Dr Andrew Greenland: 0:03

Okay, so welcome back to Voices in Health and Wellness, the show where we speak with leaders reimagining the future of care, well-being and community impact. I'm your host, andrew Greenland, and today I'm really thrilled to be joined by someone who's truly on the front lines of compassionate, tech-enabled care. Tamsin is a driving force at Avanti Home Care, I should say a company that blends high quality in-home support with thoughtful innovation. At a time when the care sector is under more pressure than ever, avanti is standing out not just by delivering vital services to those who need them most, but by building a model that's both human-centred and operationally resilient. In today's conversation, we'll explore what it takes to lead a modern healthcare landscape, the challenges of scaling with integrity, and how leaders like Tamsin are navigating the balancing act between personal connection and digital transformation. So, whether you're in health care, tech operations or just passionate about doing meaningful work, you'll take something valuable from this chat, so let's dive in. Tamsin, thank you so much for joining us again. Would you mind telling us all where you're calling from?

Tamsin Johnson: 1:06

telling us all where you are, where you're calling from. Hi, yeah, um, I'm, I'm working. I work remotely, so I am, uh, currently in malaga and near malaga, um, but it is a. Our business is a family-run business. We started our business six years ago and started by originally by my sister and my brother and my sister-in-law. Um, I am now um leading um hr in the company for them and also leading accounts and helping in marketing and recruitment. So, yeah, it's been quite a journey for us.

Dr Andrew Greenland: 1:35

Okay, thank you for that. So could you tell us a little bit about the company of AntiHealth, what it does and maybe how it sort of differs from other providers in the sector?

Tamsin Johnson: 1:47

Absolutely. I mean, we began this journey probably from our own journey, if I'm honest. So my stepfather had cancer and we were looking to provide we did as a family we provided care. My sister was working in the health and social care arena, which was incredibly helpful and she was absolutely fundamental in providing care for him. And I think what we learned very quickly and it was very long journey it's a very, very drawn out journey, I'm afraid and what we learned very quickly was that individualized care and caring, finding carers who would care for our family member in the way that we would want our family member cared for was very difficult. Um, so our marketing journey really began there, with our own journey interesting.

Dr Andrew Greenland: 2:41

So what were you sort of seeing as the kind of the gaps that you wanted to try and fill by creating something new and a little bit more personalized? What were the main things that you didn't like about what was out there for your relative?

Tamsin Johnson: 2:53

I think um a very generic approach. So a generic. There was a generic approach to what one person needs if they are in palliative care, what, what equipment one person needs if they're in palliative care, what um type, what timings, even down to the timings of care calls. You know lots of care companies offer very they can only manage to offer very structured timings. You know we understand we have to do a similar thing in terms of rotas but to be as flexible as you possibly can with that one individual's personalised journey. So we were struggling to get that flexibility and that support that my mum definitely needed at the time and tailor that care really to my stepfather's needs.

Dr Andrew Greenland: 3:38

Interesting, and how have you sort of gone about doing that? You know you kind of changed the model, shaken things up a bit. How have you managed to achieve all those things that you saw as missing from other providers?

Tamsin Johnson: 3:50

well, I think I mean I know that was very much the start of um uh, our very first marketing campaign, and I say marketing campaign. We initially have been um, a large provider for Derbyshire County Council, so actually we didn't need to market in the initial instance, although we do also provide private care and we always have from day one but it started with us just looking at that very specific journey that my stepfather had been through, identifying the gaps, using my sister's knowledge she'd been in health and social care, she'd worked in care homes as well, as she was managing a care company for another um, another provider in derbyshire and really, um, looking at what she'd seen in her time through, as well as thinking about what we would want to provide differently for my stepfather had we been able to say somebody, right, we need this and we need this and we need this actually identifying a list, a very specific list. Actually it began with um of everything that was needed and everything that we didn't have. I think Amazing.

