Surprised Managers

by Admin 1. October 2003 15:27
 

 

PART   ONE

One of the major problems in devising management training courses is in helping the participants to apply what they have learnt when they return to the work place. While it is easy to apply skills within the contrived situations of case studies and role play, it is far harder for a manager to recognise the problems (or to find the time) in the familiar routines of daily work. The key to effective training is to make that training part of the daily routine rather than merely the activity of an isolated workshop, and this can only be achieved by delegating that training to the manager. To achieve this, the focus of the training activity must be altered. Essentially a cultural shift has to occur so that the training officer is seen as the source of suggestions and the coordinator of activity: you no longer provide training, but rather you support the manager's own self-sustaining development.

Becoming a Manager

Most organisations are full of surprised managers. These are the people who are suddenly promoted because they were good at what they did, and given responsibility for projects and people which they do not understand. With surprised managers there are two major problems: they do not actually think about management issues because they do not recognize them, and they have only a limited experience upon which to draw to create solutions.

Put simply, things normally go wrong not because the new managers are stupid but only because they have never thought about managing before. The way forward is to raise the issues, to provide suggestons and, more importantly, to get the managers to evaluate solutions in the context of their own work. Ultimately, they are the ones who will have to cope in the real situations and once they have recognized that the problems exist, they will be able to apply their own common sense. Management is a skill - and like any other skill it comes with experience and practice.

If you think that is not true, ask the better athletes or musicians how long they practise in a day. The experience, however, will be made far more effective in developing that skill if managers prepare for the experience and then deliberately exploit it. Thus tennis players do not simply play tennis, they determine their own strengths, they work to overcome their weaknesses, they think carefully about what they do and how to improve, and they listen to what the trainer suggests. When master craftsmen took on an apprentice, they did not simply point to the materials and say: ‘Get on with it’; they showed the apprentice the skills in simple steps and then said: ‘Practise’. Yet a common experience at work is that new managers are expected to absorb their skills from thin air, by some magical form of osmosis. There is the irrational belief that people will develop management skills simply by being called names like: manager, supervisor, project leader. One day they are a gofer, the next they have gofers to go for them; yet the newlyappointed manager often has no initial ideas.

They ‘feel their way', ‘jump-in at the deep end', ‘go where many have gone before - without bothering anyone else', and the results are not surprising.

There is a theory (known as the Peter Principle) that people rise to the level of their own incompetence, in that they get promoted until they no longer do the job well - and then stay there, performing badly for the rest of their working lives. This is probably true because most organizations actually ignore the difference between the technical competence by which the lower levels impress their superiors and the managerial skills which are needed in the higher levels. This problem can only be addressed by training - but that training can best be obtained by using the talents of the managers themselves through effective delegation of the training task. Let us summarize: management is about pausing to ask the right questions so that common sense can provide the answers. By thinking explicitly about management skills, by deliberately practising and striving to improve, by learning from the experience and suggestions of previous managers, the surprised managers can develop their own common-sense approach to management practice. The training department has to promote the environment where this happens naturally.

The Basic Skills

The surprised manager needs to know what is expected. It must be clear what skills are considered (and rewarded) by the company to be important in its managers. If we are considering a manager with responsibility of small teams and small projects, then the skill set might be cast as:

 Organization (Time Management, Quality, Project Planning)
 Communication (Presentation, Writing, Conversation)
 Leadership (Team Work, Delegation, People)

These are nine topics, nine issues, nine skills which the training officer must bring to the attention of each of the surprised managers. Organization is about providing a plan and a structure to help the manager and the team to get the job done. By providing a structure to the activity, the manger can support and encourage the team since they will know where they are, and what they should do. It allows the manager to pace, and so to stretch, the amount of work - and to select the work to bring the greatest overall efficiency. Thus organization is concerned with the work, the manager's own time, and the team's time; and every manager must be prepared to spend time to save time for the team. Even if all the time is spent organizing others, far more may be achieved than without that organization. This is not simply a question of allocating tasks. The important point is that the tasks should be structured and allocated so that they match the ability, experience and development needs of each person to whom they are given. Thus the work itself becomes the route to staff motivation and development.

“ Most organisations are full of surprised managers. These are the people who are suddenly promoted because they were good at what they did, and given responsibility for projects and people which they do not understand.”


Communication is the most important skill of management since the implementation of all others depends upon it. A manager has to be able to communicate through writing, formal presentations, interviews, specifications and simply in day-to-day conversation - and that communication has to be error free, or time and effort will be wasted. Not only must the information be clear, it must be understood; and what a manager understands from others, must be what was meant.

Leadership is a very nebulous concept. In the last analysis it is about getting people to work with total commitment; it is getting them to follow the manager. The approach which most modern gurus advocate for leadership is through building the work group into a team so that all their talents are working together and with the manager. The theory goes as follows:

 Whipped galley slaves are not nearly as effective as dedicated warriors.
 The team has qualities and abilities which they want, and indeed expect, to use - the manager must ensure that these talents are cultivated or they will be lost.
 What the manager knows is limited; what the team knows is far greater; only by involving the team in the decision making will that greater knowledge be used.

In next months On Target we will continue this article and look at Establishing the Environment, Providing Support and Establishing Criteria for Success.

For any comments on this or any other article or feature in this edition of on target magazine please email the team on:
articles@ontargetmag.com

 

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Medtech Features

Keeping The Doors Open

by Admin 1. October 2003 15:26
 

 

 

 

 

 

 

Team work is essential within hospitals and particularly within areas of clinical care. The clinical team recognises the benefits of your expertise and they continue to invite you to join them.

However, hospital trusts are increasingly scrutinizing these invitations in the light of current data protection legislation and confidentiality guidelines.

It has now been identified that the presence of someone untrained in hospital policies and with no contractual link to the trust, presents an unquantifiable risk. As trusts continually seek to reduce the risk of litigation they must constantly review security within hospitals. The important issue of access to patient care areas and indeed to the wider hospital environs and processing of information must continue to be scrutinized and is bringing about changes that affect the medical device industry. These changes will make it more difficult for medical device representatives to gain access to areas of patient care. The problem of keeping patients and staff secure within hospitals while promoting their right to choice and freedom of movement is one whose solution will be a balance between common sense and the reduction of unnecessary risk. Access to hospitals is already becoming an issue for some medical device representatives in areas where hospital trusts are now demanding the formalisation of the visit by drawing up short term hospital contracts for specified reasons of access. This process is repeated for each visit. It is a costly and time consuming solution for both groups and perhaps alternatives should be explored.

