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Medical system's missing a link (Eve Edmonds / Richmond News)

Posted by shaquille-mohamed.pabani.1@cass.city.ac.uk on May 10, 2017 at 3:55 PM Comments comments (0)

I have to second Zina Pinkhafik when she says it’s “a very sad day,” referring to the closure of her Seafair medical walk-in clinic.

I can’t count the number of times I’ve been there for my family’s various calamities. When the dog bites (my daughter’s face and her eyes puff up), when the bee stings (and my son has a nasty allergic reaction), to paraphrase My Favourite Things, Seafair was where we went.

We have a family doctor, but a visit with her next week sometime does me little good when Little Miss has turned into a screaming banshee thanks to an ear infection.

We could race to emergency, but we would wait forever to be seen ­— and rightly so.

Even if my nerves are shot, and we’re rattling everyone else’s in the waiting area, my little banshee is not about to die, so we stay at the back of the line. Besides, a highly-trained, ER doctor, capable of cracking chests and stitching arteries is, shall we say, overkill when all we need are some antibiotics.

The owners of the Seafair clinic say they have to close because of a shortage of doctors. According to the Walk-In Clinics of BC Association, Seafair is one among a number of walk-in clinics throughout the province that have closed recently due to a doctor shortage and what they call an excess of “red tape.”

In particular, the association complains that the province has limited to 50 the number of patients for which a clinic doctor will be fully compensated. Fifty visits in a 7.5 hour day averages out to about nine minutes per visit.

Actually, that doesn’t sound unreasonable to me. What does boggle my mind, however, is the fact we’re missing this link in our health care services. Walk-in clinics are a critical part of the overall system, so how else to deal with the doctor shortage?

The association argues we need to train more and better compensate doctors. Perhaps, but I’d say we also need to think bigger.

I recently received an email from the BC Community Health Centre Association. (It’s election time so they’re looking for funding.)

Community Health Centres (CHC) provide walk-in health services, using a team of nurse practitioners, social workers — as well as doctors. It’s an integrated approach that aims to provide the right person for the job, so you don’t have ER doctors treating ear infections, or even a regular doctor treating addiction when a social worker might do it better for less. What’s important is they’re open when you need them.

There are about 10 CHCs throughout the Lower Mainland, but none in Richmond. I’m not sure why we’ve been left off the list, but with one less walk-in clinic to attend to our dog bites and bee stings, perhaps we should book an appointment to at least start the conversation.

© 2017 Richmond News - See more at: http://www.richmond-news.com/opinion/columnists/voices-column-medical-system-s-missing-a-link-1.15301998#sthash.pi4O4Sts.dpuf

Christie's Business Outlook 2017

Posted by shaquille-mohamed.pabani.1@cass.city.ac.uk on January 13, 2017 at 11:10 AM Comments comments (3)

Within Christie & Co we continue to focus on our company ethos of promoting clients’ interests rst and foremost - we are able to tap into the knowledge and expertise across the Group and share this depth of knowledge for our clients’ bene t. Longevity in our sectors While 2016 was, it’s probably fair to say, a complex series of twists and turns on the economic front, we are seeing more than ever that the sectors that Christie & Co deal in have longevity, and will remain a focus for operators and investors for the foreseeable future. At Christie & Co we don’t simply concentrate on trophy assets such as Capital hotels; many of the business sectors that we work across support the communities in which they operate, ranging from care homes to pubs and convenience stores to nurseries. Operating across the business size spectrum, we deal with businesses across the sectors from the smallest business to the largest corporate - this scope enables us to truly understand the operating levers and market dynamics of the sectors that we are in. Within these sectors customer purchases range from discretionary spends (hotels, Leisure, Restaurants, Pubs), some are high-priority spends (Petrol Filling Stations, Children’s Day nurseries), some are necessity spends (Pharmacy, Care homes, Dental) and some are essential (Convenience Stores). So although there are uncertainties in the wider market, what we can be certain of is that these businesses will continue to thrive as their customer base remains strong, and they adapt to customer requirements and trends. Over the past year the sectors in which Christie & Co operate have faced a myriad of challenges but we have been well positioned through our network of local o ces and wide-ranging expertise to support our clients.

