physio first | annual report 2018-2019 the uk’s only trade ......a v physio first | annual report...

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Physio First | Annual report 2018-2019 The UK’s only trade organisation for private physiotherapy

www.physiofirst.org.uk

Annual report 2018-2019

This caretaker approach would inevitably lead us to becoming undertakers. Both credible, defendable and comfortable after 67 years of the existence of OCPPP and Physio First.

However, I do not believe our newly elected executive will take either of these approaches. They will continue to be risk-takers striving to reinvent Physio First once again to meet the new needs of our community bound by a love of what we do as well as a need to perform in our private healthcare marketplace.

We will continue to work together and support members and clinics who are ready and willing to expose their physiotherapy practice to scrutiny in order to demonstrate the quality of service we provide to patients. We will continue to shout about this quality from the rooftops as it is always easier to be loud about something you can evidence.

We will work with the CSP to create a career structure for private practice into which we can welcome students and start to nurture a new private practice generation for the future. We will support the NHS moving to first contact practitioners as, of course, we have all been exactly that since we went into practice. Any change in public awareness that makes physiotherapists the “go-to” profession can only be great for all of us.

So, in closing, I want to say thanks to everyone who has been a part of our last four years together. It has been an honour to work with you all.

A final thought from Pastor Rick Warren:“Undertakers quietly talk about yesterday.Caretakers carefully plan for today.Risk-takers boldly plan for the future.”

Let’s be bold!

PAM SIMPSON | CHAIRMAN | Physio First

Let's be bold!I know every chairman in the history of Physio First, and OCPPP before it, has started their letter in their final Annual Report with words such as “I can’t believe how fast these last four years have flown by!”

Just because this has been said before does not mean it is any less heartfelt or accurate. It is also my privilege and slight indulgence at this time to revisit these four years with some highlights and achievements of Physio First. These are not my achievements, this is the collective activity of a huge and dedicated team. Our volunteers and our office team dreaming together, planning together and then getting things done together. Being the leader of this wonderful team has been an honour and a joy.

We have met the challenges of our changing marketplace head-on and led the way in developing solutions to enable our members to demonstrate their quality as private physiotherapy practitioners. Our executive committee has been brave enough to advocate measuring individual physiotherapists’ patient outcomes and our members have been brave enough to input those outcomes, trusting Physio First to find a way to make these count.

Of course, we owe huge thanks to our University of Brighton team and to the Private Physiotherapy Educational Foundation (PPEF) for their major parts in our Quality Assured Practitioner and Quality Assured Clinic development; but overwhelmingly we must give our members and whole team credit for dreaming with their eyes wide open and taking the risk to lead the way in the “quality agenda” of our private MSK marketplace. A risk that is now paying off in many ways.

So, a question I would put to all our members and potential members is “are we, as Physio First, risk-takers, caretakers or undertakers?”*

Almost two-thirds of our membership remain over 50 years of age and we now lose members to retirement in significant numbers each year. We could, as an organisation, recognise and plan for the fact that this is likely to continue and design our benefits and services to meet their needs as they prepare to close or sell their practices. We would be caring for them and supporting them until they no longer need us. We would be acknowledging our demise and planning proactively to make this end as comfortable and as dignified as possible.

*ref Pastor Rick Warren

2 | Annual report 2018-2019 | Chairman's report

Our Quality Assured Practitioner (QAP) scheme has become increasingly highly regarded by members, stakeholders and some major marketplace players. A Physio First member can be determined as having QAP status when they have input sufficient data using our Physio First Data for Impact (DfI) tool and their data demonstrates meeting the quality criteria defined by Physio First, in collaboration with the University of Brighton. The participating member is also required to complete a validated Patient Recorded Outcome Measure (PROM) which will contribute to the overall validation of our data, and to use a Patient Recorded Experience Measure (PREM). Congratulations to the 100 or so members who have gained QAP status since we launched the scheme.

In November 2018, we launched our Quality Assured Clinic scheme (QAC) where all MSK clinicians within a clinic contribute to a clinic-wide measurement. To support this, we offered a part-time subscriber rate making this accessible and cost effective for many clinics. The first download of data for QAC assessment occurred in

January 2019 and the next will take place in May. All the details of this benefit can be found on our Physio First website. Our progress with the University of Brighton in unstacking the data collected through DfI has enabled our evaluation on the future delivery of our centrally run courses. Education can be delivered in many ways and we acknowledge that there is pressure on everyone’s time, so our aim is to use the unstacked data from our DfI scheme to guide our planning for targeted learning in very specific areas in the coming year.

Our DfI scheme has also enabled the University of Brighton team to deliver, based on the work undertaken for Physio First, two poster presentations, and a rapid five presentation at the November 2018 Physiotherapy UK conference, covering:

1. Duration of symptoms and outcomes of treatments in musculoskeletal patients in private practice 2. DfI: exploring the benefits of standardised data collection in private physiotherapy practices across the UK3. Exploring the psychometric properties of the Brighton musculoskeletal Patient Reported Outcome Measure (PROM).

They also had three abstracts, relevant to our DfI and QAP schemes, accepted for the May

Physio First, founded in 1952, is the professional network of the Chartered Society of Physiotherapy (CSP) and trade association representing self-employed chartered physiotherapists. For more than 60 years, Physio First has represented the interests of self-employed private practitioners, identifying and assessing threats and then fighting (within the law) moves that would undermine them. We support our members by educating them on how to tackle these threats themselves and by providing, as a minimum, initial commercial and legal advice when they need it.

