The Injury Care Clinics (TICCS) is now one of the largest independent providers of rehabilitation, triage and treatment services in the UK. Based at Cams Hall Estate, Fareham, and number 116 on the 250 list, CEO Nick Delaney spoke to Sue Hughes
Healthcare is big business and a sector which is changing greatly as the demands and expectations of both users and providers grow, whether the government or private practitioners. Thanks to Google, many patients are pretty clued up when they visit a GP or specialist, and ever-evolving clinical techniques and care options mean a wider choice than has previously existed, something TICCS has responded to in a very successful manner.
There are circa 400 staff in the healthcare group. More than half are clinicians, the rest work in administration and management. CEO Nick Delaney joined TICCS in 2008, and has seen turnover increase from £7 million to circa £40m. Committed to building a market-leading specialist provider of managed rehabilitation services, a combination of service redesign and technological innovation has enabled TICCS to achieve this five-fold growth. TICCS delivers more than 500,000 sessions of treatment each year, a scale which enables it to stand apart from similar businesses in the market. TICCS has invested heavily in its IT systems and in innovative clinical delivery solutions to ensure that it can provide the best possible service in the most efficient way.
A key opportunity for TICCS during the next few years is the outsourcing of contracts by the NHS. “Our primary service is physiotherapy,“ explains Delaney, “and the Government has decided this should be outsourced. We’ve already won 15 commissioning group contracts, which equates to a lot of potential opportunities.
“TICCS originally operated in the medico-legal market, working primarily as a treatment co-ordinator. Around three years ago we made the decision that we would be able to develop a more dynamic and sustainable business if we diversified vertically into clinical delivery.
“Now employing more than 200 clinicians, our PhysioWorld brand is the only genuine national chain of physiotherapists in the UK. We can target a huge variety of new opportunities and build bespoke clinical solutions on a national basis.“
Government-sponsored screening and wellbeing projects are another potential area of opportunity, and a third strategy will be to raise PhysioWorld’s own profile as a fast developing business into a brand which will be recognised as the provider of choice for private patients.
Delaney does not see obstacles to growth, merely pauses in how he will go about exploiting so many opportunities, because TICCS cannot manage all it wants to accomplish instantly: “It’s a case of selecting the best opportunities and we are highly optimistic in both the public and the private healthcare sectors.
“The growth of the business comes from building new solutions that target specific demand in various strands of the UK healthcare market. Whilst there are no immediate plans for oversees expansion, our strategic thinking is to some extent influenced by overseas markets and how we think they may influence the future development of the healthcare market in the UK. If you look at how patients access treatments abroad, take the USA for example, they self-select a specialist clinician to deal with an ailment and go direct, they don’t waste a GP’s time trying to get a referral and then have to wait six weeks for a specialist appointment.
“With our GP model, patients access treatment through a cycle of GP surgery, referral, NHS waiting list, a specialist assessment and then finally approval for treatment. It can waste a lot of precious time – it can take weeks of pain before an injured patient accesses specialist treatment which would have been more effective if delivered earlier, and a GP’s valuable and expensive time should be used more productively than acting as a glorified triage service. Clearly there are differences in funding between the UK and the US but I don’t see why we can’t build a more efficient and clinically effective solution than we currently have regardless of the ultimate funding model.“
TICCS’s in-house PhysioWorld solution offers a robust approach to physical therapy, a pro-active manipulation, which is a deeper treatment. “There can be discomfort and bruising after treatment, but it’s designed to get people better more quickly than merely managing pain or symptoms over a longer period. PhysioWorld was founded by a medical team previously tasked with the care of Premier League footballers and elite athletes. Its approach reduces the number of treatment sessions required, cost, and speeds up patient recovery. It’s a win win solution.“
TICCS is largely self-funded, but has established banking relationships with Lloyds TSB and the Co-operative Banking Group, both of which have been supportive of its growth and expansion plans.
Staff are increasing as the business develops and participate in performance-related incentive schemes, with good options for career progression. While key senior people have not altered greatly in the past few years, barring retirements, a specific senior management team has been developed for clinical delivery.
Delaney joins his CEO peer group in saying the regulatory issues which most affect business centre on employment law: “The raft of regulations create huge difficulties when you want to deal with employees honestly and openly. The Government needs to address this archaic employment framework which is not fit for purpose in the modern economy.
“It should also continue to encourage the outsourcing of community-based clinical services which can be delivered effectively by private businesses, with appropriate governance, to free up increasingly-scarce NHS resources for what the NHS does best such as emergency response.“