Annual Report 2008/09Annual Report 2008/09
Contents1 Achievementsandhighlights
2 Chairman’sstatement
4 CEOstatement
6 Businessreview
8 Operatingcompanyperformance
12 GPengagement
14 Newspread
16 TheConsultants’Choice
18 Patientcare
20 Qualityaccounts
22 Cleanasawhistle:infectionpreventionandcontrol
24 Magnetforthebest:ourpeople
26 Corporatesocialresponsibility
28 Environmentalinitiatives
30 Corporategovernance
32 Executivecommittee
Our mission
TogrowourpositionastheUK’slargest
independenthealthcareprovider,
workingwiththebestconsultantsto
deliverthebestqualitypatientcare,
thebestclinicalpracticeandthebest
possibleclinicaloutcomes.
General Healthcare Group 1
1
67
89%
99%
115
7,000+
9,200
2,900
250,000
1million
TheUK’sNo.1independenthealthcareprovider
hospitals&treatmentcentres
oftheGBpopulationlivelessthananhourfromaBMIhospital
patientsatisfactionratingofgood,verygoodorexcellent(Patient satisfaction
survey carried out by Howard Warwick & Associates, Jan - Sept 2009)
specialties&services
consultantspecialists
permanentemployees
beds
inpatientvisitsperyear
outpatientvisitsperyear
Key highlights
General Healthcare Group at a glance
n Integratedsevenex-Nuffield
hospitalsintotheBMIestate
n Acquirednewhospitalsin
DarlingtonandincentralLondon
n Openedsixnewoutreachclinics
andoutpatientunits
n Refurbished30wards,25hospital
receptionsandopenedthecountry’s
first24-7privateemergencycare
centre
n Invested£25millioninimaging
equipmentincludingfourMRI
scanners,fourCTscannersandone
ofonlyfourgammaknivesinthe
country,invested£7millioninnew
theatresand£8millioninclinicalIT
systemstoensurewecontinuetobe
‘TheConsultants’Choice’
n Continuedourcommitmentto
clinicalexcellencebypublishingour
‘QualityAccounts’demonstrating
ourongoingcommitmenttodeliver
qualityservicestoourpatients
n Providedanextra3,000stafftraining
daysin2008/09
Annual Report 2008/092
Chairman’s statement
Position
Our focus has clearly been on maintaining our position as the UK’s number 1 independent healthcare provider whilst ensuring we deliver excellent service to our stakeholders, consultants, GPs and patients.
“
“
General Healthcare Group 3
2008/09hasbeenanexcitingyearforGeneralHealthcareGroupandayear
inwhichmuchhasbeenachieved.OverthelastthreeyearstheCompany
hasbeentransformedintermsofscaleandquality;andfinanciallyitiswell
positionedtocontinuetotakeadvantageofpositivefundamentaltrends.
Therefore,Iampleasedtoreportthat,againstabackclothofeconomic
turbulence,GHGhasagaindeliveredexcellentresults.
During2008/09wecontinuedtoacquireandexpandourfootprint.Wecannow
proudlysaythatcirca90%oftheUKpopulationlivelessthananhourfroma
BMIfacility.Weareonlynowbeginningtoseetherealbenefitsofthescaleand
nationalcoveragethatwehavecreated.
OurfocushasbeenonstrengtheningourpositionastheUK’snumber1
independenthealthcareproviderwhilstensuringwedeliverexcellentserviceto
ourstakeholders,consultants,GPsandpatients.Maintainingandextendingour
leadingpositionrequiresustoinvestinourbusiness.During2008/09weinvested
£45m,andoverthelastthreeyearswehaveinvestedcirca£150millioninour
existingestateandafurther£150millioninnewfacilities.
Duringthisyearwewereoneofthefirstindependentoperatorstopublishour
‘qualityaccounts’tocommunicatepubliclyourexcellentpatientsatisfaction
levels,ourclinicaloutcomesandourrigorousmanagementofinfectioncontrol
withinallofourfacilities.