In defining the role of the medical device representative, perhaps the service supplied should be better reflected in the job titleand be more clearly stated. Training, the provision of technical support and the life-time risk management, including maintenance of the device, provide an on-going service to the trust and the clinical team. It is the provision of this service, which contributes to the good outcome of patient care that legitimizes access to clinical areas.

The Department of Health’s guidelines ‘The Protection and Use of Patient Information’ very clearly identify the legal and ethical obligations that apply to all personnel coming into hospitals.

“ everyone working for or with the NHS who records, handles or stores or otherwise comes across information has a personal common law duty of confidence to patients and to his or her employer.” It also emphasises that “ anyone who receives information from us is also under a legal duty to keep it confidential. ”
DOH ‘The Protection and Use of Patient Information’ NHS Executive

This ‘catch all’ obligation may surprise some within the industry.

What are the legal and ethical obligations for NHS employees to which this refers? While all NHS employees are legally bound by contractual terms of employment the ethical obligations are identified within professional codes of conduct set out by their respective professional bodies. The Data Protection Act 1998 now offers patients safeguards which are upheld by a legal statute.

If we believe that the presence of a representative from the medical device industry really does contribute to a good patient outcome then the time has come for the industry to establish a Professional Code of Conduct.

The compulsory standard for medical, nursing and other related staff in hospitals is a professional qualification which must surely render the optional standards of practice for industry unacceptable.

The device industry should therefore adopt a compulsory professional standard for all personnel who access hospitals. The BTEC qualification will provide that standard. Courses that meet this standard are:

 BTEC Professional Award in Access to Operating Theatre.
 BTEC Professional Award in Access to Hospital Clinical Areas.

For further information - info@theatreskills.com
0141 951 5646
BTEC EDEXCEL 0870 240 9800

 

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Medtech Features

Time to lead or follow?

by Admin 1. October 2003 15:25
 

 

“ which is better, being a pioneer and leader or following on? ”

I have been very lucky in my medical devices career. I have worked for businesses that are pioneers’ and innovators and I have also worked for businesses that have followed on. In both situations it has often begged the question which is better, being a pioneer and leader or following on?

The timing of entry into a given market is often crucial to the success of that product, and the company has two basic choices: it can compete to enter the new product market first or it can wait for a competitor to create the market and follow their lead once that market has been proven as being viable. Apart from a conscious strategy decision the companies’ financial situation and its ability to invest in research and development also effects the direction many companies follow.

Many will simply have no choice but to be followers. However going back to the question, is it better to innovate or imitate? Many, perhaps the vast majority would immediately say that innovation and being first to market is always the best scenario for any company. However it could be argued that there can be an equally strong case made for being the follower, particularly in a conservative environment like healthcare.

The three main points behind this argument would be that the great successes of various pioneers often only take account of the surviving pioneers. Many businesses and products that are “pioneering” simply don’t make it in the long term. Additionally, the relevant research tends to focus on market share, and not profitability. High or higher market share does not mean higher profitability! There is of course no doubt that being a pioneer or innovator could have many advantages, look at brand names that have become synonnomous with specific products, like Hoover. For many new products, customers are initially uncertain about the benefit contributions of the new products and therefore their value. However the customer’s preferences for those benefits are learned over time, which does give the pioneer the benefit of shaping the customers preferences.

A pioneering and innovative product also can carry a lot of novelty value. It may open doors to accounts where previously the customer knew what you did and didn’t need to see you.

The “new” innovative product can unlock those doors again. Not just for the innovative product! Advertising and mailing campaigns are generally more successful for new products also, as your competitor’s aren’t sending out essentially the same message with a slightly different twist thus confusing the customer.

Pioneering products also have the opportunity to become the trusted brand in that area, followers must demonstrate to customers that there is no risk in changing again, and probably no associated cost, either financially or in terms of quality.

A pioneer can of course also create the opportunity to establish a large base of installed technology. This may restrict the ability of the followers, and there is sure to be some, to differentiate their product. One tactic to build that large customer base and restrict entry by others is to give away product. Perhaps where there is a capital and consumable cost it may make sense to give away the capital and tie the customer in to your consumables? At the same time you exclude, or make it much harder for your follower to imitate you, by locking them out of the market. The pioneers product then becomes the market standard. Computer companies use this tactic to great effect.

In medical devices I have seen particularly good use of one of the main benefits of being the pioneer. That benefit is the use of patents, which can keep product developments proprietary and also limit imitation by other companies. Medical, and particularly pharmaceutical is one of the markets where this can be used to great effect. However it can be costly to defend your patent!

There are however definitely benefits to being a follower. The first to market can often spend significant resources on research and development, trials, customer education etc. Many of these investments can not be kept proprietary and thus the followers can gain from your investment and market creation.

When the followers enter the market, they will undoubtedly have benefited from more information than their predecessors. The follower can avoid the innovators mistakes and gain from customers whom are now at least aware of the generic product. Earlier in the article I asked the question, which is best? For me, one measure, and perhaps the most important measure, is long term which is more profitable? Data would tend to suggest that in the early years of a product introduction the pioneer is more profitable, however this advantage is eroded over time and on average the follower is more profitable.

So when considering being the pioneer in a new market, consideration should be given to the expectation of long term and short term profitability, and how the pioneer reacts to the inevitable onslaught of competition. Otherwise the pioneer could do all the work and investment, only to find the follower makes all the money.

Duncan Wilson

Sales and Marketing Director Mantis Surgical Ltd.

 

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Medtech Features

The 7 Deadly Hiring Sins

by Admin 1. October 2003 15:24

 

The
7
Deadly
Hiring
Sins


 

 

 

 

 

 



How are salespeople hired? How were you hired? Did you take an assessment? Some kind of sales proficiency test? Were you hired for skill or attitude? Were you hired based on your test results or on gut feeling?

Hiring is expensive. Very expensive.

Hiring is subjective. Very subjective.

Training is expensive. Very expensive.

Firing is expensive. Very expensive.

You have 10 candidates who all are qualified. Who gets the job?

Hiring ain't easy, especially if you can't judge character.

Fact: Salespeople want to find the best job.

Fact: Sales managers want to find the best salespeople.

