Monday 16 March 2015

4 Viable Business Models For Professionals

In this post, I'll look at 4 business models that professionals can follow, 2 where you don't sell your own services and products and 2 where you do. In the highly flexible business environment we have now, all are viable and there are pluses and minuses for each, which I'll describe. Along the way, I'll signpost some useful resources, which can help with the different models.

I'll start with the don't have models: associate and affiliate business models. Yes, it's true, you can be successful in business as a professional without developing or selling your own services and products.

1. The Associate Business Model

As an associate you deliver other people’s services. A typical scenario is where you would deliver a training course designed by someone else (or their company) at that company’s client. Generally, the training you’re delivering is owned (intellectual property or IP) by the company you’re delivering on behalf of. It’s also their client, so in a sense they own the client too.

Are there pluses? Yes, a few. Once you become a trusted associate all you have to do is turn up and deliver the training. You don’t have to do any marketing and you didn’t have to win the client. Also, you don’t have the hassle of invoicing and credit control. You turn up, deliver the service and get paid. When I managed a team of associates, we paid them well (about £400 to £600 a day). There’s something to be said for that, obviously.

Is it a good business model? Maybe, maybe not. It’s not your client, nor your IP, so although you’re earning, you’re not building equity or value in your business. It’s like renting versus buying. If you buy, the property can accrue value. It’s yours. If you rent, the landlord (business owner) benefits, you don’t. Also, associate work is inherently risky. You’re dependent on the company’s ability to get clients, which makes it feast and famine. During feast, you can make good money but get exhausted due to all the training and travel. During famine, you don’t make money and the anxiety makes you exhausted because of lack of sleep!

One final, key drawback - other business models are more scalable. As an associate you can only be in one place at one time. So you can do OK but you can never do great. This model is not entrepreneurial as such, it’s more about making a living.

2. The Affiliate Business Model

The affiliate business model is where you promote other people’s products and get paid a commission based on sales performance. Notice I didn’t say sales, I said sales performance. By and large you aren’t doing the selling, you’re doing the marketing (or pre-selling as it’s sometimes called).

Let’s look at a typical affiliate scenario. You’re interested in personal development and you come across a great website where they sell online courses (like for example). You sign up, take a couple of courses and think: “Wow, these courses are brilliant!” Then you discover they have an affiliate program, so you sign up for that too. This means you can now promote Udemy courses and make money.

How do you do that? Well, let’s say you have an email newsletter that you send out to a list of contacts every couple of weeks (or it could be you have a facebook page with a lot of followers). When you contact people (or post), you let them know about the great course you’ve found and include a special link to the course. This is an affiliate link you get from your affiliate program, which identifies you as the person who promoted the course. When people click the link it places a cookie on their computer, which means that if your contact subsequently buys the course (or any Udemy course for that matter) your affiliate program will know and you’ll get paid a commission.

That’s it really. All affiliate programs work in pretty much the same way. Nowadays you can promote almost anything. Just about every major company or brand has an affiliate program, including the likes of Tesco and M&S.

What about your profession though? Can you build an affiliate business specifically around that? Almost certainly. Because most professions cover a broad topic, there are usually many profitable niches associated them. To prove that, all you have to do is a keyword search using something like Google’s Keyword Planner tool (part of Google AdWords). With this tool you can use a seed keyword like “psychology” for example and see quickly how many people search for all the keywords associated with psychology. You’ll be amazed, not just at the numbers of related keywords but also the number of people searching for them. If there are a lot of people searching you know there’s a market - you can promote related affiliate products to those people and make money.

There are several advantages to the affiliate model. The start-up costs are low because you don’t need your own product or service. You can run the business from anywhere and you can promote whatever you want to whomever you want. There are any number of profitable number of niches around which you could build your business. There are also multiple channels you can use for marketing such as your website, email, facebook or YouTube. And you don’t have to sell as such. That’s the job of the company (or website) providing the product. All you have to do is to recommend or pre-sell. It’s very scalable, with no limit on what you can earn. There are a lot of people making a very large amount of money from affiliate programs.

If you’re unfamiliar with the affiliate model and would like to learn more about it, a great resource is called affilorama, which has a huge amount of educational resources on affiliate marketing. Check out the free resources first. If it looks like a good fit for you, they also have some great, paid learning programs you can sign up for that will teach you how to build a profitable affiliate business, step-by-step.

