Practice Profile: Martin and Manifold Vets

While barely a  week goes by without news of at least one of the big veterinary companies buying another independent practice, it’s very rare to see the same thing happening the other way round.

But that is exactly what Lizzie Threadingham and Alice Martin did when they took over a former IVC site in Cirencester last year – and they’re making a big success of it, too.

Since taking over the unassuming 700 sq ft single-storey building on the edge of the Cotswold town in March 2022, the friends have created a thriving business and – more importantly – a working environment they can thrive in, too.

The pair had become “miserable” on “the hamster wheel” of life as employed vets, and in the months running up to the pandemic, Alice and Lizzie had both reached the point where they had a simple choice – go it alone, or just go.

Neither wanted to turn their back on the profession they had given so much to, so they decided to go it alone and create the kind of practice that was built around their needs – not the other way round.

The site they chose to make it happen had belonged to Corinium Vets before its sale to IVC, and had stood empty for three years when Alice and Lizzie stepped in to bring it back to life.

“We had been looking for somewhere on and off for a few years, and when we heard IVC wanted to move this place on we decided to take the plunge,” said Lizzie.

“The lease was signed on December 2021 and we opened in March 2022, so we had three months to get it all done but we got there. I would describe the process of opening our own business as 50 per cent terrifying and 50 per cent exhilarating.

“The building needed completely redecorating and plastering, we had to move a few walls, we re-did all the plumbing and the electrics and lights throughout, so there was quite a bit to do.

“It has been a slog at times, but almost a year into it we’re both really happy, we’ve got a great little team, great clients and great business, but most importantly, we’ve got real balance in our lives now.”

Working mums

Lizzie and Alice describe having reached a point where the demands of being vet mums (Alice has three young children and Lizzie two) had left them feeling “too young to retire, too old to retrain and too miserable to carry on”. This was not the way it was meant to be.

Despite aspiring to become vets since childhood, long and hectic days in practice serving a profession that provided little support for working mothers had left them close to burnout.

But by becoming owners, they now control their diaries, and that means days that suit them and working in a way that delivers for everyone.

Alice said: “We don’t want to take over the world, we have about 400 registered clients and I can’t see us going much more than 600.

“We have a great little team, with Lotte our vet nurse, Emma on reception, Twiggy our practice dog and the two of us vetting, and that is the way we want to keep it.

“For us that is the perfect working environment, as we are no longer on autopilot, and we can take our time and apply our brains to things more.

“Because we don’t have that crazy throughput, we are able to offer a really nice service and manage cases properly.

“And people seem to like that. Our clients only see one of two people and someone holds their hand throughout every bit of it, and we have found there are lots of people who want that from their vet.”

Sustainable model

One of the things their growing client base seem to appreciate is being given more time and more care, something that wasn’t always possible in previous jobs.

Lizzie describes conducting as many as 50 consults a day at one time, with very few lunch breaks and the constant pressure of getting the job done – even if that meant leaving two hours after her shift had ended.

And while both feel improvements are being made in the veterinary sector, with some businesses now offering enhanced maternity pay and benefits, it still has a long way to go. Many vet and vet nurse jobs still don’t offer sick pay, and with so many practices pushing their teams so hard, Lizzie and Alice believe the current model is simply not sustainable.

Lizzie added: “Most veterinary practices run on the good will and grace of the team. There are days I remember that we only got through because the team all looked after each other – not because management made it possible, not because we had a steady day.

“We got through those days because nobody had lunch and nobody had eaten properly; that is not sustainable.

“You are not in charge of how the day works like we are now; you are not in charge of your own diary, and although you are the professional person who is entirely responsible for that case, and responsible for the nurses and the clients, you are not actually in charge of your day, you are just given an enormous list and told to crack on with it.”

Alice added: “The profession is still not geared up for a cohort of working mums and in some respects, it is still not geared up for the type of people who come into the profession full stop – men or women.”

Flexible approach

As well as ensuring their days are structured so that everyone gets regular breaks and no one is worked to a crisp, just as importantly, Martin and Manifold is run in a way that allows Alice and Lizzie to practise veterinary medicine on their own terms.

Instead of spending every working day rushed off their feet in back-to-back 10-minute consults and surgery blocks, the pair now have the time and space they craved to build strong clients bonds, and flex their clinical muscles. This is helped by 20-minute consults and sufficient slack built into the system to clear the decks for when a more complicated case comes through the door.

And it is an approach that works well for clients and the team, as Alice explained: “Veterinary is not a ‘consult this time, operate that time’ job, as you never know what is coming through the door or how the day is going to go. So, having that flexibility in how we are going to work and manage our day is amazing. We work around our people and that is not often the case in this profession.