In 2013, our executive agreed our five-year vision was to champion evidence-based, cost-effective private physiotherapy with Physio First members in the changing healthcare marketplace. Having completed our agreed 9 Goals one year ahead of time, we revisited our vision in October 2017 and re-affirmed it for the next three years. It helps enormously to have such a clear vision and something on which to target all our resources. These resources include all our time, energy and money (TEM) – all considered equal, with no one any more or less important than the other.

We are run by our elected executive committee, all volunteers who are practising private physiotherapists. They are supported by more volunteers currently organised into three sub committees and up to 18 regional officers, all of whom work closely with our office team. As a professional network of the CSP, we are described as “a self-governing body that is responsible for our own financial and organisational liabilities”.

Chairman’s report 2018-2019

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Main achievements 2018-2019



2019 World Confederation for Physical Therapy conference in Geneva:

1. Exploring the feasibility of implementing an online PROM for patients attending private physiotherapy treatment in the UK 2. The development of the QAP scheme in private physiotherapy practice in the UK 3. Gathering and utilising musculoskeletal data from private physiotherapists to demonstrate the value of their services: a UK-based project.

Thanks to the collaboration with our transformational partner Blue Zinc, we were able to react swiftly to guide our members through the introduction of the General Data Protection Regulation (GDPR) in preparation for the May 2018 legislations. A series of countrywide roadshows and webinars were rolled out, giving information and Q&A sessions. We also worked with our partner, Painless Practice, who produced a comprehensive step-by-step guide on how to comply with GDPR. We intend to revisit this in 2019.

Our digital newsletter, The Core, has become a well-established information resource for our members, one that enables us to deliver news quickly in response to marketplace changes. As it can be accessed on any device, “on the go”, the volume of open and click-through rates on our articles indicate that our members are finding the information we are supplying to be convenient to view and of huge interest.

Following our report last year on discussions with our most important marketplace stakeholders, our Chairman and General Secretary, whose role is now evolving to become our Strategic and Business Lead, continue to advocate with these groups that it is our evidence-based view that demonstrating “quality” in private physiotherapy will be the new currency and that funders of MSK private physiotherapy treatment are very likely to move towards contracting on measurable quality rather than, as has been the case for some years, just on cost. Physio First is proud to have been involved in a cross-industry working group to examine this. Our members now have the opportunity to be able to differentiate themselves on quality. The result from the Private MSK working group to date has been the publication of a 26-page slide deck and one-page summary detailing how the collective representatives from the industry regard the collection of data both now and in the years to come. We are pleased to say that Physio First is still ahead of the game; both our QAP and QAC schemes stand up to scrutiny on all fronts. If private MSK

physiotherapists do not collect data using validated tools, they are unlikely to succeed in the changing marketplace. Demonstrating quality in defendable terms is something that even the self-paying public will start to demand as purchasing in this way becomes the currency of the future. As part of our involvement with the cross-industry working group, we have worked with the CSP as their professional network representing private practitioners, and they have supported our QAP and QAC schemes as more than meeting the requirements as defined in the working group’s statement.

At the beginning of January 2019, our office team numbered 10; made up of six full-time and four part-time team members, together with our externally based and employed General Secretary in his evolving role as our Strategic and Business Lead. Our overall aim for our office team is to continue to work SMARTer, (specific, measurable, achievable, relevant and time-bound) as this has allowed us to evolve to a reduced full-time equivalent (FTE) headcount through natural wastage, as has happened with our executive numbers (see “structure” on page 6). As part of this process, our Office Manager of 15 years, Julia Costello, moved on to other things and we were delighted to welcome Donna Partoon as our Operational Lead, a change of title that reflects the evolving dynamics of our superb team. Our October 2017 strategic facilitation recognised what we described as one of our most important assets: our whole strategically and culturally aligned volunteer and employed team; our written and agreed statement of intent (vision); and our powerful and empowering culture.

Our relationship with the CSP has grown over the past years and we welcomed their invitation to work with them on the co-authorship of an e-booklet, Guide to Starting in Private Practice, that was launched in October 2018. The publication is hosted on our own Physio First website and linked to the CSP’s, and is used as an information resource for enquiries about issues with regard to private practice, both by our office team and the CSP enquiries team.

In addition to these specific achievements, we continue to encourage and deliver member education via our flagship annual conference and quarterly journal, In Touch, and our website, the “traffic” analysis of which amazes advisors and experienced marketeers, remains a constantly updated source of information. We will be spending some time during 2019 reviewing its content and functionality to make sure it continues to be fit for purpose.

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Our business goals for 2018-2020Having signed off our detailed three-year business plan in October 2017, I am pleased to say we are on target with all seven of our 2018-2020 business goals, with goals one and three currently in progress, and goal two being completed. We regularly announce progress against these goals in our e-newsletter, The Core.

3-year Business Goals 2017 2018 2019 2020

1 To mould our 2017 communication strategy so that we learn to effectively communicate to the majority of our members the value of: ▷ trusting Physio First▷ feeling like a member of a team whose aim is to champion evidence-

based, cost-effective private physiotherapy with Physio First members in the changing healthcare marketplace.

