event on the ‘Health solutions for mobile workforce’.

Best Business Reads this month: Investment Biker by Jim Rogers (he set up the Quantum Fund with George Soros). The Naked Manager by Robert Heller from 1985 good points re marketing and management, which I believe Al and Laura Ries take up in their new book.

Best past business reads: Am a great fan of Jim Collins ‘Good to Great’ and ‘Built to last’.

Quote of the month: ‘The Sixth Truth of Management lays down that there are only two possibilities: either an executive is competent to run the business or he is not. In the first instance, leave him alone. In the second, move him.’ Heller (The Naked Manager)

Charity of the month: www.transplantlinks.org

2009-06-07T11:15:00.001-07:00

Day one - this will be a monthly blog with the first proper entry at the end of this month.