Fact: When managers hire people, they believe they're making the right choice.

Fact: They're also secretly hoping they don't make a big mistake.

Hard fact: Their intent is to hire the bestqualified, brightest and friendliest person every time.

Reality: Most managers ask the same questions over and over.

Reality: The reason managers make the same mistakes multiple times is because they just don't know better.

Reality: How are you supposed to know how employees are going to act in six months? How do you find out how they will conduct themselves when the pressure is on?

Grim reality: How can you know the work ethic of these people until after the honeymoon phase?

Here are seven deadly sins of hiring, being hired and staying on the job.

1. Looking at the wrong time and in the wrong place. Do you look to hire only when there's a need? That's a major mistake. Hiring in a crunch is managing by crisis. Try looking for people you want before you have a need. If you need a great salesperson, that individual probably isn't looking through the classifieds but is working for your competition. You need to solicit the best people in your industry.

2. Asking dumb questions. What kind of questions do you pose when you interview? "Can you name two strengths and two weaknesses you have?" Or perhaps "Could you describe your ideal environment?" Hiring managers ask these and other dumb questions because that's how they were taught. Try asking questions that engage the candidate to think. Ask scenario-based questions the candidate may encounter on the job. "What would you do if ...?" That will give you insight into how the candidate will react in the real world.

3. Making an offer just because you need someone. How many times have you made an offer to someone you know is not the best person for the job? It may solve your immediate problem, but a new set of bigger problems is right around the corner. Guaranteed.

4. Not setting clear expectations. Just because you understand what needs to be done does not mean your new employee understands. Ask candidates to explain what they think their responsibilities are so you know they understand. By taking this extra step in the beginning, you will eliminate confusion and frustration.

5. Not communicating to be understood. Many managers assume they are communicating effectively with their employees. Rule No. 1: Always ask job candidates to repeat the issue so you know that they understand. When employees feel involved, they feel appreciated. Communication - or lack of communication - will likely pre-determine an employee's fate.

6. Forgetting to reward the ones you have already hired. The three basic needs all people have are to be liked, to feel important and to be appreciated. You can give a cash bonus, but if you do not appreciate them, or you fail to make them feel important to the team, they will leave. Rewarding employees is not optional.

7. Failing to create loyal employees. Loyalty is determined by your actions when an employee has a problem. The way you respond to problems will tell everyone how you feel about your employees. Loyal employees will create profits for the company.

Well, there's the reality of why - or why not - to take or keep a job. So many people love their job, but hate their boss, that there needs to be a book titled "How to hire employees who love you AND love their job." The subtitle would be, "Improve job longevity, employee morale and company profits."

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Medtech Features

Growing on G.R.O.W

by Admin 1. October 2003 15:22
 

 

A more specific coaching model for busy sales managers
Coaching of employees by their sales managers is fast becoming an expectation from both senior management and employees themselves. Many sales managers are now being taught how best to coach their sales representatives by employing the standard coaching model called G.R.O.W, where G equates to the Goal, R to Reality, O for Options and W for Way Forward and Will.

G.R.O.W, constructed by Graham Alexander and championed by Sir John Whitmore, is a well-established coaching model and an excellent “starter” model to enable sales managers to get used to the structure of coaching. Very competent sales managers and sales coaches can use the model effectively by taking time and ensuring depth at each of the four stages but busy managers or less competent managers and coaches can tend to “skip” through the stages which, can often result in the following:

 Acceptance of Goals or Objectives without checking the validity of the reasons behind the goals or objectives.
 Unclear or a lack of full understanding of the Performance Gap between the present situation and the desired outcome.
 Lack of exploration in the Options phase meaning that only a few options and probably the more traditional “tried and tested” options are highlighted.
 Not enough time spent checking the Motivation of the employee to move the actions forward and also discussing how the manager is going to provide onward support.

All in all, G.R.O.W provides a structure but may not provide enough “discipline” for busy managers to ensure adequate depth of understanding and support.

The OUTCOMES™ Coaching model has been designed to enable managers and sales managers to undertake more structured coaching sessions with their employees and sales executives than perhaps they have been used to. The increased structure will result in more depth to their coaching and as such will enable an increase in more understanding, motivation and commitment to action than they may have experienced with other coaching models such as G.R.O.W. OUTCOMES™ provides more structure than G.R.O.W simply by the fact that there are more distinct stages that a manager or coach must adhere to. The initial reaction by most managers I have introduced it to has been one of initial frustration in that with it having more distinct stages to go through and check, it can take more time to implement. However, once the managers understand the reasons for the extra steps and the fact that if they use this model carefully, they will get good results, the managers have warmed to the model.

So what are the stages behind OUTCOMES™?

O = Objectives. What is the employee attempting to achieve? This stage is similar to the G in G.R.O.W in that the manager will attempt to get an idea of what specifically the employee is trying to achieve from either the coaching session or from their business or sales objectives.

U = Understand the Reasons. This is an important step as it is vital that the reasons behind wanting to achieve the objective are understood. More often than not employees either “under-stretch” or “over-stretch” their objectives. In sales, for example, one of the main “under stretches” is wanting to simply build rapport and fact-find within a sales call as opposed to actually sell anything on a first visit. By understanding the reasons behind the “rapport” objective, a manager can support and challenge a salesperson to achieve both the rapport and fact-finding objectives together with starting the selling process.

T = Take Stock of the Present Situation. It is important to spend time analysing the reality of the present situation so that a manager can establish a baseline and then –

C = Clarify the Gap between where they are now and where they need to get to, in order to achieve their objective. Sometimes with G.R.O.W an inexperienced coach or manager can perhaps jump from Reality to Options without fully understanding the “gap” that has to be “crossed” or “filled”. They can go straight to the “how” without fully understanding the “what”.

O = Options Generation. Time needs to be taken here and not the first option taken. How many managers ask; “And if there was one other way you could do it, what would it be?” or “What would be the result if you did nothing?” The pros and cons of each option need to be discussed. This stage can take time and many managers “skip” through it, or worse, manipulate their employee with leading questions that enable the employee to come up with the options that the manager wants to hear! Take your time and allow the employee to generate his or her own options.

M = Motivate to Action. Once the options have been discussed and the best way forward agreed, the manager must check the motivation of the employee to move on the actions. Are they agreeing to actions because that is what they think the manager wants to hear or are they really motivated to move on the actions? The manager must have the ability to check this and challenge any signs of demotivation.