Dr Andrew Greenland: 4:53

So what does a typical day look like for you at the moment? I know you mentioned some of the roles that you have, but how does that pan out in terms of your day? I mean, I guess there is no such thing as a same day in this kind of industry, but I just want to get some sense of what your day looks like in this role.

Tamsin Johnson: 5:09

No, I mean my day, I mean being HR. Obviously, my focus is entirely on staff and staff well-being, and that's really important to us as a company. So we also, when we market for recruitment, we market ourselves as a family company. We market ourselves as joining the avanti family and we use that phrase throughout our company.

Tamsin Johnson: 5:31

Um, we are not at the level that we are corporate. We haven't adopted corporate measure models um within our company and we like to take, we're trying to take a personalized approach with our staff as well. So we don't necessarily offer some of the larger things and the larger wellbeing stuff that larger companies might offer, for example, gym memberships and private health care, etc. But what we do offer is a one on one appraisal approach. We'd like to think that we know each one of members, each of our members of staff.

Tamsin Johnson: 6:06

So a lot of my time is taken up by making sure that personalized approach stays within our clients. So, through client surveys, which I'm currently doing a full analysis on at the moment client surveys, um, as well as surveys of our larger customers, our dubsh county council, etc. Checking what, whether our health providers are happy with what we're providing, as well as actually our employees as well. Exit interviews, um, so that that whole journey for us is really important, um, and that's where we we like to maintain our focus, that's where we use a lot of my time okay, got it, got it.

Dr Andrew Greenland: 6:41

And um, how do you find good people? I mean, there's a whole thing about recruitment in any industry, but what's your kind of secret sauce for getting the best people? What are you looking for and how do you sort of seek them out?

Tamsin Johnson: 7:17

I mean a couple of years ago, we just we couldn't recruit and we'd run numerous marketing campaigns in traditional methods and using digital methods and trying to frame particular, very specific audiences. It just nothing was working for us. So we went international and we are now, uh, recruiting um up to four candidates a month internationally. We continue to run our uk recruitment campaigns. Um, we don't get anybody. So what is currently making us successful is our international recruitment, um, uh, and and I think what makes us successful in that and we don't lose there's been a lot of abuse in that area in our industry and what makes us incredibly successful is that we again tailor their journey from the minute they and the minute we recruit them, the journey, throughout their journey, wherever they are, to get onto that plane, to get off the plane, we provide house, we provide a loan, we provide. So we we have a step-by-step journey for our international candidates which doesn't end amazing.

Dr Andrew Greenland: 8:11

Um, presumably your retention is is pretty good compared to your competitors or other people in this space.

Tamsin Johnson: 8:17

With that kind of thing in place, I guess yeah, no, and we get a lot of switch candidates coming over as well. So at the moment, the government are pushing us to recruit people who are already in the country, who have been displaced and haven't been given the journey that they should have been given in the initial instance because, of course, the situation wasn't monitored closely enough. So, yes, we are, absolutely. We are managing to retain our staff. We were actually currently going over this, our third year of international recruitment, actually currently going over this, our third year of international recruitment and so we're now renewing visas and so we have a visa renewal process, and we've had nobody. We're now on number 10. We've had nobody say no yet. So it's a good thing for us wow, very impressive.

Dr Andrew Greenland: 8:55

Um, so what sort of shifts and trends are you seeing in the healthcare sector right now, especially post pandemic? I guess you're a bit of a trailblazer in this area because of your approach and I don't know if other people are trying to catch up and do what you do. But what are you seeing?

Tamsin Johnson: 9:11

In our sector, the shifts and trends. I mean it's a continual battle for us. I think that the most important thing, if we are going to continue to provide the level of personalised care that we want to provide, the financial battle for us is continual. So at the moment, I think the trend is very much and I think I would speak for most healthcare providers out there at the moment in this industry that we are struggling to pay our staff in a way that we would like to pay our staff, because actually the county councils aren't paying us the level that we should be being paid.

