The COVID-19 pandemic has had a dramatic impact on our world, including those who provide and use complex rehab technology. It has upended the way we all do business and threatened our collective ability to meet the needs of wheelchair users.
The difficulties faced by BES Healthcare, Bodypoint’s distributor in the United Kingdom (UK), are probably typical in many ways. But along with all the hardship and juggling, Dirk ter Haar, the company’s non-executive chairman, has found reason to be optimistic.
Thinking about the pandemic from a business perspective, Dirk compares it to a wildfire. “It goes through, it burns out the old or not so healthy companies, and it brings new opportunities and resets things somewhat,” he says. “I really hope we can survive because I see there will be so many opportunities that will fall out of the back of this.”
A Tale of Two Countries
Dirk has "officially" worked for BES for 10 years, though he has actually been involved with the company for 27 years, ever since his father co-founded it in 1993. They have been a Bodypoint distributor for 25 years.
Although BES is based in Bristol, England, Dirk himself lives and works in Germany, giving him a unique perspective. He says the last few months have really highlighted the “drastic differences” between these two countries. For example, when the COVID-19 epidemic started, there were about 29 intensive care beds per 100,000 people in Germany, but in the UK that number was more like 5 or 7 beds. Germany started testing very broadly for COVID-19 right away, while the UK was only testing those in the hospital.
Interestingly, Germany has actually implemented fewer social distancing restrictions than in the UK, with more of their citizens continuing to work and go out in public. Recently, those rules have been relaxed even more. Whatever Germany has been doing, it seems to be working. As of late May, the per capita death rate from COVID-19 in the UK was one of the highest in Europe, while Germany’s was one of the lowest.
One area Dirk feels both countries have done well at is getting aid to businesses. His impression is that both Germany and the UK have been quicker about this than the United States, and he’s grateful for that.
What’s happening with complex rehab in the UK?
The majority of healthcare in the UK is provided under the publicly-funded National Health Service (NHS) umbrella, with England’s NHS being the second largest single-payer healthcare system in the world. Because essentially all the country’s providers are employed by the NHS, they have significant control over the distribution of resources.
Dirk says that when the NHS “saw this tsunami of cases coming,” they started reassigning healthcare professionals across the board. Many of the Occupational Therapists and others who would typically spend most of their time working with wheelchair users were pulled out of their regular jobs and sent to work on the COVID-19 front line. Additionally, many of the private institutions BES works with decided to furlough their workers.
Although the critical services are technically still there, most non-urgent healthcare has been “pushed down the road.” Few assistive technology providers have been available or willing to see clients since things first started shutting down due to COVID-19. There are also not many wheelchair users who want to risk an in-person appointment to see the providers who are available.
Although Dirk has seen some companies doing virtual assessments, telehealth is not widely used in the UK. A lot of equipment still has to be prescribed through a face-to-face assessment. Because the NHS is such a big organization, “it’s really bureaucratic and old-fashioned,” he says. “So any new technology like that just takes so long and is so poorly adopted.” Most facilities aren’t set up for it, and Dirk questions how effective it can be anyway. While a problematic seating position might be visible on camera, it may be harder to tell “whether this belt or this cushion or back might be better for someone,” he says.
As one would expect, all of this has caused a significant slowdown in the complex rehab and assistive technology industries.
What’s been the impact on BES?
In the assistive technology area of their business, BES saw a relatively steady level of orders through early April as a result of assessment work that was completed before COVID-19 hit. Since then, however, orders have dropped off further and further. As of late May, Dirk estimated that orders in this sector of his business were down about 50%, though some products, especially those intended for the most complex cases, have not fallen off as much. He’s grateful the overall flow is not worse, though. “We calculated that it could have dropped down to as low as 10%,” he says.
Although companies like BES who provide medical products are considered “essential businesses,” some of their suppliers are not, and there have been shortages in some areas (though not from Bodypoint). On top of all this, BES has also been hit hard by freight costs, which have “gone through the roof” due to reduced capacity on passenger planes, Dirk says. He’s found that shipping since COVID-19 began is not only 5 or 6 times more expensive, it’s also been slower and less reliable.
 On the positive side, BES benefits from being a relatively diversified company and some areas of the business have not slowed down as much as assistive technology. For example, business has actually increased for a subsidiary that sells activity packages for care homes, now being used in place of programs previously run by visiting session leaders. They are also picking up new opportunities, like the potential to sell facemasks they’ve been sourcing from China.