_ _ _ x

2 To make our volunteer structure functional for 2018 and beyond in line with the views and opinions expressed during our executive team’s October 2017 strategic facilitation.

x x _ _

3 To formulate a strategic commercial relationship with The Physio Co-op as it develops from a start-up business.

_ _ x x

4 To work with the PPEF and our University of Brighton team to actively include:▶ the voice of the patient in the development of the Physio First QAP

scheme▶ identifying Data for Impact evidence to demonstrate ▷ the advantages of Physio First QAPs’ contribution to the maintenance

of public MSK health ▷ the cost-effectiveness of Physio First QAPs and to publish

x x x x x x x x

5 With members and partners, explore the developments of technology likely to affect the delivery of MSK healthcare that might provide marketplace disruptive threats and / or QAP opportunities.

_ _ x x x x x x

6 To research and, if cogent, establish a viable business case to:▶ facilitate Physio First QAPs to provide third year undergraduate

physiotherapy students interested in private practice to gain clinical experience with them

▶ persuade such students to become student members of Physio First and thereafter be listed as contacts for Physio First members to consult about work opportunities.

x x _ _

7 By 2020, feel confident to be able to reduce our 16-word vision by three words, i.e. to replace “evidence-based, cost-effective” with “quality” so that it reads “Championing quality private physiotherapy with Physio First members in the changing healthcare marketplace”.

_ _ x x x x x x


We have, in March 2019, completed our second positioning exercise, updating the one from 2014, to enable us to understand, through member and non-member feedback, the progress of our organisation over the past five years, and determine any new direction of travel.

If successful, our structure can be summarised as in the diagram below with three main strategies driving our activities: quality, commercial and communication.

ReputationSince its sign-off in June 2015, our communication strategy has been incrementally updated as we learn more about the demographics and needs of our membership and we will continue to develop this area of our organisation to meet the demands of technology. As we explained in our 2017-2018 annual report, our full rebrand, new website and a focus on streamlining all our activities formed part of this communication strategy and our executive chose to invest a significant amount of our organisation’s reserves to achieve these aims. This led

StructureIn terms of our executive structure, we propose creating a new executive post, that of Honorary Communications Officer, to be responsible for this large and developing aspect of our organisational planning. Our Honorary Editor will become part of the wider education sub committee where our

to a deficit budget and accounts for three years running. We announced last year that this spending was now complete and, following careful planning and accounting, we are pleased to have finished this year on a small surplus.

Other activities emanating from our communication strategy include a project on Physio First member value and the identification of the personas that make up our membership so that we can become more targeted in our communications and benefits. We have also deployed our social media strategy which is growing organically.

Honorary Education Officer will have responsibility for all our education vehicles, all with the shared purpose of assisting our members towards achieving QAP and / or QAC status. These proposals will be voted upon during our April 2019 AGM.

“We are pleased to have finished this year on a small surplus”

LEADERSHIP TEAM

Chairman

Vice Chairman

Strategic & Business Lead

Operational Lead

Treasurer

EDUCATION

Hon. Education Officer

Hon. Editor

Hon. R&D Officer

Leading on our Quality Strategy

Leading on our Commercial Strategy

Leading on our Communication Strategy

COMMERCIAL

Hon. Commercial Officer

Hon. Membership Officer

COMMUNICATION

Hon. Communication Officer

RO Rep


Get the latest and unique marketplace informationCommunicating the latest and private physio specific marketplace information, through our multi-level contact with marketplace stakeholders, and from our Chairman to our members.

Benchmark your practiceBenchmarking our practices, by producing member reports that compare turnover, profit, number of partners, employees, self-employed associates, practice management software, etc. through our annual Practice Profiling report.

Join our private LinkedIn forumAccess to our private LinkedIn forum, which offers member-to-member peer advice and peer support in a safe, trusted Physio First only environment. Our forum is estimated to be the most active of its type.

Get Data for Impact reportsOur Data for Impact (DfI) data collection scheme. This is our members’ opportunity to collect patient data, understand our own patient outcomes in comparison to our Physio First national database and, as a result, really appreciate what we and our colleagues do well and where we need to improve.

Join our Quality Assured Practitioner scheme Our trademarked QAP scheme, which delivers independently verified quality assurance, i.e. evidence of our effectiveness as a private physiotherapist.

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Services offered to members Our Big 5 unique benefits

PHYS

IO FIRST BIG 5 UNIQUE BENEFITS • PH

YSIO FIRST BIG 5 UNIQUE BENEF

ITS

•

In 2016, we consolidated Physio First’s offering into our Big 5 unique benefits comprising:

All of our other member services, including legal / commercial advice, our annual conference, quarterly journal, quarterly business newsletter and education programme, serve to deliver or support each of our Big 5 unique benefits.

H


something that we have often craved but never thought we might achieve.

External marketplace stakeholders Physio First is primarily represented through our Chairman, Honorary Commercial Officer and our General Secretary. This includes sometimes frequent meetings with significant marketplace stakeholders such as Bupa, other private medical insurers, our existing and potential strategic partners, private hospitals, e.g. the Schoen Clinic, the Federation of Small Businesses and other commercial intermediaries and emerging organisations.

The business / trade professional membership organisation sector as we see it As part of our engagement with the development in technology and increasing success of marketplace disruptive businesses, we, as an organisation, have long recognised that we need to work SMARTer, nimbler, and be more flexible and agile in our changing marketplace. All membership organisations, including within healthcare, need to adapt to this new environment and learn how to engage generation Y or millennials (the population born between 1982-1995) who are set to become the majority of the workforce, and whose outlook leaves them less inclined to join organisations. This remains a challenge to us all.

To this end, we continue to engage with the MemberWise “Member Value 2025 project”. This aims to help organisations understand the difference between member benefits and member value and, with it, we intend to identify how the true “value” of membership of Physio First can be measured, e.g. in the advantages our members have over non-members in the marketplace.