Some disadvantages too though…

Like any business, it takes hard work and time to build up. There’s a learning curve, especially around keywords and online marketing. If you’re prepared to put the hours in to learn and apply those skills, then put in the hard marketing yards (mainly in front of your computer), it’s got huge potential as a business model. Otherwise, it’s probably not the business model for you.

One final thing I should add about the affiliate model and this one’s a big plus. You can very easily integrate affiliate programs into your wider professional business. You can decide to devote a proportion of your time, whatever suits, to affiliate marketing, which brings in valuable, additional and regular income. Affiliate business therefore complements other models.

Now let’s look at 2 alternative models around running a business based on your own products or services. I’m going to discuss two business models, one focusing on services, the other on products, including digital products.

3. The ‘Own Service’ Business Model

This model is where you’re developing, marketing and selling your own services. This could be in-house training, consultancy, surveys, coaching, or therapeutic services like counselling or CBT. It’s a business model that’s been around for a very long time. It’s pretty reliable, but it has its challenges like all business models. For most of my business career, this is the business model I’ve adopted although that’s changing now. I’ve sold most of these services, but I’ve been most successful with training.

There are a number of reasons. Training is a simple intervention and straightforward to deliver. Clients can see its benefits, making it easier to sell. It’s also highly scalable, more so than say coaching or therapy. If you develop a training course for example, you can train other people, associates, to deliver it, meaning that your business can be delivering a service to many clients in different locations. Luckily, training also turned out to be a good fit for my strengths and capabilities.

There are a large number of niches you can exploit with training. For example, in around the year 2,000, I found that there was a gap in the market around training managers to manage stress risks at work so I developed and marketed a course that filled this gap, which went on to generate several hundred thousand pounds (UK currency) of revenue over a few years. I don’t say that to boast, merely to highlight that a course, if a perfect fit for a niche and marketed correctly, can be very lucrative.

I mentioned challenges. Those are significant with this model and I see a lot of professionals failing to understand or overcome them. One is that you need to understand your market. It’s no good trying to sell a service that clients don’t want, or perhaps more importantly won’t pay for.

Then there is all the work involved in business development and marketing, especially if you sell services to corporate clients. Before you get a training contract, you usually go through a business development process with a number of stages. A typical lead time from first contact to getting a contract is 6 to 18 months, sometimes longer. This causes cash flow problems as you can imagine. Often, people entering this kind of business are unprepared for these challenges, which leads to business failure or under-performance.

If the service you sell is training, one way of meeting some of these challenges is by setting up a public training event, using web-based event software like Eventbrite. You still have work to do marketing the event of course, but a big advantage is that people pay you in advance for tickets, so it’s great for cash flow. Events can also help you market other services to attendees. Another advantage is that you can create an affiliate program specifically for your event and have other people promote it.

I cover marketing with events in depth in another article. It’s a powerful and effective marketing strategy for selling services.

So, can you be successful developing and selling your own services? Definitely, but you need to have good business development skills (or employ someone that has). You also need good financial management, particularly in the early days when money is tight.

4. The ‘Own Product’ Business Model

In many ways, this is now the most interesting model, because of the ways that the internet has transformed marketing and the ease with which digital products can be delivered to customers. By product, I mean something that people can buy ‘off the online shelf’ without you or another person being physically involved.

A training course that you or an associate delivers is a service. But a training course that you convert into video and text and is delivered online is a training product. You don’t have to be there, and there isn’t a limit to how many times you’re training product can be sold. Also, there is no limit on where a training product can be sold. It can be bought by anyone, anytime, anywhere in the world.

I’ve already discussed the model is where you sell other people’s products as an affiliate and I hope you can see the potential of that. Here though, I’m talking about developing your own products, especially digital products. Digital products are essentially free to produce, requiring your time rather than a financial commitment. So they are highly profitable. If you do need anything equipment wise, it’s probably stuff you already have like a webcam and a microphone.

Most professionals have niche knowledge and expertise and that has become a major business opportunity. You can use that niche knowledge (and in many ways, the ‘nichier’ the better) to develop digital products such as e-books and video-based training.

How could you benefit? In the case of Udemy, which I already mentioned in the context of affiliate marketing, you could become an Instructor then develop and upload your own courses. (Certainly, I intend to do this.) If you do that, not only can you promote your own training product, but your courses can also be searched for by Udemy’s 5+ million users. Will people find and buy your course. It’s highly likely. Yes, that will require development work but you only have to do that work once (unlike a service where you or an associate has to be there to deliver it). Also, once you have an online training product, other people, affiliates, can promote it. You’ll have a little army of people doing the marketing for you.