E = Enthusiasm & Encouragement – The manager must at all times show enthusiasm for the objectives ahead and encourage the employee to do as best they can.

S= Support. The manager must always show support for the employee in the tasks agreed and must also ask if there is any support that they have to put in, in order to assist the employee. An example of this could be a sales executive asking their sales manager to sit in on a sales call and be prepared to help them with any difficult questions the customer may ask. The last three stages are vital ones and ones which the inexperienced manager or coach may not go through when using G.R.O.W. They may have a “way forward” but many will not check the “will” and even more still will not contract any form of “support”.

In summary OUTCOMES™, in a businesscoaching context, offers the following advantages over G.R.O.W.

1. It is more structured and specific than G.R.O.W in that it has more specific steps that a manager must go through.
2. There is more explicit emphasis placed on Understanding, Performance Gap Analysis, Support and Motivation.
3. The mere wording is more business coaching focused. e.g. Objectives as opposed to Goals, which tends to be a life coaching term.

The feedback on OUTCOMES™ so far has been excellent with sales managers feeding back that the emphasis on the motivation stages is particularly useful. Many confessed to skipping through G.R.O.W and not taking the time to explore situations fully.

The biggest challenge they have highlighted is that it takes time to go through all the stages and time, particularly in sales, can be a precious commodity. However one pharmaceutical manager commented:

“ I don’t take enough time with sales reps, particularly when I should be coaching around sales objectives. I tend to go through G.R.O.W, but not in any depth and although my first reaction was that I don’t have enough time to go through OUTCOMES, I realise that the investment of spending more time coaching will help in the long run. I believe that OUTCOMES will help me to structure my coaching more effectively”


G.R.O.W is an excellent model to get people to start to structure their coaching. OUTCOMES™ will take managers to a different coaching level thus ensuring that they are effectively coaching their employees and not just rushing through the process.

Allan Mackintosh BSc. F.Inst.S.M.M. Professional Management Coach.
allan@performance-am.com
www.performance-am.com

 

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Medtech Features

Training – True Value Added Support

by Admin 1. October 2003 15:20
 

 

ACCESS AND IMPACT - THE NEEDS OF THE INDUSTRY

Looking at the big picture when it comes to sales forces is never easy; there is always a risk that analysis will be clouded by the plethora of data available.

Huge amounts of time and money are spent analysing competencies in call, key performance factors, detail follow up data, activity rates, key message delivery and a host of other performance indicators. Whilst there is no denying the importance of these combined factors, one single issue can seriously undermine them all – gaining access to the people who we know can really drive the business forwards.

In it’s simplest form, there are arguably only two truly defining components which contribute to the success of a direct sales operation in healthcare; one is access to key customers, the other is impact in front of those customers.

Some recent evidence would suggest that neither of these indicators is perhaps as healthy as they could be. The deluge of change and bureaucracy currently swamping general practice is bound to have an impact on GP availability which in turn limits opportunities for the sales representative to build good relationships with their target prescribers and consequently dilutes their overall impact. Talk to anyone at territory level and they will be emphatic about how difficult things are becoming in primary care.

Similarly, the huge rise in teams of specialist healthcare account managers has not necessarily had the impact envisaged according to some recent data. Despite a good deal of rhetoric, the strategic partnerships with PCOs which companies originally envisaged seem to be restricted to a handful of accounts.

In order to overcome these barriers, it is essential to provide a service or outcome that directly addresses the current needs of the customer, and whilst many potential solutions exist, very few seem to have the kind of impact needed to cope with the current climate. One need which seems to be virtually insatiable but largely unmet in primary and secondary care is for continuing professional development. Not only can this provide a value added service to customers at all levels, but carefully managed, can also provide access to previously inaccessible customers and a platform on which to build lasting relationships.

TRAINING AND DEVELOPMENT - THE NEEDS OF THE NHS

Needs can best be identified when viewed by customer group and are based on real everyday practical requirements generated by the current changes, which have impacted upon every healthcare professional at virtually every level in the National Health Service.

Primary Care

 Skills development Key skills such as assertiveness / stress management / communication / leadership / people management
 Team development within the practice
 Service development – issues arising from the new GMS contract
 Individual development – personal development plans and appraisal

Secondary Care

 Skills development – presentation skills / business planning
 Leadership and management for department heads and senior consultants
 Personal development – in respect of individual CPD requirements. Primary Care Organisations
 Personal development for key targets such as prescribing advisors, clinical governance leads and PEC chairs
 Organisational development in respect of managing change and people involved in change
 Service development – service and process redesign within localities

QUALITY PROCESS - THE NEEDS OF THE PROFESSIONAL

Faced with the kind of opportunity which this kind of training can provide, it is easy to get carried away and the temptation is to make it available on too wide a scale to an ill-defined customer group. Any programme needs to be carefully project managed and the target group clearly defined and identified. In order to achieve the objective of increased access and impact it is essential that the quality of the training is of the highest standard and the quality of the process by which it is applied is similarly high. To ensure that these standards are maintained, certain key steps may prove invaluable.

 An accurate assessment of the training needs. This requires spending time with the practice or organisation to determine their real needs, setting clear objectives and effectively managing their expectations.
 It is more than a simple opportunity for a quick sell
 Clear commitment from the organisation that they are serious about the training and that the target group will all attend. This ensures that the key customers actually receive the training, not simply the administrative staff. This requires an assertive approach, which emphasises the investment the company is making on behalf of the practice.
 A robust planning system, which ensures that the right training is delivered to the right person in the right place at the right time. To get the most out of the programme it is essential that the representative is part of the event and is instrumental to the logistics on the day. Simply turning up with refreshments is a wasted opportunity.
 Good outcome measures so that follow up can be integrated into the programme and SMART objectives can be measured creating the opportunity for further face to face visits and further training and development if appropriate.

Not only do the above steps reflect good practice, but they will also guarantee at least three or four quality contacts in connection with the meeting if conducted professionally. To get the most from any such project, the representatives managing the process need to be well trained and totally clear about the best way to set up and conduct the events. If the programme is regarded merely as a substitute for a standard A/V meeting then it’s success will be compromised.

The real return on investment lies in converting these contacts into potential sales opportunities, which requires considerable skill and diplomacy on the part of the sales representative.