Transformational partnersPhysio First and Blue Zinc have a transformational partnership* which provides unique benefits to our members across the UK. This was a first for both our organisations and part of its ongoing benefit to our members is the use of the Blue Zinc Pronto online booking service, which offers convenience to patients and practitioners. In addition, as mentioned in our achievements, our transformational partnership with Blue Zinc came into its own in 2018 with the implementation of the General Data Protection Regulation (GDPR). Their willingness to offer and arrange nationwide workshops and online support to help prepare our Physio First members on this new legislation was greatly appreciated by all concerned.

Strategic commercial partners As at the end of 2018, our strategic commercial relationships** are with Painless Practice, Meglio, Physiotec, Physiotools, Physique, TrackActive, the Federation of Small Businesses, Performance Health, and Vivomed.

Collaborative partners Thank you to Laura Pegg, a Chartered Marketer (We Are Circle), who continues to work closely with our executive and office teams on our ongoing marketing and communications campaigns. In 2018, she was instrumental in producing, in collaboration with the CSP, our Guide to Starting in Private Practice, and is currently working with us on producing our 2018/19 positioning report.

Independent / self-employed consultants Thank you to Jason Pelta and the Pages Creative (graphic designers) team, Ian Baughan (Solus IT support), Pixl8 (website support) and MillerTech (MRM support) for their work with Physio First over the past year.

RepresentationChartered Society of Physiotherapy (CSP) As a professional network of the CSP, we have worked closely with our CSP colleagues on a number of projects throughout the year, including a change in their allocation of funding for their professional networks, which we supported, and we look forward to seeing how the grant system develops in the coming year. In October 2018, we launched our co-branded Guide to Starting in Private Practice e-booklet which is free to download from our Physio First website and linked to the CSP website. This is where all physios thinking of, or who have questions about, starting in private practice are directed from both our office team and from CSP enquiries handling unit.

As Physio First, we are looking to the future and are working with the CSP in defining a system to support Physio First members to be able to take students into their practices to experience private practice as part of their practice-based learning schedules. This will involve helping our members to gain the skills to be practice educators and to work with CSP and the institutions on common assessment documentation. It will also be important to talk to the higher education institutions about the potential business case for private practitioners. We also expect this initiative to provide a pool of potential recruits to our members’ practices through the opportunity to mentor undergraduates into the mindset necessary for private practice.

We watch with interest the evolution of first contact practitioners within the NHS and the emerging role of an advanced practitioner. We are also working with the CSP to benchmark our QAP and QAC schemes against this framework which, if successful, has the potential to offer a form of career structure within private practice;

* Transformational partnership = having mutual, specifically agreed, high-level strategic objectives that are capable of helping to “transform” both parties** Strategic commercial relationship = provides sufficient strategic and cultural synergy, resource for Physio First, a mutually agreed realistic commercial outcome for the commercial partner and a benefit for our members


Employment profile Taken from MRM February 2019

Age range of members Age range : % of entire membership, (total members)

= 20-29

= 30-39

= 40-49

= 50-59

= 60-69

= 70-79

= 80 > and Unknown

How would you describe your role?Taken from MRM February 2019

Sole practitioner

Practice principal

Self-employed associate

Employed

36%

21%32%

<11%

10%

0%

20%

30%

40%

50%

60%

then followed by London.• The ratio of male to female members

is 27:66.• 64% of members have been with our

organisation for between 11-31 years. • Colleagues are the main driver of

awareness of Physio First, followed by the CSP; 59% of members joined Physio First because of a recommendation, 77% had recommended someone join Physio First.

implemented over the past year is in our engagement with digital communication and understanding how we can use this immediate and fast-paced medium to our best advantage in helping to keep members engaged and willing to become our volunteer post holders of the future.

We fully appreciate the time and enthusiasm our current amazing volunteers dedicate to Physio First, but we must ask ourselves whether we will always be able to rely on people

As of December 2018, our Physio First membership was at 2,738 members, aged 20-80 years old, all chartered private physiotherapists. To break this figure down further:• The majority of our members are aged

between 30-59 years old, with 10% aged 30-39, 27% aged 40-49 and 39% aged 50-59. The average age of a

Historically, Physio First members have always put themselves forward to help “run” our membership organisation. Initially, tasks were mainly to do with organising our courses or conferences, and in the production of In Touch and other publications. Our PR sub committee, later evolving to our membership team, came much later.

Having put our “stretching our structure” strategic development into action last

member is 50 years. • 21% of members define themselves as

practice principals, 36% as sole practitioners and 32% as self-employed associates. Less than 11% are employees.

• Our members are evenly spread around the UK, although Mercia has the highest percentage of members,

year, our volunteers and employees are now working well together as a full and empowered team. Donna Partoon stepped up in 2018 to become our Operational Lead and, with our Treasurer Jacqui Webb, they have empowered our office team in working together with and supporting “their” executive member colleagues and sub committees.

Another area of our strategic development that has been

Note: Statistics are analysed from our Physio First MRM, February 2019.

Description of the Physio First member market

Embracing the use of technology as a way of working with and developing the role of our volunteers

0.73%

2.7%(20)

(74)

(373)

(271)(216)

13.62%

9.89%7.4%

39%

26.66%

(1068)

(730)


willing to put themselves forward in our changing world.

