After spending numerous years developing their practice, many health practitioners, including OH professionals, decide to take the leap into setting up their own business. Emma Hammett breaks down what you should be aware of before you take this step and offers some advice based from her own experiences.
Establishing a business can be daunting and is not something nurses have generally been trained to do. However, the resilience and practical knowhow you will have gained from being a nurse, underpinned by your professional practice, is invaluable for starting out by yourself. This article, based on my own experience, highlights factors to consider when going it alone.
First, a little about me. As a nurse, I recognised the importance of prompt first aid to a casualty’s recovery. I learned invaluable business skills completing a diploma in management whilst a hospital manager. This provided a solid grounding to establish my company, First Aid for Life, which is now a multi-award-winning first aid training provider employing 46 trainers with health, military medic or emergency services backgrounds.
Starting as a sole trader, I exchanged my expertise for money. Once confident trusting others to train to my high standards, I engaged people to work with me. I defined my values and working practices and ensured I had clear contracts in place.
Further CPD resources
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With people to train for me, I could concentrate on developing my business. I developed collaborative partnerships including (but not restricted to) GP commissioning agencies, the National Childbirth Trust, numerous school and nursery franchises, and many influencers. Collaborating with other complementary businesses was pivotal to our success.
At the start of lockdown McDonald’s contacted us to develop online learning for their managers across the UK and Ireland. As a small business, agility and the ability to pivot and take advantage of any opportunities that came our way was essential. I approached clinicians from the Maudsley Hospital, London, to partner with us to develop enhanced mental health first aid courses. We had first aid and training expertise, they the clinical knowhow, which enabled us to create online pre-learning combined with a ‘live’ day delivered remotely by clinicians via Zoom. This enabled us to teach transferrable skills to anyone wishing to support themselves in achieving better mental health.
We teach critical skills, such as de-escalation, broaching difficult conversations, recognising someone may need help and offer a wealth of resources.
Self-employment has many benefits, particularly flexibility, although it generally involves working for longer hours than an employee would – however, you can reschedule work commitments around your life. You need not miss landmark events and can adjust your working hours to suit your preference – starting and finishing the working day at times that suit you.
On the downside, you are not paid if you are unable to work, so it is important to consider the financial implications of self-employment. Careful thought, planning and creative problem solving are essential. When start-up businesses fail, it is likely the result of one or a combination of inadequate planning and market research, over-ambitious growth plans, underestimating funding or failing to have a full grip on costs.
When start-up businesses fail, it is likely the result of one or a combination of inadequate planning and market research, over-ambitious growth plans, underestimating funding or failing to have a full grip on costs.”
Be aware of your own wellbeing
Be aware that you will be immersing yourself in your business for much of your waking hours; the concept of having more free time when running your own business is, sadly, a myth. You should be able to juggle your work time around your social/family commitments; this often entails burning the candle at both ends with the potential to negatively impact upon family relationships. Boundaries can quickly blur – anticipate this, set clear boundaries from the outset; consider how you apportion your time and your work space. Be mindful of your own health and wellbeing.
Lack of business and marketing know-how and a reticence to fully commit will also affect the likelihood to succeed. Often people delay launching as they want things to be perfect. My advice, based on my own experience is to just get it out there – it can be tweaked later!
Setting up an OH business
These are my top-tips for establishing your OH business and, most importantly, sustaining it:
Focus on what you enjoy. This might be case management, health coaching or training, for example.
Choose an area you know well and are passionate about. It is generally easiest to become the main player within a specific niche. If you have good relationships with people within this sector, seek their advice particularly when marketing to make your message more persuasive and powerful.
Avoid trying for the ‘mass market’ when starting out. Opt for specific niches and look to dominate those markets before developing further. Establish how many customers you need to be profitable and clearly identify then immerse yourself in your market.
Ensure there is a market for your service. Identify the competition including providers offering similar services. What can make you stand out? Small providers can provide a more personal, bespoke service compared to larger providers. You may choose to specialise in delivering health services for a particular sector such as construction or education.
Once you have identified your particular niche and anticipated market, identify what makes your service more attractive compared to competitors. This is your unique selling point. You must then plan your pricing structure – will clients be willing to pay the price that makes your business worth your while?
Research the business structure for you. This should include the pros and cons of being a sole trader versus a limited company. The government’s website provides further guidance here, including information regarding charging VAT as your business grows.
Your new business doesn’t need to be perfect. Many small businesses experience inertia as they endeavour to get things perfect before launching. It is unlikely to ever be perfect; the benefit of being a small provider is you can learn and develop new things and swiftly pivot as necessary.