BMIHealthcareremainscommittedtoservicingtheindependenthealthcaresector
andthemajorityofourrevenueandcaseloadisderivedfromourprivatepatients.
WehaveacollaborativeandproductiveworkingrelationshipwiththeNHSand
arepleasedtoworkwiththepublicsectortodeliverChooseandBookservicesin
manyofourfacilities,helpingtheNHSdeliveritscorebusiness.
Forthefullyear2008/09ourcaseloadgrewby5.9%andourrevenueby7.6%.
Ouroperatingcompany(OpCo)delivered£220.6millionofEBITDARand
£93.9millionofEBITDA,anincreaseontheprioryearof8.3%and13.3%
respectively.
Westrivetobethemostefficientoperatorandweareveryproudthateachof
ourkeymetricsareindustryleading-reflectingthehardwork,dedicationand
experienceofallourstaff.OnbehalfoftheBoardandshareholdersIwouldliketo
expressourgratitudeandpraisetothem.
Withanageingpopulationweanticipateanincreasingrolefortheindependent
sector.Lookingforward,thecompanyenjoysgoodprospectsasfundamental
trendsarepositive.GeneralHealthcareGroupiswellpositionedtotakeadvantage
ofthis.
Notable achievements this year include:
nGeographicalgapshavebeenfilled
throughacquisitionorbuildandacentral
Londoncorecreatedtoserviceour
hospitalswithintheM25
nAnincreasedinvestmentincapital
equipmenttoensurethatwestayatthe
forefrontofindependenthealthcareand
respondtoconsultants’requestsforthe
mosttechnologicallyadvancedequipment
andfacilities–underpinningour
positioningas‘TheConsultants’Choice’
nAnincreasedfocusonGPengagement
withtherecruitmentofPrimaryCare
Managers,focusingonfurtherenhancing
ourrelationshipswithGPslocaltoeachof
ourhospitals
nTheexpansionofourNationalEnquiry
Centretoservicebetterconsultant,GPand
patientenquiriesandensurethepatient
iswelllookedafterfrominitialenquiryto
finaldischarge
nFocusonprovidingcareerpathsfor
internalmanagementanddevelopment
ofemployeeskillsetsthroughadditional
training.
1 The UK’s No. 1 independent
healthcare provider
Sir Peter GershonChairman,Nov2009
Annual Report 2008/094
Commitment
Ensuring our hospitals’ commitment to delivering the highest standard of service and care to patients, consultants and everyone associated with us.
“
”
IamdelightedtoreportonceagainthatGeneralHealthcareGroup
hasdeliveredanotherreallysolidperformanceacrossallourkey
metricsintheyear2008/09.Thisisthethirdsuccessiveyearof
outstandingperformance.
CEO statement
General Healthcare Group 5
Theimprovementsputinplaceoverthelastthreeyearshave
demonstrablydifferentiatedthebusinessbyquality,scale,employee
capabilityandcustomersatisfaction.
Ourcompanyisanefficientbusinessthatcontinuestohave
significantopportunityandpotential.Thisisabusinessevery
stakeholdercanbeproudof.
TheUKeconomyhashadaturbulentyear.Neverthelessdemand
forprivatehealthcareremainedstrongandwithanageing
populationthisdynamicissettocontinue.
Wearepleasedtoreportindustryleadingresults
nTurnoverup7.6%
nOperatingCompanyEBITDAup13.3%*
nPatient/customersatisfactionmaintainedatalltimehighs–99%
good,verygoodorexcellent,with98%recommending
tofriendsandfamily.
nContinuedfocusoninfectionpreventionwithnohospital
acquiredMRSAbacteraemiasinthelast12months**
In2008/09wehaveseenprivatelyinsuredandcorporatebusiness
remainfirmbuttheselfpayelementreducesharply.Tomitigatethis
wehaveaugmentedandgrownourcapacitybyofferingChoose
andBookincarefullytargetedhospitals.Itisexpectedthatthe
NHSfundedactivitywillcontinuetoplayanimportantroleinthe
independentsector,asthelegislativepolicyofChooseandBook
rollsoutfurther.BMIHealthcarehoweverremainsverymucha
privatehealthcareproviderthatmakessomecapacityavailableto
theNHStoserviceitscustomers,whereitisefficientandeffective
todoso.Thisnowrepresentscirca10%ofourcaseload.