Using technology to find new ways of SMART working, while continuing to engage sufficient members into the heart and future of our organisation is essential and over the past year we have experimented and become more experienced in the use of GoToMeeting software that enables our volunteer officers to attend meetings electronically from the convenience of their own homes or practices.

In addition, we continue to explore the use of smaller short-life working groups or single-issue meetings that will enable more volunteers to become involved, and to become champions in many different areas of our organisation’s activity.

The Physio Co-opFollowing the groundwork undertaken on The Physio Co-op over the past two

years, its development has progressed well during 2018:− In February, our executive sanctioned

our General Secretary (Paul Donnelly), whose role is now our Strategic and Business Lead to “get on with it”

− March saw The Physio Co-op selected for inclusion in a “Platform Co-operative” accelerator programme that Paul attended between April and June

− The Physio Co-op trade stand at our Physio First annual conference in April attracted a steady flow of visitors requiring more information about the concept

− A full report with two recommended, very specific next steps was presented to our executive in September for consideration at our October meeting, i.e.

1. to establish a Founder Group who have the skills, contacts, experience and sufficient strategic and cultural alignment to have the best chance to succeed and2. that the Founder Group proceed to try to establish a data and evidence supported Minimum

Viable Product (MVP) that they have enough belief in to progress to a formal crowd-funder, aimed primarily at Physio First members.

− next steps that were fully sanctioned.

A “Guide to the recruitment process for The Physio Co-op Founder Group” was produced and published in our February 2019 edition of The Core – a step that is in progress now.

Obviously, there is a lot to do to move through these steps, but, succeed or not, our involvement in this project is teaching us a lot about what it takes to start-up and then run a business venture; lessons that are directly transferable to Physio First and our members.

Progress on The Physio Co-op and updates on Paul’s endeavour to lead this project will continue to be reported through The Core and through the various social media posts.


Value perception of Physio First to members

Support

LinkedInBenchmarking

Big5

Business

Courses

CPD

Create

Education

Empower

Engagement

InTouch

Knowledge

Lead

Liaise

Marketing

Meetings

Negotiate

Opportunities

Planning

Profiling

ProgressRecommendation

Start

Trust

Value

FAP

Information

Marketplace

Peer

QAP/QAC

Community

Conference

Endorsement

Insurance

LegalNetworking

Quality

In our largest meeting of Physio First volunteers in October 2018, a workshop produced their views on the perceived and actual value of being a member of Physio First – the results are published here


ConferenceBenchmarking

Big5 Business

Clinical

Communications

Community

DBSFAP

Feedback

Influence

Marketing

Personal

PracticeProfiling

Reputation

Research

Reviews

RO

Service

Testimonials

Trust

Website

DfI

Education

LinkedIn

Marketplace

PeerProfessional

QAP/QAC

Courses

InTouch

Legal

Support

Advice

CPD

Discounts

Experience

GuidanceInformation

Insurance

Meetings

Networking

QAP

Representation

The Core

Actual value of Physio First to members


and supported our efforts in promoting evidence-based, quality assured physiotherapy that is trusted by our internal and external stakeholders. This message will continue to be the key to the ongoing evolution of Physio First as a forward thinking, strategically aware and commercially nimble organisation in our fast-changing marketplace. Thanks also must go to our fabulous office team for their endless efficient and enthusiastic support. Our Operational Lead, Treasurer and every single individual office team member are an important part of what makes Physio First the “go-to” organisation for physiotherapists in private practice.

Every year brings its new challenges, but I am confident that our organisation is in the best position to face them head-on. Our years of preparation for proving the efficacy of private physiotherapy, our subsequent focus on quality assured practice, and our willingness to engage with the necessary technology to commercialise this with our members will ensure that Physio First is always ahead of the curve.

Physio First competitive advantages and disadvantagesOur competitive advantages are:• our volunteer post holders who are

prepared to give up their time, energy and money (TEM) and unite around a vision that gives members powerful advocates and access to our Big 5 unique member benefits

• our employed office team and our transformational, strategic, commercial and collaborative partners, all with the motivation and empowerment to make sure Physio First succeeds

• our Big 5 unique benefits • our written down vision and culture• our unity, trust and thus

empowerment of our whole strategically and culturally aligned volunteer and employed team.

Our competitive disadvantages are:• our challenges in communicating the

value and impact of Physio First to potential members

• our challenges in raising and / or saving sufficient “M” resource to employ and commission the “T and E”, and expertise needed.

The factors that will make Physio First succeedThe overwhelming commitment and resilience of every post holder; employed, self-employed or volunteer and organisational partner to:• achieve our vision and not deviate

from that strategic marker• achieve our objective of helping to

establish a private practitioner self-owned Physio Co-op

• behave in line with our culture and in our trust in each other, which is the essence of what melds our employed, self-employed, volunteers and partners into a team

• strive for absolute efficiency through “linking our thinking” (LOT) wherever possible.

Challenges and strengthsThe most significant challenges that Physio First faces now and in the foreseeable future, in no priority order, are in: • managing our resource, i.e. our TEM

so that we have enough to continue to meet our goals and our vision

• securing succession planning for all volunteer posts in terms of helping to manage their capacity, through a combination of SMARTer working and use of technology, to make roles achievable

• persuading enough current members to engage with our Big 5 unique benefits and our strategic journey, i.e. overcoming apathy and the lack of available time to engage, and in reducing the T and E that members need to find to engage

• persuading self-employed private practitioners (and their employees) who are not members to join Physio First

• finding and helping to establish a legal and robust self-owned business model that can create and then sustain The Physio Co-op for the long term.