Still, things are slow enough that BES is currently operating with a bare-bones staff, most of whom are working remotely. They have just enough people working to keep the business running and fulfill the orders that do come in. The rest of the BES team, including all but one salesperson, has been furloughed. Under the UK’s COVID-19 relief program, the government will pay 80% of the normal salary for furloughed employees, up to certain cap. The catch is, it’s all or nothing – those employees can’t work even a little.
Again, Dirk has been frustrated when comparing the UK furlough scheme with the program in Germany, which allows employees to work part-time and receive government support for the rest. His team has lots of ideas about all the things they could be getting done while business slow, but they can’t make it happen. The British government recently announced changes to the policy that will allow part-time work starting in July, which is good news for BES. But for now, it’s more financially viable for the company to have the staff furloughed and accept the government support than it is to have them work.
The Personal Toll
Dirk feels lucky that no one close to him or in the company has been seriously ill with COVID-19. They do suspect a couple of BES staff members may have had the virus early on, but their symptoms weren’t serious enough qualify for a test, and they have since recovered.
This crisis has taken a human toll in other ways, however. Dirk works from home quite often anyway, so that hasn’t been much of a change. But having his two-year-old son home all day with him is certainly different. With no child care facilities open, Dirk splits his time between child-care duty in the mornings and work in the afternoons, while his wife, a teacher, does the opposite. This sort of schedule is “quite tiring,” he says.
Dirk feels the worst part of the COVID-19 crisis for him and his team has been “the unseen pressure it puts on everyone.” Because there are so many people off at BES, there’s more to be done by the few people who are still working. On top of the usual responsibilities, there are new things like loan applications and working through the technicalities of claiming government support. “You’ve got all of that as extra and you’ve got half the amount of time, so it’s a bit more stressful,” Dirk says.
There’s also the uncertainty. Many are wondering whether the business will survive and whether they will have a job in a few weeks’ time. Like Dirk, some team members are having to look after their kids while trying to work remotely, and others are twiddling their thumbs while on furlough. Meanwhile, they are concerned about the company being dependent on government support, how long that’s going to last, and how they will be able to transition out it. And of course, everyone is “going stir crazy having to live within the same four walls all the time.”
The Positive Side
Despite the stresses, Dirk has seen “a lot of general positivity and support of one another” within BES and outside of it. He feels like the team has been very appreciative of all the steps BES has taken, including finding ways to maintain everyone’s full salaries and being transparent about the issues facing the company. In return, he’s felt the support back from the team. He sees his staff being willing to take whatever extra steps are necessary to help the company get back up and running.
Dirk has also found it very interesting to see some of the bigger organizations collaborating for the first time. Companies who would normally be major competitors are reaching out and pooling resources to help more in the community. It’s great to see something like this bringing people together, he says.
What does the future hold?
As of early May, Dirk's confidence level in the future of BES was “probably around 70%,” he said. “We’ve done everything we can do.” Still, there have been many things that are out of their control. One of those has been the government funding, which was still a bit uncertain until early June, when BES got confirmation that they'll be receiving a government-backed loan they had been waiting for. Approval of this loan, necessary for their survival, was a big relief.
Like many others in this industry, the key factor determining when BES can make a real comeback is when clinicians can start seeing their clients again. At this point, it looks like a lot of people in the UK will be returning to work in July, which is more good news. Of course, it will also be dependent on how many wheelchair users are willing to come in for appointments. Dirk’s sense is that “there’s going to be a spectrum.” Some won’t be concerned about catching the virus once restrictions lift, but others will still want to limit contact and just won’t go in no matter what their physical issues are.
Unlike many of Bodypoint’s other distributors, BES primarily sells directly to healthcare professionals, not through dealers. So one of their current challenges is figuring out the best way to facilitate assessments in a way that reduces risk and eases people’s concerns once things start to open up. Will using personal protective equipment like masks and aprons be sufficient? Or should they try to make telehealth work after all?
 But in general, Dirk is positive about the future. He’s really pleased that that the government will adapt their programs and make it financially viable to bring staff back part-time if needed. As a result, some of his staff may be coming back to work in a few weeks.
And then there are the business opportunities. As healthcare systems have had to adapt in response to COVID-19, perceptions have also changed and made certain practices more acceptable than before. Dirk is hoping this may allow BES to pursue some business models they’ve been interested in for many years that would benefit both the company and their customer base.
Although may have seemed impossible at times over the last couple of months, the future for BES could actually be bright, with some new doors opening. We certainly hope so! Bodypoint appreciates the work of BES and our other distributors and dealers around the world, and wish them the best of luck recovering from this crisis.
- Natalie Beauchene, Bodypoint Marketing Manager
Read more from this or other issues of "To the Point" on our Newsletter web page. |
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