 

The life cycle of ownership

 

Over the past few years, we have nearly doubled our service o ering to 78 services across the business – all of which provide assistance to an owner or operator across the life cycle of ownership. Christie Group can assist in making a business work. From our Business Agents helping an individual, a family or a company to buy a business, Christie Finance assisting with obtaining funding, our Consultancy teams advising on decisions concerning management and branding or looking at physical development options and operating e ciencies, Christie Insurance ensuring that the relevant coverage is in place, and Orridge and Venners covering areas of stock, logistics, management compliance and control. And then, when an owner comes to make a disposal, we are on hand to conduct the sales process, assist with marketing and advertising to complete the circle for the owner. The “B” word It would be remiss of me not to mention the “B” word – Brexit – in this overview. While the topic is covered extensively in the pages of the 2017 Business Outlook, I feel that although some uncertainty was felt a er the initial referendum outcome, the likelihood is there will be no lasting impact on Christie & Co’s sectors. All of the business sectors referred to in this document, both in the uK and internationally, are multi-domestic businesses. Although we have seen an increase in sales to overseas buyers, particularly those from Asia, 90% of sales within our markets are to buyers within the same geographic market and, as a result, the Brexit vote will have little impact on domestic transactions. there will, of course, be an economic impact, and there is much discussion as to whether trade will boom or decline, however, Christie & Co will see no change in the way we work or in the transaction process.

 

Business activity in the second half of 2016 normalised, with both buyers and sellers realising that the Brexit outcome had limited immediate impact. It’s clear that intelligent business owners or prospective buyers are unlikely to put their plans on hold for what could be upwards of three years, and so for them, business life goes on. Looking ahead Many private equity investors can be agnostic regarding the sectors they look to invest in, driven primarily by returns and for those private equity houses based outside the UK, the reduction in the value of pound sterling against major currencies, and the dollar, in particular, has made uK assets more attractively priced. the availability of funding is a driving force within the business cycle; with base rates reduced, margins have tightened, and with borrowing becoming ever-cheaper, we are likely to see more borrowers attracted. however, the challenge remains nding good businesses to buy. Encouragingly, we predict an increase in supply in 2017. In the uK in particular, although our sectors will be impacted by various legislative changes including the national Living Wage and pharmacy funding, these should be well-managed by good operators, leading to a minimal e ect on the industry. We have seen that the pub market has settled now that uncertainty over the implementation of the Pubs Code has dissipated and that momentum has been good in the second half of 2016. this is likely to continue into 2017. Internationally, we may see a potential hiatus as Germany and France go through election periods, but now that a settled government is in place in Spain, it is likely we will see a continuation of demand there, as well as in Scandinavia, Poland and CEE. Although 2016 has been quite a tumultuous year in terms of macro environmental factors, at Christie & Co we are busy assisting our clients through the strength of our business network and experienced teams. We predict a further urry of Corporate Merger & Acquisition activity as the new Year unfolds.


https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Christie-Co-Business-Outlook-2017.pdf?ext=.pdf" target="_blank">https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Christie-Co-Business-Outlook-2017.pdf?ext=.pdf

Funding, Staffing & the Bottom Line

Posted by shaquille-mohamed.pabani.1@cass.city.ac.uk on July 13, 2016 at 12:05 PM Comments comments (0)

It is now just over 12 months since we published our ground-breaking piece of research on the shortage of nurses in the UK, “The UK Nursing Workforce – Crisis or Opportunity”. With frequent reference being made to a shortage of nurses in both the NHS and adult social care, a dramatic increase in agency use and escalating sta costs, we sought to place into context the true extent of the issues and the solutions available. Key headlines from our 2015 document included an estimated shortfall of 15,000 full-time equivalent nurses and the establishment of new industry sta cost benchmarks through our survey of 12 of the largest nursing home operators. On a positive note, we also drew attention to the innovative strategies being employed by leading care home operators to address the sta ng shortfalls. This new piece of research has been produced at a time when the sector is adjusting following the introduction of the new National Living Wage on 1 April 2016. With the vast majority of care homes reliant upon local authority funding, operators will only be able to o set the increase in cost if local authorities provide appropriate compensatory fee rate increases. Within this document, we seek to place the issues of funding and sta ng into context, assess what has changed in the last 12 months and provide answers to the pivotal questions around these crucial areas. Our research has leveraged the unique insight gained from our care sector specialists in each Christie & Co regional o ce. In addition, we have surveyed every local authority and nearly 200 operators, including specialist providers. As with last year’s research, we are also looking to provide insight into the potential changes for the industry ahead. With a number of policies currently being implemented and Brexit creating new uncertainties, we will examine the factors that will impact the industry over the coming years. We hope that you nd this piece of research to be informative and would like to express our thanks to all of the operators and other organisations who have contributed.


