Working differently; starting up a business
Sarah Brown

Published In MIDIRS Midwifery Digest 15 (2) 169-170

www.midirs.org

Two working days and both so very different.  Today I found myself in a situation where I felt pressured and just about coping; yesterday, although it was very tiring, I felt a completeness about the day.  The main difference between these days was my feelings of control.    Yesterday I worked independently for my business; today I worked as an Infant Feeding Adviser in a busy clinical area for an NHS Trust.  It made me reflect on how much control we experience as midwives in our day to day working environment.

I  recognise that I am fortunate in my clinical practice as I work within a specialised field which affords a certain flexibility and independence.  This role though still has to be managed within the confines of the organisation and the expectations imposed nationally and locally.  These restraints are not personal to the National Health Service;  the task of any manager is often viewed as the organisation of the behaviour of individuals and groups in order to achieve the desired goals of the service (Huczynski & Buchanan 1991).  However, working within these frameworks, often make it difficult to plan and negotiate even day to day work when there are  issues needing urgent attention which are of benefit to the organisation rather than the individual woman and her baby.

This working framework can lead to frustration for the individual and reluctance, even  indifference, from those working within the organisation in meeting the personal needs of their staff.  It can also lead to a mind-set in practitioners of “getting the work done” rather than seeing, valuing and questioning practice (Bewley 1995, Hunt & Symonds 1995). Ideally, the use of personal power and control should be there for everyone within any organisation but I would suggest the very size of the NHS subsume the needs of the individual to the overarching demands of the service itself.

If we recognise that this is a problem, then we can challenge this way of working or seek a work-based practice or organisation that holds a similar outlooks to our own.  Sadly these opportunities are often limited.  Some practitioners may choose to work independently while others may choose to leave their profession.  My change was more gradual as I chose to start a business using my qualification as an International Board Certified Lactation Consultant (IBCLC) while still working in my other role.   The anticipated outcome was that eventually I could become part-time or leave my present job.

In the United States of America many IBCLC’s run their own business.  The type of businesses they run range from a private consultancy breastfeeding service to educational courses.  A few IBCLC’s also run such consultancy and educational services in the United Kingdom. 

My journey to greater independence started after running some breastfeeding workshops, initially on a voluntary basis for Lactation Consultants Great Britain.  I found that in facilitating the workshops I met people who shared my enthusiasm for breastfeeding and who renewed and extended my knowledge in the subject.  Through recognising that  “by teaching you are taught” (Bell 1808 cited Jacobs p 32), I had found a way of improving my work within the organisational setting as well as developing an outlet for some of my ideas. 

I asked a colleague, Carolyn Westcott, an infant feeding specialist to join me, and we decided to launch Lactation Consultants South UK in 2003. We felt the business title reflected who we were and our geographical base in the United Kingdom although our workshops are run nationally. 

The process was incredibly easy once we had made that decision.  The first thing we had to do was to notify the local Inland Revenue office that we were running a business alongside our full time jobs.   We discovered that the Inland Revenue provided some excellent information on starting up a business which included access to free half-day workshops run by business advisors and links into business support teams if necessary.  Unfortunately we could not make use of any of these offers as we were far too busy with work commitments but an information file on starting up in business, which they sent, was very useful.  The file covers everything from starting a business to growing it and includes many contact numbers and many ideas about types of business and how to get further help (Inland Revenue 2001).  There is also some useful advice on the Department of Trade and Industry site (www.dti.gov.uk).

After the first year trading we had to complete a self-assessment form for taxation purposes. This has to be completed on an annual basis and failure to submit the form on time incurs a £100.00 penalty.  We found an accountant who audited the accounts and submitted the forms for us.  The accountant’s fee was more than covered through her recommendations on how to claim business expenses and her negotiation with the tax office on changing our tax codes.  We now are in a stronger position financially and maintain better accounts because of this help.

Sadly it appears that two in every three new businesses flounder usually within the first two years of starting up.  I have found that apart from the “good idea” you also need a supportive business framework.  This has probably been the most difficult aspect for us and starting small on a very part-time basis has been good, as it has given us a feel for the business.   The business is our baby and we would like to see it grow and this is our next challenge.  Both of us are probably retiring in the next few years and we feel we want to continue with this business into our retirement.

Starting your own business is a bit of a leap into the unknown and the success or failure is very much down to your own efforts.  At the end of a busy day at work it can be difficult to turn on the computer and get going again but sharing the load, managing small amounts on a daily basis and learning about and using modern technology has helped us.  Part of the enjoyment I have gained from working this way in the first few years is meeting people who also run their own business and are supporting us in our enterprise.   They range from printers, designers and computer experts.  The enjoyment also stems from meeting all the wonderful people who have attended our workshops and who have provided us with the motivation to continue.

We started out with a common business philosophy of providing quality interactive workshops for anyone wanting to develop their breastfeeding practice.  We have a wide mixture of people attending from many parts of the country.  They range from IBCLC’s to voluntary group breastfeeding counselors, doctors, midwives, health visitors,  students and neonatal staff.  The core of our programme is six study days based on aspects of the core curriculum for Lactation Consultant practice (Walker 2002) from which we develop other sessions.  Last year we also held a very successful conference and we have provided two-day workshops for some local groups and Trusts.  Most of the workshops are held in the Portsmouth area but four days in 2004 were held in Manchester and in 2005 we are returning to Manchester and visiting Taunton for the first time.

We believe that developing breastfeeding practice has to be an interactive process and our days are built on a structure that should enable those links between theory and practice.  The day begins by reviewing and revising our present knowledge on a topic and building and expanding on this throughout the day.  We especially work with small groups as we feel everyone has something to contribute and learn, including ourselves.  The day finishes with a few multiple-choice questions on the topics for anyone who wants to complete them.  This educational framework has worked very well and we have had nothing but very positive evaluations of the days so far.

Starting and running a business is not an easy option but I would recommend it to anyone who thinks that this is the way they would like to work.  It provides flexibility and freedom to try things out but it also has moments of dark despair when you wonder if your ideas will appeal to others.  It also takes time, time to be known, time to manage the business and time before you make any money.  If you are planning to go into business on your own you will also need to consider what kind of a support network you will need in place for such times as when you are away.  Finally I would stress that you need to enjoy it especially the chance to try out your own ideas and follow them through. 

While writing this article I have found that our ideas appear to be linked to walking holidays.  The business started when walking around Ayers Rock following a conference in Sydney.  The conference last year was planned when walking around Derwent Water following a workshop we led in Darlington, and probably future plans will come from our next walking holiday in Turkey this spring.  This holiday is our business treat to ourselves for having a very enjoyable and exciting first year.

Click here to return to the About LCSUK page

References

Bell, 1808. Treatise on teaching. In: B, Jacobs. Peer Teaching. London, Sage Publications.

Bewley, C. 1995. Clinical teaching: an exploration of meaning. Nurse Education Today 15(2), 129-135.

Huczynski, A. Buchanan, D. 1991. Organizational behaviour: an introductory text 2nd Ed London: Prentice Hall.

Hunt, S. Symonds, A. 1995. The Social Meaning of Midwifery. Basingstoke: Macmillan

Inland Revenue, 2003. The right way to start a business: cutting through the red tape. London: Inland Marketing and Communications.