A key point is that with digital products there isn’t the same business development process or lead time. If people like what they see on a website, there’s a good chance they will buy it, there and then. Impulse buying in other words.

Of course, your own digital products can help your business in other ways. You could use a free digital product like an e-book as a lead generator for your service. The typical way this is done is by having people opt-in on your website and give you their details in order to download your e-book. You can then provide them with valuable content or promote products and services over a series of emails (known as an autoresponder - a great resource for this is called Aweber). You could also embed affiliate links into your free digital product, generating additional income from products you’re happy to recommend.

If there’s a down side, again it’s the learning curve. You certainly need to be computer literate and understand digital products. And like the affiliate model, you need to learn about online marketing and social media.

From experience, my feeling is that most professionals haven’t yet seen the business potential of developing digital products. If you’re reading this post, I hope you don’t make the same mistake. I’d urge you to look into this business model and go through the learning curve involved. If you do, you’ll be miles ahead of the competition and it will open up income streams where you can make money while you sleep.


This post looked at whether or not you should develop your own products and services and discussed 4 viable business models associated with each approach. Each model has its pluses and minuses:
  • As an associate, you're delivering other people's services. You can make a decent living as an associate and you don’t have to do any marketing, but there’s a limit to how much you can earn and you’re never building value or equity in your own business.
  • As an affiliate, you’re promoting other people’s products and services. There’s little or no cost of entry to this business model and there no limit on how much you can earn. You can run your business from anywhere. However, you do need good online marketing skills and be prepared to learn. One big advantage is that affiliate marketing can complement other business models.
  • Selling your own services is a tried and tested model. Training is a very saleable service and can be very lucrative if you find a good niche. Drawbacks include very long lead times and cash flow problems. Running events can help shorten lead times and speed up payments. Good business development skills are essential for success.
  • Developing and selling digital products has become much easier and cheaper with advances in technology. Online training products in particular can be highly profitable. Like the affiliate model there is a learning curve, but once products are produced, they can be sold to anyone, anytime, anywhere. Digital products can be used in other ways such as lead generators for your service. Other people, affiliates, can promote your products, doing the marketing for you.
  • Which business model(s) you choose will be governed by your strengths and preferences but never close your mind to new business models. There are multiple ways to make money and build a successful business.
Good luck with growing and developing your professional business!

Alan Bradshaw, Business Psychologist

Useful links, tools and resources related to this post:

Wednesday 11 March 2015

What Jeremy Clarkson can teach us about business and marketing

A 'fracas' involving Jeremy Clarkson of BBC Top Gear fame has become the big news story over the last couple of days and not just on the BBC. It's trending everywhere. Are there business and marketing lessons, good and bad, from all the buzz surrounding this story?

Celebrity + Controversy is a potent PR combination

Celebrity has always been important in marketing, but with the way media works now it seems on a whole new level. It's something about the way stories spread virally now on multiple channels and platforms, between channels, and between all of us individually. Throw in a dose of controversy and you have the perfect combination. No one does (repeated) controversy as well as Clarkson has in recent years. The Clarkson story is all the rage in the Bradshaw household. Do we both love the man? No. Do we agree. No, in fact, there have been some heated debates. Are we talking about it? Definitely.

Lessons? We could probably all do with a enhanced dose of celebrity. OK we're never going to be as famous as Jeremy Clarkson, but with a bit of marketing we could maybe become a celebrity in our own domain. Secondly, although there's 'a fine line' (more on this below), a bit of controversy gets people talking. Every profession and business niche has its hot issues. So don't be too much of a shrinking violet, it's better have an opinion about those issues and express your views. You might generate some news.

If 50% hate you and 50% love you that's about perfect

In business, bland is bad. No, its worse. Bland is marketing death. If you can't get any attention in a crowded marketplace, you're stuffed. So let's say you're just about the best at what you do. But you play safe with your marketing. You never rock the boat. You do the same as everyone else does. Who cares? Not one will notice, even if you are the best. We care about and pay attention to Clarkson, because he divides opinion. Some see him as the 'badest' of the bad - yes, he's a "bad, bad boy". Others see him as a man's man, a champion of the politically incorrect. But one thing's for sure, everyone's talking about him. Attention. Without it, it's very difficult to grow a business.