QUALITY OUTOMES - NEEDS FOR ALL PARTIES

Retrospective data has provided positive evidence that sponsored training directed at key customers has created

 Access to key customers otherwise unseen
 Positive development of the working relationship
 Positive development of the profile of the sales representative, the product and the sponsoring company
 Highly satisfied customers whose development needs are met

There is a clearly expressed need for more training and development within the NHS but their lack of self-sufficiency creates a potential opportunity for a win / win outcome for both parties.

Training and development is also ongoing and has the capacity to lend itself to long- term projects. The industry has been much criticised for it’s short termism and opportunistic approach to customers - investing in customer centred value added programmes would go a long way to redressing this imbalance. In addition the increased level of understanding and customer awareness generated by these programmes is bound to provide a competitive edge in an increasingly tight commercial environment

Charles Marshall

Charles Marshall is a director of AXIS Development (Oxford) Ltd.

For more information on customer development programmes email or visit:

charles@axis-development.co.uk
www.axis-development.co.uk

For any comments on this or any other article or feature in this edition of on target magazine please email the team on: articles@ontargetmag.com

 

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Medtech Features

Five Secrets to Managing your Sales Manager

by Admin 1. October 2003 05:00

MANY PEOPLE believe that the main reason for representatives leaving their organisation is that of money in that they leave for a bigger salary. In fact, the biggest reason why people leave organisations is that the role they are doing is no longer offering any challenge or excitement. The second reason is due to the behaviour and capability of the immediate line manager. Often the blame is laid at the manager’s door, but the representative must take a share of the responsibility also. The trouble usually arises when expectations are not laid out “on the table” with both parties unaware of each other’s needs, motiva-tions and expectations. The end result is often a lack of trust and respect between the representative and manager which leads inevitably to conflict. A good manager will ensure that a “contract” is created between the manager and the representative and that this contract is “two-way”. Unfortunately this rarely happens and if any contract is put in place it is “one-way”, with the manager outlining what he or she expects from the representative and not the other way around.

So how can you avoid this conflict and start to work productively with your manager? Act on these five secrets and watch the relationship with your manager grow.

Secret 1: Learn about behavioural styles and find out what your own is and your manager’s. Compare the two and if there are differences then work on these differences by matching your manager’s body language very discreetly. Match their tone and volume of voice, remembering not to mimic only discreetly match. Look at their eye movements and do similar. Again, do similar with body movements. When you start to discreetly match their body language you will be amazed that they start to match yours also. This is the start of the rapport building process and this goes a long way to start the building of trust.

Secret 2: Contract with your manager by getting agreement about how best the two of you are going to work together. Ask questions such as:
• “What are your specific expectations of me as your representative?”
• “What are my specific objectives and how am I going to be measured?”
• “What behaviours annoy you?”
• “What motivates and de-motivates you?”
• “What reports do you want? When do you want them? What content?”
• “How often do you want to visit me in the field?”

Contracting is all about managing expectations. A good manager will always outline his or her expectations and will ask you about yours. Once you both are clear about what each other’s expectations are, then this is another building block in the foun-dations of trust and respect.

One of the hardest lessons I learned was when I did not contract with a senior sales manager. We had completely opposite behavioural styles, which meant that we didn’t get off to the best start. He thought I was too energetic, flighty and too much of a risk taker and I though he was too detailed with no personality and constantly stuck in front of spreadsheets. We were in constant conflict because he asked me for reports that I could see no reason for and I was frustrated when he ignored my pleas for more training budget. If we had contracted and discussed our similarities and differences and how best to work with them, we may not have had the conflict that we did have. The result of this “person-ality clash” was that there was little trust and respect between us and very little communication. Meetings between the two of us were, to say the least, fraught!

Secret 3: Ask for regular feedback on your progress. Ask your manager to coach you. Be pro-active and do not wait for your manager to come to you. On the other hand do not always be seen to be reliant on your manager and give them space. Agree this area of support in your contract. A great time to enlist this support is on field visits. Ask your manager if some time can be “protected” during the field visit to discuss your progress and for them to coach you through any ideas and, or, challenges you have.

Secret 4: Be seen to be a support for your manager. Management can be lonely and stressful particularly if the manager isn’t managing their boss partic-ularly well or if the company and/or team results are not doing as well as expected. Be supportive and offer to take on extra tasks. These tasks will not only make space for the manager to work more produc-tively and strategically they will also enable you to develop your own capabilities. Be careful to ensure you manage your team-mates expectations here too. Being seen as supporting the manager can be taken the wrong way by some of your colleagues and on occasion, the less enlightened representa-tives can see this behaviour as threatening.

Secret 5: Go with your instincts! If you feel that the relationship with your manager is starting to go sour, then immediately call a meeting and openly discuss your feelings. To make this easier than it may sound, again build it into your contract right at the start. Something like, “If I feel our relationship is not what it should be, can I address it immediately as opposed to letting it linger?” Do not where possible discuss your feelings with all of your sales team. You will find some people very supportive and helpful but you may also find that some may go out of their way to reinforce the feelings you have thereby making it more difficult to address with the manager. Always best to tackle these feelings head on with-out referring to your team mates. If you have a coach, then they are often the best people to enable and support you to handle these situations.

Relationships between managers and representa-tives usually deteriorate because there was little trust in the first place and as a result openness is not usually achieved. Follow the five secrets and you will go a long way to ensuring a lasting and productive relationship with your manager.

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Features

Surviving Assessment Centres

by Admin 1. October 2003 05:00

Nothing is as straightforward as it used to be – and Recruitment is no different! The good old days of two-stage interviews and job offer are behind us as. Over the years, other selection methodologies have come in and out of vogue, including verbal and numerical reasoning tests, personality and psychometric profiling, IQ measurements, NLP assessment, presentations, competency interviewing, in tray exercises, group exercises, role play, and coaching or sales exercises, in groups or (horror of horrors!) on video!

So what is in vogue now?

Organisations vary, but most have learnt from the past and don’t put too much emphasis on any single indicator - hence the assessment centre has gathered momentum.

Assessment centres have benefits for both recruiter and candidate:

• The length of time involved lets the potential employee and the recruiting companies get a better look at each other.

• The time/financial investment by both parties demonstrates mutual commitment to the process.

• There are a number of assessors involved, which allows for a candidate to be identified on merit rather than subjective information.

• The tools used tend to measure natural attributes or trained skills, which allows individuals who haven’t done the same job before, but have excellent potential, to be identified.