The strengths that members of our executive committee bring to Physio First are:• passion, intellect, determination,

loyalty, energy, enthusiasm, selflessness, willingness to learn new and modern “business fundamentals” and to apply them

• their burning ambition for: ▷ the independence of members to

deliver private physiotherapy to the highest standards

▷ like-minded colleagues to be able to demonstrate and articulate quality, which we define as evidence-based cost-effectiveness. In marketplace terms, this is also described as “value”.

Finally, thanks again to every single volunteer member who has worked towards our goals during 2018 and who, in whatever capacity, has championed private physiotherapy,

14 | Annual report 2018-2019 | treasurer's report

ConferenceThe overall result from our 2018 conference was a surplus of £26.6k. This was an increase on our surplus of £25.7k in the previous year. Both surpluses are calculated before allocating administration costs associated with producing such a successful conference.• Conference income and expenditure

reduced in 2018 compared to 2017 levels, resulting in a small increased net income.

• Our conference delegates contributed a total of £1.2k to the Benevolent Society. We would like to thank everyone who contributed for their donations.

EducationOur education day and courses offered by our Regional Officers through the year delivered a surplus of £5.2k, up from £4.6k in 2017. These contributions are also calculated before allocating administrative costs in delivering them.

In TouchOur In Touch publication produced a deficit of £8.2k in 2018, which was reduced to £2.9k after journal subscriptions and a £3.6k grant award from the PPEF for our post-conference edition were taken into account: • Advertising and insert income was

down £13.5k on the previous year. It is becoming increasingly difficult to attract advertisers in this digital age.

• Costs of production and delivery of In Touch reduced by £9.6k, from £42.5k in 2017 to £32.9k in 2018.

Our Treasurer’s report aims to identify the major financial matters that have arisen during the year, to review the end of year financial position of our organisation and to look into the future for financial opportunities.

Results for the yearDuring 2018, we continued at pace with our intent to champion evidence-based, cost-effective private physiotherapy with Physio First members in a changing healthcare marketplace. As a result, we have:• developed and launched our Quality

Assured Clinic (QAC) scheme enabling recognition of a quality clinic status

• developed and launched a part-timer subscription scheme which enables those working part-time to actively contribute to a clinic’s quality status

• again, taken massive strides to champion quality as a whole and our Quality Assured Practitioner (QAP) scheme to our members and the entire healthcare sector, through our participation in the Quality in Private MSK Healthcare Working Group, as well as at individual marketplace meetings.

Our result for 2018 was a surplus of £1.6k, having put behind us the massive investment of our reserve over the previous three years. Our organisation remains financially secure and costs continue to be fully budgeted, controlled and indeed reduced as shown in figure 1, which illustrates the expenditure comparisons for 2017 and 2018.

In 2019, we will continue to aim for a small surplus in order to continue to replenish our reserves as planned.

Details of our activities in 2018MembershipMember numbers reduced by 205 in 2018; this reduction is continuing to be addressed in our recruitment and retention projects, the promotion and development of our Big 5 unique member benefits (that include our QAP and QAC schemes), all of which have been documented fully in The Core and In Touch throughout the year.

Major features of our membership results are as follows:• Our membership subscriptions gross

income increased by £5.8k in the year with a £20 increase in subscriptions.

• There were more leavers than the previous year with retirement again stated as the most common reason.

• The costs for our Physio First Data for Impact scheme in 2018 were £98.3k, compared to £59.3k in 2017. This was due to the fact that we have contracted with the University of Brighton for a further two years up to the summer of 2020, and a deposit was lodged at commencement. This activity is generously funded by the Private Physiotherapy Educational Foundation (PPEF).

This resulted in a membership net income of £460k (figure 2, p17).

Treasurer’s report for the year ended 31 December 2018


Figure 1: Comparisons in Physio First central expenditure for 2018 and 2017

Office Costs

Maintainance

Computer Costs

Professional Fees

Secretarial Fees & Expenses

Utilities

Depreciation

Financial Costs

Postage, Stationery & Telephone

Rent & Rates

Travel

Meetings

Physio First expenditure

2018

351,655

10,997

40,743

12,226

25,459

55,700

3,221

49,2554,85547,444

6,645

36,045

Physio First expenditure

2017

366,82615,596

64,469

13,200

23,636

55,995

3,070

57,7105,73251,211

6,603

38,622


Balance sheetAt the end of December 2018, our reserves were £159.1k, up from £157.5k at the end of 2017. There were fixed asset purchases of £20.6k during the year and £2.4k disposals.

In 2019, Physio First will continue on our strategic journey with you, our members. We plan to continue to invest all our efforts in the future of our organisation and the goals we have set, while ensuring our financial stability. This planning has led our executive committee to again budget for an approved small surplus for the coming year.

As Treasurer, I have continued to ensure tight control over our members’ funds, supported fantastically by our whole team to include: our executive, regional officers and office team and thank them all for their efforts. My special thanks go to Caroline Coxon for her hard work alongside me ensuring the purse strings are always held tightly.

2019 will be a different year for the UK. However, we will continue to champion private physiotherapy in an ever-changing healthcare marketplace together.

JACQUI WEBB | TREASURER

Grant incomeGrants received from the PPEF during the year totalled £139.9k and funded the following activities:• Data for Impact project – £116.8k*• Website and communication project

– £7.1k • Conference speakers – £7k• IPPTA and WCPT attendance – £5.4k• In Touch publication – £3.6k* this figure includes VAT which is written off in our financial budget

We would like to thank the PPEF for their continued support of Physio First and our activities that help towards the delivery of their charitable objectives.