Establishing clients’ health and wellbeing needs
When considering prospective clients needs, consider their size, work processes and associated hazards to which their workforce may be exposed. The client may need advice regarding how these can be eliminated or controlled. If they cannot be eliminated, statutory health surveillance may be required.
When considering prospective clients needs, consider their size, work processes and associated hazards to which their workforce may be exposed.”
Identify the ‘pain-points’ of prospective customers. How will your business help them resolve the health and wellbeing issues they face? Ask them, read what they read, and find out who they follow. How might you engage with any of their membership bodies? You could write for such organisations as a thought leader, or contribute articles to their magazines or blogs.
Organisations increasingly recognise the benefits of workplace wellbeing and may wish to discuss campaigns on topics such as mental health. Small and medium sized businesses in particular may be more comfortable engaging smaller consultancies to assist them. Small providers are well placed to provide a tailored, personal approach to address workplace health management needs, including compliance with statutory duties relating to health, safety and health surveillance.
Getting support
Be sure to develop relationships with other health professionals. There may be occasions when you too would value advice. Membership of organisations such as the Commercial Occupational Health Providers Association (COHPA), The Association of Occupational Health and Wellbeing (iOH) and the Society of Occupational Medicine (SOM) will be useful for networking, accessing business advice, and making links with other OH professionals.
Small providers are well-placed to provide a tailored, personal approach to address workplace health management needs, including compliance with statutory duties relating to health, safety and health surveillance.”
For example, when undertaking a management referral and planning a return-to-work strategy for a person with complex health needs, perhaps following a brain injury, additional advice may be required from other professionals, such as via an occupational therapist or physical therapist. If providing statutory health surveillance for hand-arm vibration, say, you will need to refer on to an appropriately qualified, experienced occupational physician for tier 4 assessment.
Quality over price
Don’t undercharge.Value your services appropriately as others may charge less, so compete on quality rather than price. Bundle up options, perhaps offering three versions of your product or service to entice clients to opt for a higher-value purchase, you can discount and offer special bundles if you feel the need to. You may be surprised that many clients value services and products at a particular level and may be put off by too low a price!
Understand your costs. Just as it is vital to understand your value, it is also critical you have a handle on your fixed and variable costs. Overheads include premises, administration, accountancy, legal and tax advice. You may need HR advice should you employ others.
Ongoing costs are variable and directly attributable to your product or service. Once you understand the level of fixed costs to be covered, you can calculate the variable price you need to charge to make your required profit. It is advisable to seek professional advice regarding offsetting business expenses against tax. Remain on top of your cash flow, as this could cause your business to fail.
Value your time properly. New business owners may try to undertake all elements of the business in order to save money. This is a false economy – outsource what you are not that good at, or do not enjoy. Outsourcing elements including book-keeping to a freelancer may cost less than your hourly rate and free up your time.
Outsourcing websites, like Fiverr or PeoplePerHour are available to contact freelance professionals for such tasks. Read their reviews carefully, however, then test them prior to sharing any sensitive information. When subcontracting, or working in association with others, have robust contracts and protect your intellectual property.
Getting your name out there
Be sure to market your business. You want to be able to demonstrate within marketing materials that you are appropriately qualified and competent to deliver the services you offer. What qualifications do you hold?
Be sure to market your business and demonstrate within marketing materials that you are appropriately qualified and competent to deliver the services you offer.”
Raise your profile by contributing to websites your clients are likely to use, and write for reputable journals and magazines they read (such as, of course, OHW+). Select topics likely to lead prospective clients to you. Working with charities, professional organisations and others will help you to build your reputation.Â
Use interesting ways for people to become familiar with what you do. Joining professional associations, particularly those offering opportunities for networking and continuing professional development (such as, again, SOM, iOH and COHPA), to name a few, may be beneficial. Such bodies provide resources/opportunities including local groups or directories, these may assist to highlight your company profile.
You may also want to create valuable downloads and ‘lead magnets’. These are valuable information that people will want to sign up to receive. These may include useful tools and resources such as infographics, checklists and e-books.
Avoid being pushed into purchasing advertising, advertise on your own terms. There are many free ways to communicate your business. Social media can be very useful. You may think of using scheduling tools to plan social media activity, such as TweetDeck or Hootsuite.
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As your business grows you may decide to develop other facets; perhaps creating online products and services. You may also work with others in the delivery of your services, transforming your business from sole trader into a more robust entity. At this point you can start to create more of a structure around your offering and those providing it.
Establishing a successful business can be rewarding but is not for everyone although there are a significant number of occupational health professionals who would not go back to being an employee. If self-employment is for you, I hope the tips in this article will help you plan, then navigate, your journey.
