Slow but steady treatment

Slow but steady treatment

A company that has moved into a landmark Leeds pub is leading the way in offering physiotherapy in the workplace, says Peter Baber.

Back in the days when Leeds United were a successful Premiership side, eager fans happy to slake their thirst before or after a match would never have to walk far.

Even if they didn’t fancy what Elland Road itself had to offer, the Wheatsheaf pub on nearby Gelderd Road was always open for business and became a regular hangout.

In the years since then, just as the club has been languishing in the Championship – and sometimes even lower – so the fortunes of the pub itself have declined.

Indeed, for much of the past two years it has been boarded up, echoing only to the sound of traffic rushing past.

If the dip in the club’s fortunes and the drift away of fans didn’t kill it off, then the smoking ban probably did.

Those with a reason for driving past in recent months, however, might have noticed new activity.

In fact, on a typically drizzly October Leeds day this year, the building reopened.

Not, it has to be said, as a pub once again providing a base for football fans, but as the headquarters of a company that is really going places in physiotherapy – not usually the most thrusting, talked about industry.

You could say the new owners have kept up the sporting links with the venue – one of the directors was a physiotherapist for the Bradford Bulls during the management of Matthew Elliott and Brian Noble.

But what is perhaps more interesting for the business reader is that this company has managed to fund its expansion, unlike Leeds United, without accumulating any debt.

Physiomed, as the company is called, is now one of the country’s major providers of physiotherapy in the workplace.

It has contracts with more than 50 organisations nationwide, including Carlsberg-Tetley, and the Royal Mail.

Postal workers and beer barrel delivery people all around the country are just some of those who have benefited from its services to get them back to work.

And it has saved their employers money too by not requiring their employees to take days off to visit the physio for a consultation – most initial assessments are carried out over the phone.

Only if the problem is serious is the patient booked in to see one of the 650 practices currently part of the Physiomed nationwide network.

The contracts are all managed by a staff of around 16 at the Leeds headquarters.

The company now has ambitious expansion plans, too.

“Between now and 2016 we plan to take turnover to £5m,” says managing director, Phil Clayton.

“Last year it was £1.9m. This year we are aiming at £2.3m.” As has already been said that will be a turnover that is growing on a balance sheet that is free of debt. But for those reasons it is a vision that has taken some time to achieve. Clayton, who is not a physiotherapist himself, joined the company as long ago as 2002. Before that he had been a London-based recruitment consultant who was moved up to Yorkshire to turn around a regional office that had been losing money for five years.

He did that successfully, and in the meantime met one Jake Fletcher, whose older brother Mark is very much the physiotherapy brains behind the business.

The three of them decided that they could start to grow the private physiotherapy practice Mark had already been running for the best part of a decade to be something much more extensive.

But Jake Fletcher and Phil Clayton only transferred over to join the company when it had grown sufficiently.

But neither regret that they never chose the option of trying to bring in a private equity firm to speed up that growth, even during the years when such people would probably have been banging on their door.

“We weren’t looking for a five-minute wonder,” says Clayton, “This was always going to be a long-term project. We're all young guys, still are.” (Both men are in their mid-40s.) “In fact,” he says, “how can you be sorry when you are sat in a lovely building like this, running a company with great profits, and an excellent team?” You can possibly see what he means about the building. All traces of its past as a pub have been completely obliterated – it was stripped right back to the brick walls.

But in its place is a sleek modern office that even comes complete with a roof terrace for the staff – albeit one with a not exactly inspiring view of the Leeds Ring Road.

“We wanted to be solely responsible for everything we do, right or wrong,” Clayton concludes. And Fletcher echoes him.

“It’s very easy to borrow money,” he says. “We still have people knocking on our door even now, wanting to lend us some.” Fletcher says he came to want to expand into the kind of physiotherapy service the company is providing now through the many different aspects of the profession he witnessed in the early part of his career. After graduating from Newcastle University in 1988 he came to work initially at the Leeds General Infirmary (LGI).

“I started a clinic in Guiseley,” he says, “and always worked part-time there, mainly out of financial necessity. The basic grade physio’s salary then was only around £600 a month. But I also loved doing orthopaedic physiotherapy, and you don’t always do that in the NHS.” Nevertheless, he says, the NHS was a great grounding for a young graduate to hone their skills, and to learn about looking at the whole patient, rather than the particular problem – something that has stood him in good stead with Physiomed.

“It’s a wonderful environment,” he says.

“I did 10 years in many different areas – outpatients, GPs surgeries, and community centres.” The years he spent being a phsyiotherapist for the Bradford Bulls were a glamorous extra, he says – and even now, nearly a decade after he left the club, he still gets people asking him about it.

