out of hours retainers

RE: out of hours retainers

Clive Ansell — Fri, 01 Jun 2018 10:58:12 GMT

Other considerations:

Are you happy to keep critical cases during the following day(s) too, to ensure continuity of care and avoid transporting animals back and forth between user practices, in the interests of the patients welfare? (An issue with some current OOH providers is that doors close at 0830 and there is no provision for on premises on going care, with ALL cases pushed back to user practices, usually with the client having to arrange transport)

Will user practices agree to this and not accuse you of stealing clients? (I've seen this happen)

Are you able to facilitate OOH home visits where deemed clinically necessary? or where not necessary and just requested?

RE: out of hours retainers

Anthony Dennison — Fri, 01 Jun 2018 10:38:03 GMT

The other thing to consider is how many patients that you see OOH will decide to stay with you as you provide the 24 hour care in house?

RE: out of hours retainers

Julie Innes — Fri, 01 Jun 2018 09:06:12 GMT

I used to pay £180/ month to my initial OOH provider. The alternative was Vets Now, who I think were a little more expensive and a little further away. Then the local vet school here started doing OOH for free, which caused an absolute uproar! The upshot was that my OOH provider quit, and Vets Now here don't charge a retainer! Lucky us!

RE: out of hours retainers

Marie Kubiak — Fri, 01 Jun 2018 08:11:58 GMT

[quote user="Martin Atkinson"]I'm at risk of turbo posting so this will (possibly!) be my last word but the OP reads: 'We're considering providing some out of hours cover for a neighbouring practice'. That implies they are inviting them to use already existing facilities with the intention of generating income from the additional cases they will see[/quote]

Depends on what their current system is. If they have dedicated night staff and facilities then the extra cost will be offset by cases seen as they won't need to invest further. If they currently only see their own cases OOH this may be a significant change to their structure, with extra vets/lieu time in the day/increased salaries/improved facilities etc. Either way a retainer seems reasonable to me for providing a service to the practice shedding their OOH (potentially recouped by a drop in their vets' salaries??)

Marie

RE: out of hours retainers

Clive Ansell — Thu, 31 May 2018 17:19:26 GMT

[quote user="Martin Atkinson"]Perhaps in the light of that we need to know the level of service the OP is considering offering[/quote]

That's a good point, so far not mentioned.

It could range from a vet on call at home with no one on premises and patients left caged and unattended, right through to a fully staffed PSS rated emergency clinic with availability to specialists on site?

RE: out of hours retainers

Martin Atkinson — Thu, 31 May 2018 16:03:49 GMT

[quote user="Clive Ansell"]I understand that completely, but my point was that providing cover where no work is actually generated has a cost and a value to it, even if only miniscule. [/quote]I'm at risk of turbo posting so this will (possibly!) be my last word but the OP reads: 'We're considering providing some out of hours cover for a neighbouring practice'. That implies they are inviting them to use already existing facilities with the intention of generating income from the additional cases they will see. In my case the two local practices who took my OOH before VetsNow, approached me and asked if I'd like to use them on that basis. I took the offers at the time as I didn't want to pay VetsNow if I could avoid it. Now I have no choice but I am very happy that the service VetsNow provide cannot be faulted and I have no issue with paying them a subscription fee. The OP needs to justify any fee with an equally professional service.

[quote user="Clive Ansell"]If as a practice owner you had an employee or a locum on call, or used a professional answering service, they would have to be paid. How is paying another practice to do the same any different? [/quote]Because the employee is exactly that so he/she is entitled to be paid by me for their time and an answering service doesn't generate any income itself so again I'd expect to pay for that.

[quote user="Clive Ansell"]If I was burdened with OOH duties, I would gladly pay someone to take the phone. [/quote]Agreed and I do but given the choice between paying VetsNow £120 a month or the practice up the road which may have no better facilities than me then it is a no-brainer. Perhaps in the light of that we need to know the level of service the OP is considering offering and maybe if there are no other OOH services available locally it is a kind of Hobson's choice.

RE: out of hours retainers

Clive Ansell — Thu, 31 May 2018 14:33:51 GMT

[quote user="Martin Atkinson"]But my point is that they're already there for their own clients, any other practice that chooses to use them adds income but doesn't increase standing costs.[/quote]

I understand that completely, but my point was that providing cover where no work is actually generated has a cost and a value to it, even if only miniscule.

If as a practice owner you had an employee or a locum on call, or used a professional answering service, they would have to be paid. How is paying another practice to do the same any different?

If I was burdened with OOH duties, I would gladly pay someone to take the phone.

RE: out of hours retainers

Martin Atkinson — Thu, 31 May 2018 14:24:38 GMT

[quote user="Clive Ansell"]Having staff on call to answer the telephone, and ready to attend as needed as a cost and a value to it.[/quote]But my point is that they're already there for their own clients, any other practice that chooses to use them adds income but doesn't increase standing costs. If the set up was solely to give shared OOH cover for one practice then that would be different.

[quote user="Clive Ansell"]If working on call as a locum I would charge either a fixed rate for the night, or a lower fixed fee for being on call plus an additional fee for clients seen. [/quote]But you're an employee not the owner, of course you expect to be paid to be on call even if you're not working, in that respect its no different than from during the day.

RE: out of hours retainers

Clive Ansell — Thu, 31 May 2018 10:22:52 GMT

I think you should charge a retainer.

Having staff on call to answer the telephone, and ready to attend as needed has a cost associated with it, and a value to it.

If working on call as a locum I would charge either a fixed rate for the night, or a lower fixed fee for being on call plus an additional fee for clients seen.

RE: out of hours retainers

Bob Russell — Wed, 30 May 2018 16:40:36 GMT

Not a case of poaching if the staff would not work for you because of OOH work.

Also one vet bands do not necessarily have the ability or inclination to undercut the opposition. I see clients that don't like going to a large practice and they see some that like a larger practice.

I see nothing wrong with charging/paying a retainer. It helps to cover some of the fixed costs and allows the work generated to cover the rest plus the other costs.

RE: out of hours retainers

Stephen Courtney — Wed, 30 May 2018 15:43:29 GMT

Problem is you cannot guarantee your income from the OOH work, especially at first, and likely will have to increase staffing/provide time in lieue or other incentives to get your staff to take on the work...

In addition providing OOH cover for other practices makes it easier for them to employ and or poach staff who won't come to you because you do OOH.... and makes it easier for one vet bands to spring up and undercut you.....

RE: out of hours retainers

Martin Atkinson — Wed, 30 May 2018 14:04:05 GMT

The two local practices I sent my OOH hours work to for about 10 years before they both stopped didn't charge a retainer, indeed one actually gave me a cut equivalent to their normal consultation fee to encourage me to use them. We now use VetsNow and I can see why they charge a 'retainer'/admin fee: they have a lot of overheads and provide a lot of support/additional services. For the record I pay them £121.50 + VAT a month. Unless you can provide a similar level of support or are only doing this for the neighbouring practice and otherwise wouldn't be providing this service, I think it is unreasonable to ask for such a retainer, you are after all getting extra work and no doubt intend charging a premium for it.