Practice Profile: Hawthorn Veterinary Surgeries

When Jonathan Underwood decided to buy Hawthorn Veterinary Surgeries, it wasn’t just the fulfilment of a lifelong dream – it was also something of a homecoming.

Having harboured dreams of opening his own business since graduating from the RVC in 2002, when the two-site practice became available in 2012 it seemed the perfect fit.

Jonathan grew up on a farm near Henfield, where the practice was based, and had even locumed for previous owners Malcolm and Jennie Wild.

And things went well for Jonathan and wife Annelise (who also works as a vet at Hawthorn), and the business grew steadily during the next few years.

But like a lot of businesses, Hawthorn reached a crossroads and Jonathan found himself faced with an all-too-familiar question – stick or twist?

To stick meant continuing to work from a rather cramped site in Henfield while using the Partridge Green site as the main hub; to twist involved throwing everything up in the air, acquiring a new site and relocating the main hub to Henfield.

Having weighed up his options, Jonathan decided on the latter course of action, obtained the lease on the old Barclays Bank building in Henfield High Street and pushed ahead with plans to grow his business.

He said: “We had owned the practice for eight years and were at the stage where we either just stagnated or tried to do something. I was getting itchy feet as I knew we couldn’t stay as we were for the next 10 years or so; I wanted that challenge.

“Also, for things like recruitment, you have to have a building and a business that people want to work in – I wanted to make somewhere that people would be proud to work in and put us on the map locally.

“Doing this was more about making an investment in our staff and in our clients. The demographic in this area is such that our clients expect – and will pay for – a very high standard of service. As an independent practice, that was important for the previous owners and has remained a real focus for us.

“Being in the heart of Henfield has really helped us, too. There were actually three banks that all came up at a similar time – Lloyds, Barclays and NatWest – but this was the best site as it had a car park, which appealed, and there is a large public car park next door to the practice.”

Progress

Once the site was chosen, the project got under way and progressed at a rapid pace. The building came up for lease in March 2019, Jonathan got an agreement in principle on the lease from the landlord in April, change of use from A2 to D1 was confirmed in June and the builders started demolitions in July.

Building then began in August – and while Jonathan had plenty of experience managing a growing business from his time as clinical director at Nine Mile Vets in Berkshire, overseeing a building project was not something he was relishing.

So, rather than try to juggle keeping the practice functioning and managing the build, Jonathan decided to save himself the headaches by employing a team of builders and architects with plenty of experience in the veterinary sector.

“We used a company called Capella Construction, which also helped us with the planning application. They were very good – and what they did was project manage the whole thing,” added Jonathan.

“They are experienced in building veterinary practices, so knew about a lot of the aspects I wouldn’t have known about – like ventilation and drainage, where to put the hot water tank and how big the turning circles need to be in the car park.

“It would have been a nightmare to try to manage that all myself while still running the practice, so I cannot speak highly enough of them.”

Challenges

While plenty of parking and features – like electronic doors and access ramps – were already in place from its previous life as a bank, the site did present certain challenges.

For a start, there was the task of converting the underground vault into an office, staff room and overnight boarding kennels, as well as adding the ventilation required for the purpose.

The builders broke more drill bits than the Hatton Garden gang drilling through the steel reinforced walls, while there was no other option than leave the enormous solid steel vault door in place.

Jonathan added: “One of the benefits of this building is that there are no structural internal walls in it, which meant we were able to have a blank canvas in terms of how we were going to divide the space up.

“The only space we couldn’t do that was the old vault, which we now use as an office for vets and the vet nurses. It took the builders two days to drill through the walls in here, but I guess bank vaults should, by their very nature, be difficult to get into.

“We had to leave the vault door in the end as the only way we could have got that out was through the roof with a crane – not an option on any level really, especially as we have two flats above us.

“I must admit it did feel like a nuclear bunker down here before, but the builders have done a great job and it feels like a really nice space now.”

Drainage was an issue, too, so several Saniflo pumps were installed on the basement level to ensure waste water from the taps in the staff area and downstairs toilet was pumped upstairs and into the practice drainage system.

Functioning spaces

While things were a little complicated below ground level, the build was more straightforward when it came to the main functioning spaces of the practice.

The old bank is a very linear building, but Jonathan and his team were able to work closely with architects to make the most of these dimensions and he is rightly proud of the results.

He added: “We have a long, thin building, and I sat down with the architects and told them what I wanted – three consult rooms, two theatres, a dog and a cat ward, and then all the imaging stuff and where that would go.

“At that stage I sat down with my wife and the rest of the team to find a way of configuring the new place in a way that suited everyone – the pets, the staff and the clients – and I really think we have done it.

“We made some compromises, which is why we ended up with a dental zone in prep, rather than a dental room. The prep room is quite long and narrow, but that hub works well.

