Nicola from Tops Health – Lessons learnt and positives from Covid

Nicola Graham, MD, Tops Health and member of MSKPN, reflects on the lessons learnt and positives from Covid over the last 15 months, and how MSKPN has supported business owners like herself, through peer networking, commercial webinars, courses and support.

“Having the knowledge that as business owners we are all going through the same challenges has been very reassuring and the support of the MSKPN has been hugely welcome. I feel reassured and positive that the services we provide are needed in healthcare.”


Reflections on the pandemic

 It is fair to say that no one has found the last 15 months easy; it has involved constant juggles, adaptations and innovations. As a small business owner, there were definite dark times but also huge lifelines, namely, mortgage holidays, furlough, business rates relief and also the fundamental knowledge that everyone is going through the same thing together. The devastating effects on business are not due to a poor business plan or poor leadership or management; the global factors were out of our control, however, how we respond to them at the time and going forward are of course in our control.

Once you replace negative thoughts with positive ones, you’ll start having positive results –Willie Nelson

Tops:health, my business, had acquired another local Physiotherapy business across two sites in February 2020 and we were also due to acquire a local Gym and move premises in May 2020. These activities were reliant on healthy sales as well as a small business loan. Unfortunately the acquisition of the gym had to be put on hold as I wasn’t willing to take on the liabilities at that uncertain time, and it would only have been successful with an uninterrupted cash flow.

In June 2020, the clinic doors at tops:health reopened after three months of delivering our services solely virtually. We adapted overnight back in March 2020 and moved our physio clinics and Pilates and yoga classes online and will be ever grateful for the team’s ability to engage and innovate, and our client’s loyalty and support to join us in the world of Zoom.

Once we did reopen in June 2020, there were feelings of nervousness, anticipation and constant worry as to whether our policies and procedures were correct, were we keeping our staff and clients safe from an invisible threat, and would people come back to us. These thoughts haven’t really changed through this time and the continual uncertainty remains present; however it is to a lesser extent.

Through the subsequent lockdowns, the ability to adapt has become easier as well as the reopening of services. The virtual delivery of appointments and classes as well as hybrid options, are now embedded in our main services and will be for the foreseeable future. Updated timely guidance from professional bodies, even if it was to reiterate previous advice, could have been more forthcoming, however, very supportive peer networks and groups have filled this gap.


What have I missed the most during this time?

Certainty, connection, and ability to plan. However, there are numerous positives that can’t be overlooked and warrant further discussion.

Firstly, becoming part of the MSKPN (Musculoskeletal Partners Network – the trade association committed to improving quality and raising standards), during the pandemic has provided opportunities for peer support, networking and professional development that wouldn’t have been possible before this time. Being able to log into webinars or various topics relevant for business leaders as well as an interactive WhatsApp group has been invaluable.

More specifically to my business, due to some of our classes being oversubscribed, we had been looking at online classes for a while and therefore the hybrid nature of our class delivery now is fantastic. The software and technology advancements that have occurred during this time have also been hugely positive; online payments, Zoom integration with class booking system to automatically send out links, and inbuilt telehealth to deliver virtual consults. As a business we have also been able to negotiate affordable premises rents, secure a new city centre location at a desired location, and personally, I have thoroughly welcomed the ability to join courses, webinars and events online which otherwise wouldn’t be possible due to work and family commitments.

There is no underestimating the challenges that are still ahead within the UK and globally on many levels. The delay and interruption of healthcare services specifically, even at our small scale, are seen by the demand on our physiotherapy services, and the complexity of the cases that we are now seeing. The challenges of the last 15 months both personally and professionally for our team have had a knock on effect and therefore, the ability as a business leader to balance the priorities of the business, the clients and the team, continues to be a juggle that requires energy and empathy.

What continues to be clear, is the essential need for high quality physiotherapy that can provide accurate diagnosis, progressive and personalised rehab plans, and a discussion regarding how to prevent recurrence and how to address contributing health and lifestyle factors. This reactive and preventative approach underpins my personal and professional view of health; an episode of an illness or injury is an opportunity to become fitter and healthier.


Nicola Graham, Managing Director, Tops Health

Hear more from Nicola here