Make 'em laugh, or at least feel something

It's good to engage people on an emotional level. Love him or hate him, Clarkson does this brilliantly and emotional engagement has played a huge part in his success. Lessons for the rest of us? Be more human. Play to your strengths. Be warm, humorous, passionate, or enthusiastic, angry even. Have conversations, discussions, arguments. Use less slides and bullet points. Maybe even avoid PowerPoint completely (I know, controversial!). Be yourself.

Don't worry what people think

There's very little evidence that Jeremy Clarkson gives two hoots what people think. And that might yet lead to his downfall, who knows? But there's something to be said for this "I really don't give a ****" mindset, particularly if you have to perform. By which I mean make a presentation, deliver a pitch, record a video, that kind of thing. Worrying what people think generates performance anxiety and inhibits, a bit like a speed-limiter set artificially low. None of us can control others' expectations or what they think. So to give your best, do your best, and let people think what they will. You'll perform way better.

There IS a fine line, but where it lies is context dependent

There IS a fine line. Even for Jeremy Clarkson. Maybe he's crossed his, it remains to be seen. It seems though that context is very important. We expect Clarkson to be on the edge and push the boundaries. His BBC producers have played up to this and even created situations they surely knew would generate controversy (and marketing 'buzz'). His fine line is not in the same place as ours. Perhaps the lesson for us is that we need to try to work out where our fine line is and have some strategies in place to avoid crossing it. Perhaps the (risky) art is to be prepared to 'sail close to the wind' or be 'on the edge' at times, but not to cross our own fine line.

Don't bite the feeding hand

Here the feeding hand is the BBC and all that goes with fronting the BBC's most profitable and marketable product, Top Gear. I'm sure Clarkson could go to ITV or Sky and pretty much name his price. But it's not the BBC and that would mean a huge loss of exposure. Ultimately, his business and media profile will suffer.

Think about golf and Rory McIlroy not winning BBC Sports Personality of the Year. It was ridiculous. The world number one and two-time major winner in a truly world-wide sport was beaten by someone in the best Formula One car who really only had to beat his team-mate! Why? Because golf is no longer on terrestrial television. It just doesn't have the exposure it did. In business, you need long-term exposure.

Likewise, think about Michel Roux Jr. He was on the telly (here in the UK) all the time till he and the BBC fell out over his commercial interests. Now you never see him, except on adverts for potatoes. Maybe potato ads pay very well, I don't know. But if you only appear on ads for potatoes, that is hardly the same as being regularly on prime time TV. If you have a feeding media hand, best keep it sweet!

Look after yourself better

By his own admission, Clarkson has done a terrible job of looking after himself. You can see the evidence. The trouble with looking after yourself very badly is that there's a price to pay, physically but also mentally. This includes the long-term cognitive impact of what you eat and drink. You can end up behaving badly more frequently and making some poor decisions, with serious consequences.

Treat people with respect

Treating people with disrespect will come back to haunt you, eventually. People, whether in high places or low, won't forget, and some won't forgive either. This includes disrespecting on social media. Insulting people on twitter is not a joke and it doesn't matter if it's a politician or a journalist. It's still stupid and damaging.

You're only as good as your support network

Support matters. It's the number one buffer against the negative effects of stress. My own experience (and research) suggests that support from a partner or spouse is particularly important, especially in stopping you doing very stupid things. Partners also make sure you eat well and don't drink too much. They calm you down and, where necessary, tell you straight when you're not getting it right. When you lose that 'hand on the emotional and behavioural tiller' it's a big loss. Single and divorced men can fare particularly badly and this is why. We need our wives to protect us from our own stupidity and worst excesses.

photo credit: Hiding My Most Recent Scar via photopin (license)
photo credit: Jonathan, Jeff, Rain via photopin (license)
photo credit: Sweet Potatoes via photopin (license)

Thursday 5 March 2015

Flipboard and Udemy: Two great web tools for business development

I launched an online magazine this week called "Stress News". You can see it here. I described it as: 
"An online magazine devoted to stress management including: stress news, stress videos, stress blogs, stress management techniques and the latest stress research." At the moment, it has 15 articles.
I made it with an app called Flipboard, which I discovered from taking a Udemy course on YouTube. It makes it super-easy to put together an online magazine. You can add pretty much any media using an add-on called "flip-it".