“As it’s such a linear space, we ended up with a configuration whereby a corridor ran the length of the building with all the rooms feeding off that and then they all feed into prep, but it seems to have worked and everything flows really well.”

It is clear the new practice has gone down well with existing clients as well as some potential new ones. At the time of VBJ’s visit, the practice had only been open a week – but judging by the numbers who turned out for the open day the weekend before, Henfield looks to have embraced the latest addition to its high street.

Jonathan said: “Opening up on this site has created a lot of interest – we had hundreds of people for our open day and they feel the practice is part of their community.

“Henfield has remained a village and it has a community feel about it. Due to the location of the previous Henfield branch it never had that feel, but being here on the High Street has put us right at the heart of the action. Everyone seems to feel like they are invested in this place.”

Investment

Jonathan has certainly made a significant investment in the place, with £100,000 spent on additional equipment as well of the costs of the conversion itself. Equipment included digital x-ray, laparoscopic kit, tonometry equipment, operating tables and a host of other items needed to fit out a modern, attractive, first opinion practice.

This quality fit out extends to the cat and dog wards, where Casco cages have been fitted throughout. With built-in heat pads and integrated LED lighting, the fitting of these glass units ensures all patients are comfortable and secure during their stay at Hawthorn.

The practice employs six vets, eight nurses, three animal care assistants, a student nurse and eight receptionists across its two sites, with three of those vets permanently on duty at the new Henfield branch.

Jonathan added: “Vet to client ratio is quite low – around 750 clients per FTE – but that is the way it is going. It is all about trying to offer a lot to your clients, rather than trying to rush them through – so we get to spend more time with them.

“That is what this building was about – an environment where our clients felt valued and as if their practice was investing in them and their pets.

“We can do a lot more here now too, of course, and the extra surgery space has made planning easier and avoided the backlogs we used to get. We now have x-ray and ultrasound at both sites, so that should help grow revenues, too. We are also benefiting from being in the heart of the village now, as we have found there have been a lot of people registering from Henfield in our first week here.”

Special cases

Due to its location, Hawthorn has some of the UK’s most respected referral centres on its doorstep. Anderson Moores and North Downs Referrals are the main practices referred to, while complicated orthopaedic cases are sent to Anderson Abercromby and oncology cases go to Fitzpatrick.

But as competent orthopaedic and soft tissue surgeons, Jonathan and colleague Vicki Roberts can handle a lot, while Areti Tsioka is a medicine certificate holder and Jonathan’s wife Annelise takes exotic cases from miles around.

The practice also uses a peripatetic surgeon for some cases – including tibial plateau-levelling osteotomies – to ensure as much work as possible is carried out on site.

One area Hawthorn has traditionally been very strong in is its health plan and comprehensive use of diagnostic testing. The monthly price of the health plan starts at £13.50 for cats and goes up to £20 for giant dog breeds. For that price, clients get gold standard veterinary care, which includes two vet consults a year, unlimited nurse consults, health checks and vaccines, and flea and worming treatment.

The deal also includes regular blood and urine testing, which helps Jonathan and his team spot long-term health trends in their patients.

He added: “The annual blood test is really interesting; we are in the fifth year of the health plan and we do free blood and urine tests – including a lot of sediment testing since we acquired an IDEXX SediVue two years ago.

“What that means is we are picking up a lot more problems. For example, we had a dog which we diagnosed with a splenic tumour on a routine blood test – it came in slightly anaemic, and we rechecked it in a couple of weeks and it was still anaemic, so we did an ultrasound, found the problem and performed a splenectomy.

“Because of that blood test, that animal never actually became ill at all [the histology indicated a benign lesion, so the long-term prognosis is good]. Once you have done five or six years of testing on an animal you can start to trend – for example, if a cat always has a urea of 9mmol/L and suddenly it goes up to 12mmol/L, that may be within the normal range. But for that cat that’s not normal – so it’s great for spotting potential early changes. So we test a lot and our lab is always running.”

Like practices all over the UK, Hawthorn is predominantly “a dog practice” – 68 per cent of its patients are of the canine variety and 25 per cent are cats. Roughly 40 per cent of all patients are insured.

Future

So the future looks bright for Hawthorn, even if Jonathan admits to going through the full gamut of emotions during the past few months. He said: “We just wanted a nice practice where everyone is happy – and we have that, but it has been stressful.

“I think I’ve been through the full seven stages of bereavement from happiness to denial, regret and acceptance. So I look at the people who have built five branches or whatever and wonder how they do it – I have only moved a branch and it has been stressful on a number of levels.

“So I certainly have no plans to build anything else; the next few years are about consolidation and building on what we already have – if we do that I will be a very happy man.”