“It has been a revelation. If there is something that we think might have complications, we can just not consult that morning and have another vet completely available as that extra pair of hands, so you are never doing something without the support you might need.

“Everything gets thought through, so one of us might be doing paperwork when one of those cases comes in so we are available to double vet that animal.

“We have built slack into the system and most practices do not do that. Our style of vetting is about keeping animals well rather than only seeing them when they are sick, and that needs time and well-developed personal relationships with clients, so we know each animal we look after and we just know when they are not right early rather than when they are just bad.”

Lizzie added: “People come to this practice as they want a certain level of care; people who are happy with a different scenario don’t move here. Our clients tend to be people who want a bit of looking after, and so they are prepared to be flexible if we need to prioritise a case or need to shuffle things around a bit. The way we see it is that our clients are joining our family and, like all good families, we look after each other – and if that means us doing home visits then that’s what we do.”

High-level care

As experienced vets, both Lizzie and Alice have developed clinical interests that have helped the practice develop in its first 12 months.

Both Lizzie and Alice enjoy surgery, while Lizzie has a General Practitioner Certificate in Western Veterinary Acupuncture and Chronic Pain Management, which has led to the practice taking on a lot of advanced pain management cases and second opinion work.

The practice has also quickly built a strong reputation for exotic veterinary care – in particular, chickens – and for the high level of clinical expertise and client care on offer.

Alice and Lizzie are both vastly experienced vets, and they spent big to ensure they had the right level of equipment they would need to deal with cases to the highest level possible.

Alice said: “It’s small, but we have all the kit and the expertise to use it so we can do first opinion work right up to the maximum really.

“We are both keen imagers and medics and we also have various visiting specialists who come in to help, too.

“We have a lovely ultrasound machine, we have a DR x-ray, lovely tables that warm up, and hold the patient beautifully and a bear hugger external heating device to recover animals post-theatre.

“We also have a great lab and a great microscope as we do a lot of cytology – we invested a lot in tech and we bought all the kit outright.”

Growing the family

Alice and Lizzie have also invested in their team, paying “substantially higher” salaries than the industry average, and ensuring everyone gets plenty of variety in their work.

Lizzie added: “As a business, it is important to employ people in the right roles to be efficient, but, going back to the hamster wheel, if your efficiency is putting a vet in a room for 11 or 12 hours with very minimal breaks, that is not efficient, that’s dangerous.

“Whereas if you have a day like me, where I might spend an hour on reception or something, that is efficient because I have had a mental break and a change of scene – that is so good for you. The alternative is being a rushed hermit in a little room not being able to offer a good service or particularly good medicine.”

Martin and Manifold Vets had something of a soft start, with Lizzie and Alice spending two weeks at the practice before they opened “fixing animals” for friends and family as a trial run ahead of officially opening for business on 7 March 2022.

Very little by way of marketing was done ahead of the opening day, and no advance marketing or early client sign-up initiatives took place.

“We just opened and very gently made ourselves available to local pet owners, and as we make up half the workforce, we could afford to do that,” said Alice. “It is quite an unusual way of doing it, but it has worked for us.”

Lizzie added: “It was quite a good time to open, as people are struggling to find vets and there are definitely clients out there, and it is a big enough area as it draws from a large area. We have a lot of clients who come from villages around Cheltenham.

“We put one little poster on the back of the building a few months before we opened to say a new vet was opening and we did quite a bit of Facebook, and we still do quite a bit of gentle and careful Instagram and Facebook.

“But it helped that we grew up in the area and know a lot of people with pets, so we did have a solid base of people who came to see us as we are part of the community.”

Business booming

The pair have also been careful to create their own solid business community, choosing only suppliers and service partners who fit with their ethos, rather than simply going for the cheapest deal.

As well as help from the team at Vet Dynamics to find the site, Jack Peploe and his team at Veterinary IT Services took responsibility for the entire IT set up, and a phone system that automatically switches all calls to out-of-hours provider, Eastcott Referrals at 5:30pm every evening. The practice opens five days a week from 8:30am to 5:30pm and from 8:30am to noon on Saturdays.

And financially the business is performing well, breaking even after its first month and growing in-line with the business plan, but this was never about money, as Lizzie explained. “We did this to get a nice job, not to get rich,” she said.

“Yes, we have a lot of responsibility, but we also have more control and that is the key as having that control helps reduce the stress.

“It probably says something about how the profession is being managed that setting up a business from scratch is actually less stressful and less pressurised than a salaried job.”