Further grant funding was received from the CSP (£5.9k) and Northamptonshire County Council (£2.5k). We thank them both for helping us work towards our intent.

Commercial incomeCommercial and sundry income totalled £13.7k in 2018, a £24.5k decrease from the £38.1k we received in 2017. This is due to a change in how we work with our strategic partners to enable us to deliver our vision, and this will continue throughout 2019.

Overall income 2018In 2018, our net income passed the 2017 level by £8.2k, with grant income being the area of the largest increase, as shown in figure 2.

Central costsThe total costs of running our organisation were £644.2k, compared with £702.7k in 2017. This is a saving on the previous year of £58.5k. The analysis of the change in our costs between the two years as seen in figure 1 show the following:• Depreciation decreased by £8.5k from

previous levels.• Professional fees reduced by £23.7k

to £40.7k, due to the upskilling of our team.

• A review of our office team business priorities combined with natural attrition resulted in a reduction of £15.2k for salaries and training in our secretarial costs.

• Meeting costs were reduced by £3.8k in 2018, by again moving more meetings to an electronic format with greater use of a software meeting package called GoToMeeting. Further cost reductions are planned for 2019, with meetings being increasingly held in this way.


Figure 2: Comparisons in Physio First total income received for 2017 and 2018

148,305

5,188

26,639

305

13,658-8,243

Net Income 2018

459,999

102,895

4,598

25,725

321

38,140

-4,392

Net Income 2017470,358

Conference

Grants Recieved (gross)

Publications

Investment Income (gross)

Education

Membership

Trade Commissions & Administration Fees

18 | Annual report 2018-2019 | annual accounts

to safeguard the assets of the organisation and to prevent and detect fraud and other irregularities.

Each member of the executive committee has taken steps that they ought to have taken as a member in order to make themselves aware of any relevant audit information and to establish that the organisation's auditors are aware of that information. The executive committee confirms that there is no relevant information that they know of and which they know the auditors are unaware of.

By order of the executive committee on 8 February 2019.

P. SIMPSON | CHAIRMAN J. WEBB | TREASURER

The executive committee is responsible for preparing the Annual Report and the financial statements in accordance with applicable law and United Kingdom Generally Accepted Accounting Practice.

The executive committee is required to prepare financial statements which give a true and fair view of the state of affairs of the organisation and of the income and expenditure of the organisation for that period. In preparing those financial statements, the executive committee is required to:

• select suitable accounting policies and apply them consistently;

• make judgements and estimates that are reasonable and prudent;

• prepare the financial statements on a going concern basis unless it is inappropriate to presume that the organisation will continue in business.

The executive committee is responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the organisation. It has a general responsibility for taking reasonable steps

Physio First Annual Report for the year ended 31 December 2018

Executive committee’s responsibilities for the year ended 31 December 2018


In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Responsibilities of the committee of managementAs explained more fully in the executive committee’s responsibilities statement, set out on page 18, the executive committee is responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as it determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the committee of management is responsible for assessing the organisation’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the committee of management either intends to liquidate the organisation or to cease operations, or has no realistic alternative but to do so.

OpinionWe have audited the financial statements of Physio First for the year ended 31 December 2018 which comprise an Income and Expenditure Account, a Balance Sheet and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is United Kingdom Accounting Standards, including Financial Reporting Standard 102 Section 1A The Financial Reporting Standard applicable in the UK and Republic of Ireland Section 1A (United Kingdom Generally Accepted Accounting Practice).

This report is made solely to the organisation’s members, as a body. Our audit work has been undertaken so that we might state to the organisation’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the organisation and the organisation’s members as a body, for our audit work, for this report, or for the opinions we have formed.

In our opinion, the financial statements:• give a true and fair view of the state

of the organisation’s affairs as at 31 December 2018 and of its income and expenditure for the year then ended; and

• have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice.

Basis for opinionWe conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)). Our responsibilities

under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the organisation in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concernWe have nothing to report in respect of the following matters in relation to which the ISAs (UK) require us to report to you where:• the executive committee’s use of the

going concern basis of accounting in the preparation of the financial statements is not appropriate; or

• the executive committee has not disclosed in the financial statements any identified material uncertainties that may cast significant doubt about the organisation’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from the date when the financial statements are authorised for issue.

Other informationThe executive committee is responsible for the other information. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and we do not express any form of assurance conclusion thereon.

Independent Auditors’ Report to the members of Physio First


Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the organisation to cease to continue as a going concern.

• Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

DAVID OWENS

SENIOR STATUTORY AUDITOR

For and on behalf of:

Hawsons Chartered AccountantsStatutory AuditorJubilee House32 Duncan CloseMoulton ParkNorthamptonNN3 6WL

Auditor’s responsibilities for the audit of the financial statementsOur objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

As part of an audit in accordance with ISAs (UK), we exercise professional judgement and maintain professional scepticism throughout the audit. We also:• Identify and assess the risks of

material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide

a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.

• Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the organisation’s internal control.

• Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the committee of management.

• Conclude on the appropriateness of the committee of management’s use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the organisation’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion.