A 'heads-up' if you fancy producing your own online magazine (which seems to me a good business development idea for any professional or business niche and perfect for psychologists) - To use the app and the 'flip-it' add-on for building your magazine, you need to use the Chrome browser. I don't think it works with other browsers at this time. However you can view online magazines on any browser.
Screenshot from

I mentioned Udemy. It's a wonderful resource and I intend to use it more and more. I urge you to take a look at it. Udemy is a website where you can access all kinds of online, video-based training. There are courses on all kinds of stuff, with both free and paid courses you can access.

Screenshot from
 Why might you find Udemy useful?

3 main ways. Firstly, it's great for learning. I am currently on a steep learning curve with YouTube, which has been transformed by Google recently. I found a great course on this, which has been incredibly helpful.

But you can also become an Instructor and upload your own courses. I have a load of training material and courses, which I intend to develop in Udemy format (video and text) so that I can upload and sell them on Udemy. A bit of work obviously (well OK, a lot of work), but you only need to do it once and then you'll have ongoing, additional income streams. Very useful for business psychologists (like me) - in fact anyone who develops and delivers training.

Some persuasive stats? Udemy currently has over 5 million students searching for stuff to learn and 13 million course enrollments. You can promote you own Udemy courses once developed, but Udemy will promote your stuff too and students can find your courses through their search engine. If Udemy finds you students, they take a cut, which seems fair enough to me.

The third way you can benefit is via Udemy's affiliate program, which is on the linkshare affiliate network. Then you can generate income from promoting other people's courses. Other affiliates can make money too promoting your courses.

All in all, worth looking into.

Tuesday 17 February 2015

Google+ Hangout with Professor Derek Mowbray discussing stress in the NHS

I recently recorded this Google+ Hangout with Professor Derek Mowbray. We were discussing stress in the NHS, a topic we both have a strong professional interest in.

Last week, I set up a project last week called Tackling Stress in the NHS where you can get get involved if you're interested in this issue. Stress is a big and complex problem for the NHS with many causes and a number of solutions with potential to make a real difference.

Derek was heavily involved in developing the NHS Manager's Code of Conduct, which was launched in 2012 in association with the Institute for Healthcare Management. The aim of the Code is to facilitate Positive Work Cultures in NHS organizations, preventing work-related stress and promoting wellbeing and performance.

The video is quite long, about 25 minutes, but well worth watching if you're at all interested in issues around stress in the NHS. (You can three shorter videos specifically about the NHS Managers Code on this page.)

Tuesday 10 February 2015

Tackling Stress in the NHS launched

Yesterday, I took the first steps in what is going to be a major project, Tackling Stress in the NHS. (you can register for updates here)

It's an ambitious project to say the least. The NHS is a huge organization and stress is a big problem in the NHS, with high levels of stress-related absence and presenteeism. My experience (and available data) suggests this is having major human impacts on staff at all levels: on managers, doctors, nurses, support staff, ancillary staff, everyone.

It's not a trivial task to tackle this problem I know, but it's surely worth the effort. We already know there's a substantial return-on-investment from such activity. I intend to use the skills I have to do something about it; to raise awareness and help NHS organizations and their staff prevent and reduce stress. I certainly can't do it on my own, so I'm in discussion with professional colleagues to see what can be done.
Prof Derek Mowbray

One expert I'm already working with on this project is Professor Derek Mowbray. I've known and worked with Derek for many years. He's done more than anyone else I know to make a difference to stress in the NHS having developed the NHS Managers Code back in 2010.

What I've done so far is set up Google+ and Facebook pages and a YouTube channel. As I write this (10th Feb 2015), no videos have been uploaded to YouTube but that will change very soon.

I'll be setting up conferences and regional roadshow events, which will kick off in October 2015

I'll also be working with Derek and others to promote existing tools and develop some new tools and resources. New interventions will include a range of training courses and train-the-trainer. 

If you want to get involved, I've set up a web page with an overview of the project where you can find links to useful resources and social media channels. You can also sign up for regular updates.

Wednesday 21 January 2015

Stress Management Best Practice Checklist Tool for Managers and Support Professionals

 Recently, I developed a Stress Management Best Practice Checklist Tool, which you can download from my website.

This resource, which can be used by managers and those who support them, is designed to help identify current gaps in stress management skills and knowledge. Development interventions such as management training and coaching can help plug these gaps and move the organization towards best practice in managing stress risks at work.