Both he and Clayton say such a connection was good PR in the early years of Physiomed too – even if rugby league is really only of interest to people in the north of England.

But they always knew that they wanted to take the company onto more of an occupational health focus, so eventually the Bulls had to go.

The big break really came when the practice was doing work for Carlsberg-Tetley in 2001.

“We had been working with Carlsberg for a year or so,” says Fletcher.

“They were very happy with what we did. They felt we solved company with our findings quickly, and worked closely with their managers. In short, we had really brought absenteeism down. So they then decided they wanted to set up similar arrangements with other practices at Carlsberg depots all around the country. I pointed out that it would be very difficult if they were non-physiotherapists to find clinics that might suit their needs – in particular physiotherapists with the right skills within occupational health. So why didn’t they let me find the clinics for them?” And so the Physiomed network was born.

Fletcher and the team sourced practices which would want to be part of a network that could honestly serve a client anywhere in the country.

“We are in effect their marketing team now,” says Clayton, although Fletcher still works as a physiotherapist in the Leeds office.

“Physios are good at treating people, but not necessarily good at business.” The opportunities that such a network would bring were so compelling, in fact, when Clayton joined in 2002 the company had just started the contract with Royal Mail as a pilot.

“But we always thought we would take it into full contract,” he says. And they did. But the two of them both insist that the initial offer to Carlsberg was not just a way of keeping business in-house. It was really important that if the company wanted to maintain the success it had been having with physiotherapy treatments elsewhere in the country, somebody with an inside knowledge of how physiotherapy practices work would need to find suitable practices for them.

“Their skills in occupational health was actually one of 20 factors,” says Fletcher.

“We also looked at things like opening hours, location, parking, and accessibility. There would be no point in having a person with all the right qualifications but who was only prepared to be open one evening a week for two hours.

And did those practices want to work with us? With the arrangement we offer comes commitment – the person has to be booked in within two days of the initial call, and they have to report back to the company in a similar time.” Sometimes, he concedes, it could be hard to buy into what they wanted.

“We also have to work to very strict guidelines on clinical governance,” says Clayton.

“Unless you understand those, as we do, you can’t probe enough to make sure someone isn’t just saying that they will be able to do what you want.

We turned down many practices who applied, but we also had some saying to us: ‘I don’t want to be told I have to do a report within 24 hours.’ In which case we would say, ‘You’re just not right in our environment.’” The results of all this rigour, they say, is a service that may not be unique but is certainly starting to pull away from the competition.

“We have just won a contract away from a major competitor just as they were about to sign, because our online tools and our outcomes could be proven to have a 30% better success rate,” says Clayton.

Fletcher insists that the fact that employees are initially consulted over the phone is no handicap.

“Diagnosis is not at the end of the physio’s fingertips,” he says. “It’s the questions and answers you give. So questions we ask over the phone are exactly the ones we would ask face to face with a few alterations. We still get to ‘see’ the individual, because we still get them to do movements. And the ‘hands on’ side is still always there, but they only get it if they need it. If you told me your story about a tennis elbow, it wouldn’t take me long to realise you had a tennis elbow. At the end of the talking part, a physiotherapist should have 90% of the diagnosis.”

It’s one of the reasons, he says, why, rather like dyslexic people having a tendency towards architecture, there is a trend for blind people to go into physiotherapy. Physiomed employs some of them. Now the company has evolved to offer more online services as well. Clayton says this makes even greater savings for its customers.

“The return on investment for using our network is one in five,” he says.

“For the PAL online service, which is pay per click, it’s one in 10. Every pound you spend you save £10.” Fletcher says the educational material they have brought onto the site is also reaping dividends. Patients can go onto the site to find out more about their condition and how it should be treated through exercise and other treatments. They are currently planning new innovations to the site as well. Could these include providing assessments by online video feeds? “Watch this space,” is all they will say.

In the end, says Clayton, while they put great emphasis on customer service, with complaints being dealt with swiftly and professionally, there is something of a double-edged sword in their relationship with patients.

“Employers want to know whether their person is unwell and how long they can expect them to be off for,” he says.

“We treat the ones who do need to be treated, but we also stop the ones who used to go off with a bad back whenever the World Cup was on.” With Euro 2012, this is an issue more employers are likely to be finding important.

Clayton was thrilled to see an HR decisionmaker from Waitrose come up for the new office opening – even if her train times meant she could only stay for 20 minutes.

“She knows what we are doing is that important,” he says.