Theobjectivefortheyearwastostrengthenfurtherourpositionas
thenumber1healthcareproviderintheUK,furtheremphasising
ourcommitmenttodeliveringthehigheststandardofserviceand
caretopatients,consultantsandallourstakeholders.
Wehavecompletedamajorrefurbishmentprogrammeofwards
andreceptionareasacross23ofourhospitalsandhaveinvested
significantlyinleadingedgescanningandimagingequipment.
Wealsosoughttoexpandourgeographicpresenceandintroduce
newservicestomanyofourhospitalsthroughourongoing
investmentprogramme.
Intheyear2008/09wehaveacquiredfacilitiesinDarlingtonand
Oxford,andopenednewunitsincentral&westLondon,Aberdeen
andSwindon.Wealsowonamajorcontracttomanagethe
CoombeWingPrivatePatientUnitwithinKingstonNHSTrust.
Wehavedoubledspendonstafftrainingoverthelastthreeyears
andinthecomingyearwewillcontinuetoinvestinthetraining
anddevelopmentofourstaff,recognisingthemasthebestpeople
intheindustry.
Iampleasedtoreportthatinthelastyearbothourclinicalstaff
andourmanagementhaveagainbeenrecognisedasleadersinthe
sector.
12ofourhospitalswerelistedintheNursingTimesTop100and
individualstaffhavereceivedsignificantemployment,leadership
andmanagementawards.Mostpositivelyhowever,asitunderpins
ourbusiness,wearenowdeliveringpatientsatisfactionalmost10%
pointsclearofthemarket–arealbarometerforfuturereferrals.
Inshort,BMIHealthcarehashadanotherstrongyearandweare
wellplacedtocontinuetoleverageourmarketleadingposition
andexploitthemanyincrementalgrowthopportunitiesasthe
marketconsolidates.
Thebusinessreviewthatfollowsgivesfurtherdetailaboutwhathas
beenhappeninginourbusinessandtheindustry.
Iamproudoftheachievementsofthiscompanyandits
transformationintoanefficientservice-ledbusinessthathasthe
potentialtoextenditsleadershipandgrowsignificantly.
Adrian FawcettChiefExecutiveOfficer,Nov2009
“ ”Our company is an efficient business that continues to have significant opportunity and potential.
*Seefinancialreview**ToAug09
Annual Report 2008/096
Business review
BMIHealthcare,theacuteprivatehospitaldivision
ofGeneralHealthcareGroup,isthelargest
independentproviderofprivatehealthcarein
theUK.
TheGrouphas67hospitalsandtreatmentcentres
throughouttheUK,eachhavinganenviable
reputationforprovidingexcellentmedicaland
surgicalfacilitiessupportedbystate-of-the-art
equipmentandahighstandardofnursingcare.
BMIhospitalsreceiveover250,000in-patientand
1,000,000out-patientvisitseachyear,andperform
morecomplexsurgerythananyotherindependent
privatehealthcareproviderinthecountry.Nearly
halftheproceduresundertakenforpatientsareof
amajororcomplexnature.
BMIhospitalsattractconsultantsfromawide
rangeofspecialties,mostofwhomhaveextensive
experiencegainedwithintheNHS.Supportedby
BMIHealthcare’shighcalibrestaff,theyareableto
undertakeawiderangeofproceduresfromroutine
investigationstothemostcomplex,highacuity
casessuchascardiacsurgeryandneurosurgery.
BMIHealthcareiscommitted
toprovidingaconsistent,
highqualityservicetolocal
communities.89%oftheGB
populationlivelessthanan
hourfromaBMIhospital.