Tamsin Johnson: 9:51

So, whilst a national increase would be suggested at 17%, local authorities this year, for example, have only increased between 5% to 7%. So we're seeing a real problem with rises, of course, in national insurance. So every employee is costing us more. But actually for us to privately privately, yes, we can charge higher rates, but again the market is competitive we're having to be very, very careful, um, but for us to be able to pay our employees in the way that we want to pay them, to be able to provide the care that we're continually providing because we do pay at the top of our market, is becoming increasingly difficult with lack of funding got it, um, I guess the way you were describing this more personalized approach, there's probably a fair amount of tech behind it to kind of really um well to do.

Dr Andrew Greenland: 10:44

You talk about rotas and all the different operational aspects. So how has the rise in demand for tech driven care impacted how Avanti operates its business?

Tamsin Johnson: 10:56

I mean tech, I use use tech loosely in the health and social care industry. We, um, I mean platforms. Why, absolutely so we are using. I mean, if we're talking about software platforms and making ourselves far more, um, efficient in our approach to rotors, then absolutely than we are having to use so clearly getting costs go up.

Tamsin Johnson: 11:18

But I think one of the key things for us has been our training. So we have our own training centre. We don't outsource training unless we are looking to look at less employees are looking to increase their qualifications up to a level five, which would make them registered manager. So for us, our training center has been highly effective in making sure that we are delivering that personalized approach, because we we have a lot of our carers may well have a lot of them. They're international now, but even when we're recruiting uk, they might not have been in care before you know. So, um, we would take people who possibly have got no experience at all in care and therefore for us to train from the minute they walk through the door in our values and our values we hold very close to our heart. I think it's been at the core of our success of being able to make sure that that journey remains solid through our company able to make sure that that journey remains solid through our company.

Dr Andrew Greenland: 12:21

Brilliant. So what's kind of working well for you and the team at the moment in the business and kind of the healthcare? Landscape In terms of marketing, in terms of In general, what's sort of working well in terms of all the things and strategies you do to kind of drive your mission. I just wonder what's going particularly well? What are you proud of?

Tamsin Johnson: 12:38

Really proud of our training centre and we've just actually recruited a second trainer, which is big for us. We're currently developing our infrastructure in terms of our staffing infrastructure. So what's going really well for us at the moment is we're really putting in place a strong management team and increasing our management team to make sure that we can therefore provide that level of personalised approach that we want to provide for our employees, for our clients, and also I think I would put into that in terms of success it's the standard of staff that we have. I think this is one of our biggest success.

Tamsin Johnson: 13:19

We lean very heavily on our staff in terms of and I don't mean lean in a negative sense, I mean we rely on them to provide the values that we hold very dear to us and very close to us, and our staff are fundamentally the core of what we do, and our CEO works very, very, very hard behind the background to make sure that every year, our staff are given a pay rise and every year, our staff are given benefits that maybe other providers wouldn't give, because we work in an industry whereby, you know, we're in a minimum wage industry. We don't want to provide minimum wage because we believe our carers what we know. Our carers are highly skilled, got it and then?

Dr Andrew Greenland: 14:01

so the opposite of that question is, what are the kind of sticking points at the moment? I mean, I think you alluded to sort of government funding as being perhaps one thing, but are there anything else that are sticking points in your operation?

Tamsin Johnson: 14:13

Yeah, I mean definitely government funding. That's an ongoing issue through the whole of self-help and social care and the lack of recognition. I think that carers get. You know it is a very, very skilled job, it's a highly skilled job. So the government are out there and they're creating what they call which is great, you know a care workforce pathway. So they want to upskill all carers so they get to a certain level. But actually alongside that there's no money to go with that. So you're not encouraging people to come into the care industry and want to be upskilled, because if you're upskilling somebody, then let's pay these people as if they are the skilled individuals that they are going out into community. So definitely funding is a huge issue for us and I think the other issue it does continue to be recruitment.