So… how can you perform at your best?

Look the part!

Unpolished shoes, poorly ironed shirts, a suit that has seen better days… all create a less than stunning first impression. Equally, trend setting young guns in today’s hottest in high street tailoring may feel like the best dressed in town, but in reality the potential customer base is really quite conservative. If they notice your suit but not your product presentation – you’ve failed.

Doing the research

Employers often comment that candidates appeared ‘really keen on the job but when I asked why, they had no idea’.

If you don’t know exactly what the job is going to involve or what the challenges in the market place might be, how can you really convince your potential employer that you’re serious about your application? How can you demonstrate how you plan to achieve success in the role?

Something important to remember is that it’s not only what you’ve learned in your research that’s important, but how you’ve gathered the information. If you’re fully briefed by a recruiter supporting your application – but you’ve made no efforts to find additional information independently – you will not have impressed upon the interviewer your ability to use your investigative and networking skills. The same is true if your research is confined solely to published media – to really impress with your research skills, talk to people, network, ask questions.

Evidence of your Success

If you introduced a new product to a customer and made claims about it’s efficacy with no clinical data, you wouldn’t be surprised if the customer was a little sceptical! The same applies to you. You need to present some specific examples and evidences of your success, as well as explaining how you achieved it. Take your evidence in an organised format – employers have been known to complain about candidates who root around box files of ageing, yellowed papers in search of ‘just one more e-mail’.

The interview

In simple terms, you have just an hour or so to convince the inter-viewer that you’re the right candidate– and that’s not much time!

Preparation is the key:

• What is the job role?

• How much of that have I done before?

• How can I demonstrate my transferable skills?

• Look at your CV from a third party perspective – what would you ask? Are there any gaps, omissions or changes in direction?

• Make sure you know why you want the job.

One of the most important things about the interview is to make sure you answer the questions – fully, openly and honestly, backed up with a specific example. Employers’ feedback along the lines of ‘his skills just didn’t come through’ or ‘I didn’t really get to the bottom of this’ indicate that the questions have only been half answered and the interviewer left unconvinced. It’s up to you to check that the interviewer has all the detail they need.

The presentation

With sufficient preparation everyone should be able to prepare a good presentation. If a presentation is part of your assessment;

• Familiarise yourself with the ‘text book’ version of how to do a presentation – they’re all fairly similar but have some good, common-sense themes.

• Spend time planning the content.

• Spell check your slides!

• Rehearse the presentation in front of people – and get their feedback

• Make sure you get the timings right.

• Be ready for interruptions – how will you handle them? Don’t be thrown off your stride.

The psychometric test

Fundamentally, they are used early in selection to screen out candi-dates who have a low match for the company culture or the demands of the position. Unless you are a maestro of personal subterfuge . . . it isn’t worth trying to second guess what the employer is looking for. If you try to skew the answers, you may cause inconsistencies in the ultimate profile that might actually cause you to be deselected!

The sales skills exercise

The key thing is. . . . Don’t stress! What they’re looking for is your knowledge of, and ability to use, the ‘text book’ sales process. So, back to basics!

• Build rapport.

• Use open probes and questions to identify the customer need.

• Explain the key features and benefits of your product that meet these needs.

• Flush for concerns / overcome those objections.

• Check that you’ve met all the needs you can in this call.

• And finally… close for commitment!

Verbal and Numerical testing.

It may feel like being back at school, but these tests are often not as complex as we fear! Many of them are designed not only to test out your basic verbal and numerical reasoning skills, but also to see how you perform under rigid time constraints – many have so many questions that it is rare for people to actually finish the test. It’s impor-tant to bear in mind that it may be error rate that’s being assessed, rather than volume of questions answered. The best course of action is to work through the questions at a reasonable pace and not waste time by labouring over the same question again and again.

Business Planning Exercises

It is increasingly common for a business planning exercise to form part of the assessment process – you may be presented with a scenario and volumes of supporting data with the task of drawing out the key issues. Often, the supporting information includes sales data or RSA type figures. Make sure you know how to read, interpret and draw useful conclusions from it! Points to bear in mind:

• Identify your key objectives.

• What you have to do to achieve the objectives?

• Generate a plan.

• What measures will you build in to qualify that your plan is correct?

• What modifications to plan are you going to make? Under what circumstances?

• How are you going to measure your outcomes?

Group exercise

Depending on the role, the Assessors might be looking for very different attributes, so try to find out beforehand. Typically, though, group exercises are designed to identify leadership skills – the ability to facilitate the group in moving forward without ‘bulldozing’ into submission. Active participation is crucial – sitting on the sidelines rarely scores plus points. Other than that, the ability to listen, challenge constructively, input creatively and negotiate your position, are all important elements of a successful group exercise.

Over to You!

Whilst by no means exhaustive, this should get you to think about how you might be assessed, which will help you focus on how to present your natural skills and attributes to your best advantage. Good luck!

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Features

The Matrix: DECODING THE NHS - Primary Care Prescribing Advisers

by Admin 1. October 2003 05:00

In the 3rd and final part of Prescribing Advisers, Omar Ali looks at how prescribing advisers influence their GPs. Given that the Pharmaceutical Industry has numerous resources, funds and social influence, how does the pharmacist ‘regulate’ or ‘control’ the GPs? Why should a GP listen to and act in accordance with the prescribing adviser?

Influencing GPs
As mentioned in the last issue of PF Magazine, the prescribing adviser’s activity involves running around telling GPs what to prescribe. When observed from a distance, the pharmaceutical repre-sentative’s activity looks similar – running around, telling GPs which products they should prescribe. This brings us to an interesting dilemma – why should a GP listen to me over and above a represen-tative.

3 IMPORTANT POINTS ABOUT INFLUENCING GPs
• Whatever the GP might tell you, I cannot force him/her to prescribe certain drugs
• Whatever the GP might tell you, I cannot force him/her to not prescribe certain drugs
• I am merely an adviser. A pharmaceutical adviser. So I give advice. It is up to the GP to decide whether or not to follow ‘my advice’

1 IMPORTANT POINT ABOUT INFLUENCING PRESCRIBING
“I cannot force a GP to not prescribe a given drug. However, I can make him/her wish they hadn’t”

Prescribing Incentives
PHARMACEUTICAL COMPANY INCENTIVES:

Attractive but relevant gifts: mugs, staplers, calendars, pens & pads. Now more sophisticated electronic calendar clocks, thermos flasks, thermal blanket and even a fire extinguisher!