You can use the checklist tool in a number of important ways:
  • To raise awareness of best practice in managing work-related stress
  • To identify current gaps in management skills and knowledge
  • To facilitate discussion with colleagues around the issues involved
  • To help you/managers think about and prioritize actions that may be required to
  • plug any gaps identified
  • To clarify what resources and support (internal and external) may be required to enable managers better tackle stress problems
  • To help generate ideas about quick wins and longer-term strategies
The checklist tool looks at four key areas of management practice:
  1. Awareness – questions highlighting the level of management awareness about work-related stress and the associated risks
  2. Preventing stress – questions related to management actions, skills and behaviours known to help prevent stress at work
  3. Monitoring stress – questions related to actions that enable early identification of stress problems at work
  4. Responding to stress problems – questions related to how managers respond once stress problems have been identified
The tool includes guidance notes both for line managers and for support professionals (who advise and support managers dealing with stress issues). There is also advice around next steps; making positive changes to improve management practice.

A second version of the tool is available which 'maps' the questions to the UK Health and Safety Excutive (HSE) Management Standards. These Standards cover the known risk factors for work-related stress and provide guidance for organizations on how to assess and manage such risks.

Thursday 8 January 2015

Outstanding leadership development at Imperial College Healthcare NHS Trust

Recently, I have been contributing some input around stress management and resilience to a leadership development programme called "Aspire" at Imperial NHS. I play a very small part, contributing a workshop for each cohort around what NHS leaders can do to maintain resilience and promote wellbeing in what is undoubtedly a highly pressurized working environment. I talk to delegates about two sides of resilience: what they can do to deal with the bad, stressful, stuff (especially around stress prevention and if-then planning), and what they can do to promote the good stuff (where we discuss positive psychology approaches).

My limited involvement has given me an insight into what is an outstanding leadership development programme, developed by the Head of Leadership there, Beverley Aylott. On the days I go along, the delegates are nearing the end of the programme. They make presentations on team projects they have undertaken over a few months to apply what they have learned to real-life (and stressful!) work problems facing colleagues and patients. They explain what their team chose to look at, how they approached the challenge, how they applied what they had learned, and how what they had done made a difference.

The presentations have all been excellent, inspiring in fact, especially in the ways that delegates worked together to apply aspects of their learning. One project that demonstrated this in spades was SMILE, developed by managers Di Dunn, Stephanie Harrison-White and Sue Newton. The background to their project was that Imperial hadn't shown up too well in a 2013 survey of cancer patient experience. Di, Steph and Sue wanted to change this in a sustainable and meaningful way and their answer was SMILE.

SMILE stands for:
  • Support groups;  
  • My name your name; 
  • Information;  
  • Link to Clinical Nurse Specialist, and;
  • Encourage family/friend. 
Di, Steph and Sue identified these 5 areas as all critically important to patient experience and they set about making a real difference in all areas.

They did.

They developed new resources for all the areas. They worked with colleagues and with patients to get involvement, feedback and buy in. They developed training materials and delivered training. Then they piloted everything and got extensive feedback from colleagues and patients, so that they could make improvements and refinements.

Two particularly impressive outcomes were the development of a toolkit, so the approach can be easily and widely disseminated, and a new format for name badges which is now being widely adopted.

It all warmed the heart of a business psychologist I can tell you! They applied psychology to different aspects of their project such as their leadership roles, their working as a team and how they delivered their project. A couple of aspects stood out for me. Firstly, Di, Steph and Sue discussed how they applied principles authentic leadership. They found that they could be better leaders by being themselves and giving their best, not by trying to be something they weren't. They also described how they found that they had different but complementary strengths and how playing to those strengths enabled them to achieve much more (and enjoy the process along the way).

The psychology around what they did to improve patient experience was interesting too. Support acts as a buffer against the negative effects of stress and SMILE boosts 3 aspects of support: access to support structures, staff support and social support from family and friends. Simple easy-to-understand, accessible information related to conditions also makes a huge difference, and not just for patients. It reduces uncertainty about what's happening and why, and boosts a sense of control, which promotes resilience. And this is boosted by clarity about who is there to help clinically and how they can be contacted. Perhaps most important of all, SMILE improves the relationships between the patients and those who care for them.

Ultimately, relationships probably make the biggest difference of all to wellbeing and quality of life, including at work.