Tamsin Johnson: 15:00

You know, even though we're recruiting internationally, most of our recruitment has come from African countries. We are struggling now to knock on the door and to find a way in to knock on the door into countries. For example, we know there's lots coming in from Philippines, even the European countries. You know we're struggling to get our foot into the door in India. A lot of recruitment happens around India and I think, of course, the changing nature.

Tamsin Johnson: 15:32

You know, the last government recognized there was a health care crisis then, so we were allowed to internationally recruit the absolute. The bureaucracy surrounding that failed and it failed huge amounts of individuals. So now what they're trying to do is they're trying to say, okay, let's, let's close the doors, let's stop a level of international recruitment and let's get recruiters to recruit everybody, people that we've already got in the country. But actually the bureaucracy surrounding that is incredibly difficult to navigate, so you've got a block on saying no, you can't recruit anymore there. But actually for us to be able to recruit anybody from this pool, we can barely even get near it because it's tied up in so much bureaucracy got it.

Dr Andrew Greenland: 16:14

I guess you have a fairly big operational role in this business and obviously HR and recruitment is one of the things that you drive. What do you measure? What are your sort of metrics and outcomes that you look for in this business to kind of get a sense that you're moving in the right direction and kind of keeping track of what's happening in the organization? What do you what?

Tamsin Johnson: 16:31

do you? Look out for I mean obviously, obviously massively data driven um and our ceo would be far better place to answer this question. She spends a lot of time in the background, a lot of time in the background analyzing all of our metrics, down to how many people are knocking on our door um.

Tamsin Johnson: 16:51

As well as that, we also have a chief operations officer she's also one, my sister-in-law one, my daughter but they spend the majority of their time measuring our metrics in terms of like, where are we missing? Why are we not getting any clicks from India, from the Philippines, on our website? Why are we not getting private customers currently from a really quite wealthy area that we know we'd like to dip into? Because we're not managing to get the work out of Derbyshire County Council that we were before, and Derbyshire County Council are giving more and more work to NHS providers and less and less to private providers.

Tamsin Johnson: 17:27

So we are constantly, we're measuring every, but I think the main one for us at the moment definitely is our recruitment and our client base. You know, how are we going to get more clients through our door and they're spending a lot of time focusing on those metrics and what the trends are out there where? Because we still use some incredibly traditional marketing strategies. You know we're still using print in magazines, because people in doctors and people in old people's homes pick up magazines, you know. So we're still using some very traditional methods as well as trying to drive a more digital method as well.

Dr Andrew Greenland: 18:05

Is that what? So, in terms of things you might be trying to focus on improving? That's one of them. Really more clients through the door and using more innovative digital methods. Is that kind of what you're the direction that you're trying to take to get more people in?

Tamsin Johnson: 18:18

absolutely, we know we we probably aren't, so we've just we've actually just appointed um a new people development manager, which is exciting for us and they're going to be starting in july, because we really do need somebody to focus even more in detail, we think, on our digital methods of marketing in the, in the local area we work in a very. Our two offices, our two care offices, are in two quite low socioeconomic areas. So to reach those areas those are target markets in terms of marketing, we haven't, we still haven't, found the best way. You know, know we are stumbling around here and there and we're managing to get enough work through the door, but in terms of a streamlined approach, we are finding it. We're finding it hard. We're finding it hard to find those client areas, to find those private clients, which is where we need to kind of diversify into now, and to find the marketing strategies that are going to work.

Tamsin Johnson: 19:12

To find us that, like I say, we've spent quite a lot of money on um traditional methods probably we need to. We spent, we spent a lot of money on our website and obviously, um, we monitor that really, really closely. Social media is not something we've done massively. We use it more as a celebration of our carers and a celebration of what we do, and we know that we've got areas for development it more as a celebration of our carers and a celebration of what we do, and we know that we've got areas for development there. So I think that's going to be our focus moving forward got it.