Wining, dining and eating out: probably too many to count. Legitimate educational meetings are still the most frequently used event with a local/renown KOL (Key Opinion Leader). Often used to endorse/strengthen/support a product. Sometimes used to break into/challenge a market place.

Sponsored staff: audit nurses, specialist clinics and training resources. Many of these are very useful, and with the impending GP contract will be even more used (the new GP contract makes for expen-sive staff as they will no longer be reimbursed as they currently are). I can see this being more important as PCTs need more targets to reach and there are not enough staff to reach them Sponsored resources: software data, risk manage-ment calculators, audit trails and the like are rife. Many are useful though invariably will lead to ‘their product’ being the main ‘conclusion’ of the software profile. Almost all companies have some form of software that shows how much you can save if you swap PPI Brand X for PPI Brand Y (they can’t all be right!)

Sponsored research: whilst research in secondary care is almost always sponsored this doesn’t neces-sarily colour the validity of the research. It just means one drug is continually investigated until something good turns up. The results are still valid. But begs the question if another company had invested in their molecule being researched, would it be any better?

Conferencing & Hospitality: increasingly common and now often targeting clinical & non-clinical staff together as part of team-building exercises. Practice Days (GP, receptionist, practice manager and nurses) looking at clinical governance issues and risk management (ie) MMR vaccines policy, out-patient anticoagulation services, out-of-hours management. Very useful investment for compa-nies looking to build relationships with practices. Remember the practice manager has now become very key to the whole process. This is due to 3 main reasons:

1) The practice manager is responsible for all the accounts & finance
2) The GPs under the new contract will be ‘contractually obliged’ to the practice manager and not to the patient
3) The patients will now be registered with the ‘practice’ and not a ‘GP’ Hence the new contract really does mean GPs will be ‘contractually obliged’ to varying degrees (see later).

Evidence Based Mailshots: for each marketing message there is an ‘anti-marketing message’. I am surprised just how much I spend on this! Some examples are given below:

- DRUG X COMPANY MESSAGE: 3 key papers show reductions in hospitalisations, exacerba-tions and good quality of life. One of the papers showed Drug X fairs better than Atrovent when looking at St Georges Health Questionnaire and SF36 index.

- PRESCRIBING ADVISER ANTI-MARKETING MESSAGE: 1st paper (Eur R J) did show that Drug X reduced hospitalisations and exacerba-tions in COPD. But the author concluded ‘statis-tically, you cant tell the difference’ 2nd paper (Thorax) did show that quality of life with Drug X vs Serevent was good. But again, statistically, it was the same. 3rd paper (Eur R J) did show that Drug X vs Atrovent fared better on St Georges Health Questionnaire. But the scores were similar (41 vs 44). Interestingly the SF36 index showed they fared exactly the same.

- DRUG X COMPANY MESSAGE: Drug X represents a breakthrough in COPD management

- PRESCRIBING ADVISER ANTI-MARKETING MESSAGE: why are we paying £350 per year vs £50 per year for a product which in all 3 papers statistically, it was difficult to tell the difference? The difference in cost far outweighs the differ-ence in efficacy.

Educational Meetings: we do hold prescribing forums – but we don’t hold them in fancy venues and I would get the sack immediately if I take my GPs out for dinner! We cover national guidance and difference in performances. We also ‘name & shame’ individual doctors for ‘overusing’ expensive drugs. We do also recommend certain GPs should use more statins for example. Or should be check-ing HbA1c more often.

Prescribing Incentives: if all else fails, and non-formulary drugs are being overused, we resort to the only tactic left in the book . . . bribery! - I can do the only thing you can’t do.

- I can’t take them out for dinner. I can’t by them free gifts. I can’t pay for them to go to the American Diabetic Association.
- But I can pay them ‘cash incentives’ if they stop using drugs that I don’t want them to use!

How do I do this? See next issue for more revelations . . .

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Features

NEW GMS & OUTCOMES FRAMEWORK - Good news for patients, Practice income and your bonus!

by Admin 1. October 2003 05:00

In the third article in a series of five, Paul Midgley of the Healthcare Partnership looks at how the ‘Quality & Outcomes’ framework (QOF) within the new GMS contract (nGMS) will help pharma repre-sentatives work more closely with practices to their mutual benefit. Next month’s nGMS article focuses on the opportunities arising from extended roles for nurses, practice managers, GPs and pharmacists, followed in December by the implications of PCT enhanced services commissioning on local healthcare.

Introduction
The new UK-wide General Medical Services comes into force in April 2004. This contract will affect all practices – whether they are currently working under a GMS contract (about 65% of UK GPs) or a PMS contract. The implications of nGMS will be far reaching for all parties involved in chronic disease man-agement – practices, GPs, PCOs, acute trusts (in time), SHAs – and you as a representative. The biggest lever of change in nGMS is the ‘Quality and Outcomes Framework’ an incen-tive scheme devised to boost standards of care for patients, and improve the way care is delivered by encouraging a better use of skill mix, in the following areas of general practice:

  • Chronic Disease Management (reducing the need for hospital involvement)
  • Practice Management
  • Patient Experience
  • Additional services

Rewarding Quality and Outcomes
By the third year of nGMS, additional General Practice funding through the ‘Quality and Outcomes Framework’ is predicted to account for an extra £1.3billion per year out of a total of £1.9billion of new money avail-able through nGMS. This additional practice income will be paid to all practices who can prove they have achieved levels of quality pre-agreed with their PCO. The higher the points total, the better the payment, therefore practices will inevitably try to climb the Quality Ladder each year to increase their income.

How does the Quality Ladder work?
A ‘points means prizes’ scheme, with a maximum of 1050 quality points, will be available to all GMS practices (to be con-firmed for PMS practices). In the first year of nGMS (2004-5) each point is worth £72 for the ‘average practice’ (5500 patients). Practices calculate their £ per point by divid-ing their list size/5500, multiplied by £72. In year two (2005-6) each point will be worth £120 for the average practice. So, an average practice, achieving 350 points in nGMS year one will earn an additional £25k over and above their current (guaranteed) level of income. If the practice were to ‘up’ their qual-ity and achieve 500 points in year two, this would earn an additional £60k. Clearly, this kind of additional income is significant, and a real incentive for practices to completely re-think how they deliver their service to strive for these extra resources. Will we see GPs devising staff incentive schemes to ensure they hit target?