https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Care/Christie-Co-Finding-staffing-bottom-line-care-report-2016.pdf?ext=.pdf" target="_blank">https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Care/Christie-Co-Finding-staffing-bottom-line-care-report-2016.pdf?ext=.pdf

Christies Business Outlook 2016

Posted by shaquille-mohamed.pabani.1@cass.city.ac.uk on January 19, 2016 at 11:00 AM Comments comments (0)

This disparity between supply and demand looks set to continue in 2016. low volumes In the business retail market, Christie & Co experienced continued ‘business blocking’ during 2015. interest receivable on deposits is at an all-time low and many private business owners are simply staying put. Coupled with the fact that banks have mostly disposed of large portfolios of over-geared loans, the result is that volumes in the market remain stubbornly subdued. In 2016 we may see some spin-o sales from large portfolios that have been bought in recent years as the acquirers sell o the assets that don’t t with their medium-term aspirations. Funding landscape as nick Baker, Managing director of Christie Finance, explains, the lending market has been diversifying since the recession and there are a range of challenger banks in the market. it’s interesting that crowd funding is also becoming a source of income and debt funding for new and expanding businesses. It appears less appropriate for business-purchase nance, as where any acquisition is uncertain, vendors are understandably reluctant to engage with potential purchasers whose nance is in the public realm. Value uptick With the exception of the Care sector, values have largely recovered to pre-recession levels. Encouragingly, merger and acquisition activity has been evenly spread across all our business sectors. This is one key di erentiator between 2015 and 2014, when the Hotel market was hectic but other sectors weren’t to the same extent. We expect the value of businesses across the medium term to continue to rise and outstrip pre-recession levels, in line with any increase in their pro tability. the changing buy-to-let environment the government’s decision to reduce future buy- to-let mortgage interest tax relief contrasts with business-purchased mortgages whereby currently all interest is allowable. This decision, coupled with the announcement in November’s Spending Review of an increase in stamp duty on buy-to-let properties of 3%, is likely to impact the landlord market in 2016. Stamp Duty on business acquisitions remains unchanged. uncertainty remains Though we expect values to rise in the medium term, there are still areas of uncertainty in several of our sectors caused by factors such as the living Wage, as our sector heads explain in this Business Outlook. Our consultancy team wrote an incisive report on the implications, following this surprise announcement last April. In June 2015 we published our report ‘The UK Nursing Workforce: Crisis or Opportunity’, which was debated in the House of lords, and we will continue to research the area of sta ng costs, whichis highly relevant to all our business sectors. our teams across the UK and abroad have the specialist knowledge and research available to gauge the e ect of various scenarios on business growth. The impact of politics The UK has been through quite a period of political change in 2015 and the continued impact on our markets is varied. the dominance of the Snp in Scotland is dissuading migration from the South which has historically provided lifestyle buyers to Scotland, while in contrast the awaited referendum on the uk’s membership of the EU doesn’t particularly impact our domestic businesses. political instability elsewhere in the world only serves to enforce the uk’s safe haven status. legislative change as we start a new year, as an industry, we are faced with a number of legislative processes which will have an impact on all of the sectors that Christie & Co covers. Whilst the implementation of the national living Wage will undoubtedly create challenges within certain sectors, it would appear that most operators are proactively tackling it and drawing up inventive plans to limit the impact on their businesses. across all of our sectors, it is likely that corporate operators will undergo strategic reviews of their estates and poorer performing units will come out of the corporate sphere and return to the individual sector. We have already seen that there is a ready market waiting for such investment opportunities. A second, more recent example saw the Department of Health announce in December that funding for community pharmacy in 2016/17 will be cut by £170m – a reduction of more than 6% in cash terms. Rumour has circled the market for some months, but as yet we’ve seen no reduction in purchaser appetite. The announcement may accelerate some operators’ plans to exit the market, however, with over 4,000 registered applicants nationally, others may see any potential increase of pharmacies being put up for sale as a real opportunity to acquire in an easing market. overseas interest continues overseas investment volumes should continue to rise in 2016. good businesses enjoying secure tenure of su cient scale in an open market will always attract overseas investment, but the nationality of those purchasers varies depending on currency and political restrictions. Christie & Co’s teams speak 23 languages between them and our network of o ces puts us in an unrivalled position to advise clients on cross-border interactions.


https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Christie-Co-BO2016.pdf?ext=.pdf" target="_blank">https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Christie-Co-BO2016.pdf?ext=.pdf

Is the National Living Wage creating National Living Rage?

