The BVNA is a successful organisation, doing the right things, but over the years it has also become a victim of its own success.

The governance review within the BVNA came about over a period of time as successive Presidents realised that the organisation had outgrown its informal origins. Key processes such as succession planning, the involvement of Officers in day-to-day operational decisions and the quality of information available to make more strategic decisions needed reviewing. But these only became apparent to Presidents once in office and needed more time and energy than could be afforded in a year.

The demands of this growing organisation were out growing the structures and skills in place. In the first two parts of this three-part series on the changes in the BVNA, we have looked at our responses to these challenges. In this final part we ask a further question: if this programme works, what would success look like?

At the start of any change programme you want to know why you are doing it and what you hope to achieve by the end of it. The BVNA knew why they were embarking on a governance review and what they wanted to achieve – for example, better planning, better information and better decisions – but a real question was how can the changes be measured?

The first trap to avoid is not just look at what we can measure as a way of deciding if we have succeeded. Or to put it another way, we must be careful to measure the things we value – not default to valuing the things we measure, because they are available. This is especially true if the normal way of doing things is changing.

The obvious example is money. This is an easy measure to use. There is something very appealing about a number on the page, watching if it goes up or down – attributing a value to that movement and linking it to the actions taken. Certainly, we could project with some confidence that the costs of the governance review were neutral (savings matched investment) over a relatively short window of time. We could also be clear that in the 12 months to December 2017, the BVNA reported a surplus of about £60,000 – a significant improvement on preceding years and achieved in spite of the changes during the review.

But even this doesn’t tell the whole story. Some aspects of finance cannot be captured directly with a single number. One of the changes we have made at the BVNA is our accounting basis from cash to accruals. A key advantage is that this allows a more realistic “snapshot” of our position at any given point in time. With turnover growing steadily and approaching £750,000 each year, with thousands of transactions in memberships, tickets and such, the organisation is now far too complex to keep track of and respond quickly to changes through cash accounting alone. If it is to grow it must make investments. But if the snapshot is misleading, how can accurate investments be targeted, or a priority made of one service to members over another?

These sorts of conversations, driven by an awareness of second (and third) order benefits and informed by the right information, characterise more mature organisations thinking beyond “bottom line” reporting. It is the only way to realise a change in culture or ways of working or perhaps most importantly in a practice or hospital, an improvement in patient outcomes.

This is the reality for nurses and vets and the environment they work in. They do not have the luxury of a simple commercial or profit measure of success. Financial measures must be balanced alongside ethical and other concerns over patient welfare. Compromising on care and undermining long-term health outcomes for short-term financial gain is not an option for the ethical or effective veterinary practice. Indicators such as the number of revisits for a patient or client in a small animal practice can be used both ways. On the one hand, revisits could indicate a satisfied client who understands that regular check-ups and the right help when it is needed are aspects of good animal care. Alternatively, it could drive unintended commercial behaviours of securing repeat fees, without necessarily considering first patient or client welfare.

Likewise for the BVNA, becoming purely profit focused would be a failure if we also lost sight of members’ priorities and promotion of the nursing profession. The question in the BVNA was therefore framed differently: how do we make the organisation ready for the challenges and opportunities its members face in the 21st century?

The fundamentals are just the start then, as we ensure continued relevance to members, able to support and respond to their needs. At Congress we revealed our strategy was partly about positioning – making sure we are regarded correctly by the RCVS, BVA and even government – so we can make sure our voice is heard by the right people in the right way, to deliver benefits for veterinary nurses.

There is a saying that “not everything that can be measured matters, not everything that matters can be measured”. Measures can be used to indicate what is going on as much as what has happened. The right measures are a sign of things to come as much as what has already happened in the past. Simply put, measures are the difference between doing the right things – which is a great place to start – and doing those things right.

In this short series we have dug beneath the surface on why and how the BVNA is changing. The principles we have highlighted hold true for the veterinary practice and for businesses in the veterinary sector: get the right team together, have the right processes in place and make sure the measures you are using are driving the behaviours and outcomes you want to see.

And the evidence of the governance review to date is that the nurses on Council have grasped this. The future looks bright for the BVNA and its members.


Robin Millar Strategic Director

VOL 33 • December 2018 • Veterinary Nursing Journal