Physio First Income and expenditure account For the year ended 31 December 2018

Notes 2018 £

2017 £

Net Income 2

Conference 26,639 25,725

Education 5,188 4,598

Grants Received (gross) 148,305 102,895

Membership 459,999 470,358

Publications (8,243) (4,392)

Trade Commissions and Administration Fees 13,658 38,140

Investment Income (gross) 4 305 321

645,851 637,645

Central Costs

Office Costs 4,855 5,732

Depreciation 49,255 57,710

Maintenance 3,221 3,070

Finance Costs 55,700 55,995

Computer Costs 25,459 23,636

Postage, Stationery and Telephone 12,226 13,200

Professional Fees 40,743 64,469

Rent and Rates 10,997 15,596

Secretarial Fees and Expenses 351,655 366,826

Travel 36,045 38,622

Utilities 6,645 6,603

Meetings 47,444 51,211

644,245 702,670

Net Surplus/(Deficit) transferred to reserves 5 1,606 (65,025)


Physio First Balance Sheet As at 31 December 2018

Notes £ 2018 £ £ 2017

£

Fixed assets 6 413,754 442,366

Current assets

Debtors and prepayments 8 15,510 12,359

Cash and bank balances 42,756 49,365

58,266 61,724

Creditors – amounts falling due within one year

Creditors and accruals 9 277,901 296,577

277,901 296,577

Net current liabilities (219,635) (234,853)

Total assets less current liabilities 194,119 207,513

Creditors – amounts falling after more than one yearOther creditors 10 (35,000) (50,000)

Net assets 159,119 157,513

Accumulated fund

Balance brought forward 157,513 222,538

Suplus/(Deficit) for year 1,606 (65,025)

159,119 157,513

The financial statements on pages 21 to 28 were approved by the executive committee on 8 February 2019 and were signed on its behalf by:

P. SIMPSON | CHAIRMAN J. WEBB | TREASURER


Physio First Notes to the financial statements For the year ended 31 December 2018

1. Accounting policiesAccounting ConventionThe financial statements have been prepared under the historical cost convention and in accordance with the Financial Reporting Standard section 1A (effective January 2016).

DepreciationDepreciation is calculated to write down the cost, less estimated residual value, of all tangible fixed assets over their expected useful lives. The rates generally applicable are: Office equipment 10% - 25% straight lineComputer equipment 33% - 50% straight lineFreehold property 2.5% straight line

Depreciation commences from the date of purchase of the assets.

IncomeGross income (note 2) represents the value of goods and services provided during the year and are recognised when the organisation is entitled to receive it. Subscription income is matched to the period to which it relates.


2. Analysis of income


2018 £

2017 £

Conference

Gross Income 91,870 112,940

Expenses (65,231) (87,215)

Net Income 26,639 25,725

Education


Expenses (17,347) (35,187)

Net Income 5,188 4,598

Grants

Gross Income 148,305 102,895

Expenses - -

Net Income 148,305 102,895

Membership

Gross Income 587,161 581,319

Expenses (127,162) (110,961)

Net Income 459,999 470,358

Publications


Expenses (32,923) (42,540)

Net Deficit (8,243) (4,392)

Commercial and sundry income


Expenses - -

Net Income 13,658 38,140

Benevolent Society Contributions

Collection at conference 1,165 1,850

Payment to Benevolent Society (1,165) (1,850)

- -



5. Net Surplus/(Deficit)2018

£2017

£

The net surplus/(deficit) is stated after charging:

Auditor's remuneration 4,500 4,500

Depreciation 49,255 57,710

Committee expenses 47,444 51,211

4. Interest received2018

£2017

£

Bank interest 305 321

3. Staff numbers

2018 No.

2017 No.

Employees 13 14

The average number of persons employed by the organisation during the year was as follows:


6. Fixed assets


FreeholdLand & Buildings

£

Office & computer equipment

£

Total £

Cost

As at 1 January 2018 360,946 348,608 709,554

Additions - 20,643 20,643

Disposals - (2,449) (2,449)

As at 31 December 2018 360,946 366,802 727,748

Depreciation

As at 1 January 2018 54,488 212,700 267,188

Charge for year 6,811 42,444 49,255

Eliminated on disposal - (2,449) (2,449)

As at 31 December 2018 61,299 252,695 313,994

Net book value

31 December 2018 299,647 114,107 413,754

31 December 2017 306,458 135,908 442,366


8. Debtors

10. Creditors after one year

9. Creditors due within one year


2018 £

2017 £

Trade debtors 7,129 3,071

Prepayments 8,381 9,288

15,510 12,359

2018 £

2017 £

Other creditors 35,000 50,000

35,000 50,000

2018 £

2017 £

Trade creditors 9,823 32,591

Other creditors 16,001 405

Advanced subscriptions 153,484 146,834

Income received in advance 76,858 99,236

Accruals 12,634 4,907

Taxation and other social security 9,101 12,604

277,901 296,577

7. InvestmentsMembers of the executive committee hold the ordinary shares in the dormant companies Network First Centres Limited and Physio First Limited. These were fully impaired in 2006 and have a carrying value of £nil.



2018 £

2017£

P. Simpson - 3,638

K. Willcock 673 -

673 3,638

12. Related party transactionsDuring the year, committee members were paid £47,444 (2017: £51,211) to attend the committee meetings. At the year end, the amounts owed to committee members were as follows:

11. Operating lease commitments

The total future value of minimum lease payments is as follows:

2018 £

2017 £

Not later than one year 7,122 7,157

Later than one year and not later than five years 158 505

7,280 7,662

www.physiofirst.org.uk

Physio FirstMinerva HouseTithe Barn WaySwan ValleyNorthamptonNorthants NN4 9BA

01604 [email protected]

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