Dr Andrew Greenland: 19:40

So where do you see avanti in the next six to twelve months? Have you got any major initiatives on the horizon other than some of the things you've talked about on this call in terms of sort of hr drives and marketing, anything in particular you're looking to achieve?

Tamsin Johnson: 19:58

I know what my CEO is saying. She's saying so I'm running a successful business is no longer a charity. No, no, she um in terms of we want to grow, we want to develop, we, we know that good health and social care um providers, um, there are lots and lots of providers who have gone under for reasons that some some through absolute lack of government funding, others because they should have gone under because the level of care they're providing is just not up to scratch. What we'd really like to see is a standardized level of care across the health and social care industry. So actually, there are lots of high-, high level providers.

Tamsin Johnson: 20:33

We believe we provide care at a higher level. We will continue to do that. So for us, 10 to 12 years time is making sure that our approach that we're taking now, that we don't lose sight of our values, that we aren't forced down into a market area, that we need to lose sight of our values, and that we're able to continue to drive those forward in in a landscape where we can pay our carers the money we want to pay them and also be able to infiltrate a market that we're currently struggling to market. But the aim is for us to open two or three more sites, if we can oh, wow.

Dr Andrew Greenland: 21:06

So um, what kind of, what kind of areas or geographies are we talking about?

Tamsin Johnson: 21:13

of what kind of areas or geographies are we talking about? So we're currently in ilkeston and ripley. Um, I know that, um, uh, so our ceo has got her eyes on and again, I I couldn't give you firm locations right now, but we would stay. We did have a site in long eaton. Our training house is now in long eaton. We found that we could. We struggled with the market in long eaton so we couldn't. Actually that's not an area we'd go down. But are we interested in potentially branching out into Nottinghamshire? Absolutely, maybe across into the border of Leicestershire, working with other care providers other than just Derbyshire, because it's proving for us extremely, just, slightly more tricky. We need to diversify. So, yeah, looking around the borders, borders that's where we're going, we currently are got it.

Dr Andrew Greenland: 21:57

So if you've got a magic wand and you could solve any particular challenge in the business at the moment, what do you think that might be? I mean, you may have alluded to a few things on this call, but is it?

Tamsin Johnson: 22:07

giving opportunity definitely funding, city councils being absolutely tied up in systems and bureaucracy and not being able to get work out the door quickly enough. So there have been lots of elderly people out there, disabled people, who are not receiving the care that they need because their systems are just not working effectively. And yes, funding definitely the work and marketing finding the right way to market for us, I think really is and we're hoping, like I say, that our new, we've got somebody new starting who's really going to kind of diversify us in that area.

Dr Andrew Greenland: 22:55

And I am guessing that none of this isn't in. None of this isn't avanti specific problem. This is probably an industry-wide issue with local authorities and some of the things that you mentioned absolutely, absolutely.

Tamsin Johnson: 23:05

and you know local authorities are in crisis themselves, aren't they? They're in a terrible crisis, you know, and we know that. You know, everybody's aware of that, and so pushing, pushing is no point in getting pushy. They are, they are, they're so segmented, the local authorities. Now there's absolutely lack of communication that goes on between parties to parties to parties, and for them to get any, to get anything pushed through the level of bureaucracy is just insane. So you know it's tricky, which is why we need to branch out and become more private, because we can't rely on the local authorities, providers of the work that they originally were. When we first opened, we were so busy that we couldn't turn away Sorry, we were turning away work.

Dr Andrew Greenland: 23:51

Got it, tamsin, this. This has been incredibly insightful conversation. Thank you so much for your time and joining us today. Really interesting to hear about the company, your ethos and where you're going and how you're really trying to do something a little bit more different, personalized and really looking after your staff. I think it's very impressive, um what you've managed to achieve with you and your, obviously, your family members and within the company. But thank you very much for your time today and giving us these really interesting insights into the care sector no, thank you very much.

Tamsin Johnson: 24:20

It was wonderful to join you thank you.