Payments schedule
Payments are made as follows. One third of the ‘aspirational’ points target agreed with the PCO (ie, where the practice hopes to be by year-end) are paid in monthly instal-ments over the year. The balance of the money is paid at the end of the year, follow-ing submission of audit evidence of points achieved, and verified by a practice visit from the PCO nGMS inspection team. Any over-achievement against the aspirational level is guaranteed to be paid in full. Gross under-achievement (ie less than one third of the aspirational points) will result in a repayment to the PCO.

Preparing for Quality
Prior to the first year of nGMS, and each year thereafter, PCOs will visit each practice to determine the current level of Quality Points achieved, and agree a target for the end of the next year. Practices will be given a ‘Preparation Payment’ before April 2004 of £9k (again, based on a multiplier of the aver-age practice size), and again in Q1 2005 (£3.25k). This payment is to help practices take time out to review their existing services, plan for the year ahead, and make any struc-tural changes to help them climb the quality ladder. Practice away days and Protected Learning Time sessions are the ideal way for practices to review their services and plan for the year ahead (see ideas to help this process at the end of the article).

How can you help practices achieve these targets?
Those of you selling the types of products listed below in the following clinical areas will be able to help practices attain quality pay-ments directly, by persuading them to work with you, use your products and the allied services your company offers to improve management to the required standards to hit the quality payments on offer in the clinical section.

  • Smoking cessation (see CHD, Stroke, Hypertension, Diabetes, COPD and Asthma quality indicator section) Flu vaccines (see CHD, Stroke, Diabetes, COPD and Asthma quality indicator section)
  • Ace/A2 antagonists (see CHD, LVF and Diabetes quality indicator section) Statins/cholesterol lowering (see CHD, Stroke and Diabetes quality indicator section)
  • Anti-platelet/anti-coagulation therapy (see CHD and Stroke quality indicator section)
  • Beta blockers (see CHD quality indicator section)
  • Hypertension treatments (see hyperten-sion and diabetes quality indicator sections)
  • Diabetes treatments (see diabetes quality indicator section)
  • COPD treatments (see COPD quality indi-cators section)
  • Epilepsy treatments (see epilepsy quality indicators section)
  • Schizophrenia treatments (see mental health quality indicator section)
  • Asthma treatments (see asthma quality indicator section)

So, get familiar with the QOF standards relevant to your therapy area. Help the prac-tice audit their existing quality standard. Then agree with them the areas where you and your company can help to boost them higher up the Quality Ladder in your therapy area(s). This will mean that your marketing colleagues will have to reframe your product offering into nGMS language – if they can do that, and you can help practices boost their income, you may never have been so popular!

What if your drugs are not in these therapeutic areas?
Practices still have a duty to provide essen-tial services for all comers presenting with non-life-threatening diseases, so they still need to keep up to date with information about drugs in all common disease areas. However, practices are likely to concentrate their energy on developing those more rewarding therapeutic areas mentioned above and building therapy-based partnerships with relevant representatives. So if that doesn’t include your drugs, you may find that time and interest in your drug and therapy area being squeezed.

Don’t despair!
You can instead build partnerships by pro-viding support to practices in the non-clinical quality domains. Whilst this may be unrelat-ed to your product, you will still have an opportunity to promote your product whilst spending time helping the practice with these other key quality areas.

Practices face major challenges to devel-op the organisational and patient experi-ence aspects of their service – these are the areas you should examine in more detail to look to provide an added-value service over and above information about your drug and disease area. You too can become a valuable partner to the practice and help them boost their income – and your access and scripts. Implementation Timetable

Preparations to implement the Quality and Outcomes framework will start in Q4 2003. Here is a guide to what practices will need to do so you will know where your help may be welcomed:

• Audit their existing standards against the framework to establish their baseline points score (they may need to do some work on their IT to make this possible, eg standardising their READ coding of diag-noses, to enable accurate data input and extraction) - can you provide IT support?
• Agree as a practice which Quality areas they wish to focus on and their aspira-tional points target for 2004/5 (probably a top team decision, ie GPs, nurses, Practice manager – may be best achieved at an ‘Away Day’) which you could sponsor
• Meet with the PCO and agree a realistic aspirational points target, based on their existing points and service development plans - can you provide lunch?
• Produce a detailed Practice Development Plan to ensure the required changes are brought in – detailing what, by whom, by when for each change required - again, away from the practice - another sponsorship opportunity.

A ‘Preparation Payment’ will be made to practices before April 04 as mentioned above. In April 04, the first monthly instalment of one third of the agreed ‘Aspirational Points’ will then be made, and each month thereafter till March 2005. In Q1 2005, £3.25k prepara-tion money will be paid for the year head. If all has gone well, and with your help, by April 2005 practices should be able to prove achievement of improved quality, have hit or exceeded vs target, and gain significant new money as described above.

Summary – QOF a Critical Success Factor in your 2004 Territory Business Plan
You need to know the detail of the QOF in areas relevant to your product. This frame-work will drive through changes to your key target practices very quickly due to the guar-anteed extra funding available, and because GPs largely agree with a quality-rewarded system as it is good for patients too. It is also likely that QOF performance will be included amongst a PCO’s star rating indicators from 2005 onwards.

You need to start asking key GPs, Practice Nurses and Practice Managers what you can do to help them maximise their Quality points (and come along armed with ideas of your own). Based on this, your 2004 business plan should re-allocate resources to those target practices who are first to innovate (and pre-pared to work with you to maximise their Quality points). Get a copy of the detailed quality standards document (see below). Read it thoroughly and identify areas where you and your company can help practices. Be pre-pared to look at both clinical and non-clinical areas of quality improvement. Use outside help if required to provide you with support. This is too good an opportunity to miss to be at the cutting edge with your key customers.

End of PGEA requires new thinking for meetings
You can help organise away days to enable practices to consider an overhaul of the way they deliver their service, then specific training around key elements that need changing over the following year. You can be sure that if you aren’t offering help to key customers around nGMS, there will be plenty of competitor companies prepared to fill the breach. Remember, PGEA ends with the advent of nGMS in April 2004, so plan to spend your budget in different ways from next year. Supporting practices to implement nGMS is one way to continue to offer a valuable service that will keep target customers coming to your meetings. Who needs PGEA after all?

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