Posted by shaquille-mohamed.pabani.1@cass.city.ac.uk on December 9, 2015 at 10:55 AM Comments comments (0)

First introduced in the UK in 1999, the National Minimum Wage (the NMW), and its potential impact on UK businesses prompted debate and divided opinions at the time. A decade and a half later, the debate has been reignited with the revelation of the National Living Wage (the NLW) announced to replace the NMW for workers aged 25 and over. The NLW will be initially set at £7.20 per hour in April 2016, with the government planning on ambitious wage growth to over £9.00 by 2020. These rates are not arbitrary, corresponding to 55% and 60% of the median salary for workers above 25 in the UK, in 2016 and 2020 respectively, according to the recent publication from the Resolution Foundation think tank “Taking up the oor, exploring the impact of the National Living Wage on employers” September 2015. Despite the obvious bene ts for employees, the UK labour market is bound to experience signi cant changes and employers are preparing for major challenges. According to the Of ce for Budget Responsibility, primary analysis estimates that 23% of the total UK workforce (c. 6m employees) will bene t from the NLW increase by 2020, leading to a £4.5bn total wage increase across the country. These numbers also re ect the additional cost of wage compression to maintain salary differentials and pay equity, as a large share of employees are currently paid just above the future NLW. Undoubtedly, the extent of the impact will be very uneven across sectors, as workforce characteristics and remuneration levels differ widely across industries. The vast majority of sectors covered by Christie + Co are not only labour intensive, but also highly dependent on low-paid labour. In their September 2015 publication, the Resolution Foundation commented that hospitality and social care are sectors where the impact is expected to be the highest, with total wages expected to increase by c. 2.5% on average. This analysis also shows that this measure will bene t one out of two employees in the hospitality sector (Restaurants, Hotels, Events Management, Catering, Pubs and Bars), despite a large proportion of this industry’s workforce being under 25. In the context of various debates taking place around the introduction of the NLW, we give our experts’ opinion on this key issue and share initial reactions from our business partners and key industry players. Our sector heads identify speci c challenges and opportunities in their respective sectors: Hotels, Pubs, Restaurants, Care, Childcare, Convenience Retail and Medical; as well as potential mitigating solutions. Our care sector head, Richard Lunn, also comments on whether the announcements of the joint 2015 Spending Review and Autumn Statement can compensate the care sector for the National Living Wage costs.


https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/National-living-wage-UK.pdf?ext=.pdf" target="_blank">http://https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/National-living-wage-UK.pdf?ext=.pdf

The UK Nursing Workforce - Crisis or Opportunity?

Posted by shaquille-mohamed.pabani.1@cass.city.ac.uk on June 8, 2015 at 11:40 AM Comments comments (0)

Introduction With the UK population growing older, living longer and suffering from an ever increasing range of conditions, the need for good quality care has never been higher. Investors have recognised the opportunities in the UK’s private health & social care sectors and signi cant progress has been made to develop new state of the art care homes and hospitals. The last three years have heralded the arrival of many new, well-funded investors to the sector. These investors, many of whom Christie + Co has guided through a number of high-pro le deals and strategic restructurings, have actively targeted the private sector and were responsible for a number of major transactions. Coming from an environment that has been dominated by distress, we now see that the market has gained considerable con dence again. This con dence drives investors to transform the market towards a higher level of quality, particularly in real estate. From an operational perspective, however, the sector has signi cant challenges to overcome. Staf ng remains the most important factor in the delivery of high-quality care and has been a key area of focus for operators and regulators in recent years. Frequent reference has been made to a shortage of nurses in both the NHS and adult social care. Similarly, operators have reported a dramatic increase in the use of agency staff and rising staff costs. Christie + Co now looks to give an answer to the true extent of the problem. Using our network and relationships with the major UK care home operators, we have conducted a survey of the largest nursing home operators on their use of agency staff and the effects on overall staff costs. Supported by a substantial amount of published data, we establish the true extent of the shortage and the key issues. To provide solutions to the issues, we have invited three industry leaders to share their insight with us. We are grateful for the comments from our main contributors Dr Pete Calveley, CEO of Barchester Healthcare, Kevin Groombridge, Executive Chairman of Health Care Management Solutions, and Dr Chai Patel, CEO & Chairman of HC-One.

https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Care/UK-nursing-workforce.pdf?ext=.pdf" target="_blank">https://www.christie.com/christieMediaLibraries/christie/PDFs-Publications/Care/UK-nursing-workforce.pdf?ext=.pdf


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