Totalhealthcarespendingin
theUKreached£136billion
in2008,comparedwith
£60billionadecadeearlier,
withtheshareofgrossdomestic
productgoingtohealthrising
to9.4%from6.9%in1998,
puttingtheUKroughlyon
parwiththeEuropeanUnion
average.
PressuresontheBritish
healthcaresystemarelikely
togrowandforecastslooks
challenging,withpublic
spendingacrosstheboardlikely
tobecurtailedbycrippling
governmentdebtoverthenext
fiveyears.Exacerbatingthe
problemarethedemographic
realitiesofasicker,ageing
population,andtheadditional
expenseofnewtechnologies
beingdevelopedtotreatthem.
AJune2009paperbytheNHS
Confederation,themembership
bodyfortheinstitutionsmaking
uptheNationalHealthService,
predictedthattheNHSwould
facea“veryseverecontraction
initsfinancewithan£8-£10
billioncutinrealtermslikely
inthethreeyearsfrom2011.”
TheKing’sFund,inaJuly2009
report,discussedthreepotential
scenariosforfundingofthe
EnglishNHSfrom2011/12to
2016/17:a“tepid”outlook,with
annualrealincreasesof2%for
thefirstthreeyearsand3%for
thefinalthreeyears;a“cold”
outlookofzerorealchange
infunding;andan“arctic”
scenariothatforeseesannual
realreductionsof2%forthefirst
threeyears,fallingto1%forthe
finalthreeyears.Giventhislack
offundinggrowth,therewillbe
anincreasingrolefortheprivate
General Healthcare Group 7
BMI Healthcare’s core focus remains the private sector and providing quality healthcare for insured and self pay patients.
“
”Focus
sector,evenifNHSefficiencies
canoffsetsomeofthebudget
pressure.
FallingNHSbudgetswillprevent
capacityexpansion,andcost
savingsmayimpactonquality
intheNHS,furtherincreasing
demandforhighqualityprivate
sectorservicesofferingchoiceof
consultants,andhighstandards
ofcleanliness.
In2009GeneralHealthcare
experiencedtoughtrading
conditionsduetotheweak
economy,anditisexpectedthat
challengingmarketconditions
willcontinuetoimpactgrowth
ofthecorebusinessinthe
shortterm.Howeverexcellent
opportunitiesforbusiness
developmentremainand
smalleroperatorsareseeking
securitythroughpartnerships
withlargerorganisations.
BMIHealthcare’scorefocus
remainsontheprivatesector
andprovidingqualityhealthcare
forinsuredandselfpaypatients.
BMIhospitalsareconnected
totheNHSChooseandBook
serviceandofferarangeof
servicesundertheExtended
ChoiceNetwork.Wehavebeen
veryselectiveinlistingChoose
andBookservicestoensurebest
utilisationofoursparecapacity.
InBMIHealthcarewe
recognisetheimportanceof
ourrelationshipswithourkey
stakeholders,theconsultants
whoworkinourhospitalsand
theGPswhorefertheirpatients
tous.
In2009wehavefurther
expandedourteamsofPrimary
CareManagerswhoare
responsibleforliaisonwith
GPslocaltoourhospitals,
ensuringtheyarefullyaware
ofourproductsandservices
andfacilitatingandeasingthe
referralprocess.
GHGGROWTH
Qualitybusiness&sites
Newfacilities
Efficienthospitals
Newservices
Stakeholderengagement
Capitalinvestment
Annual Report 2008/098
Operating company performance
Financials8 Directors’reportfor
financialstatements
8 Corporatefinanceactivities
8 Capitalprojects
8 Financing
9 Operatingperformance
10 Groupprofitandloss
11 Cashflow
11 Borrowings
Directors’ report for financial statements
GeneralHealthcareGrouphasproduced
strongrevenueandprofitgrowthduringa
challengingyear.Revenuehasincreased
7.6%from2008levelswhich,coupledwith
improvedefficiencyhasseenitsEBITDA
marginincreasefrom10.7%to11.3%.
EBITDAgrewby13.3%to£94m.
Corporate finance activitiesDuring2009GeneralHealthcareGroup
hasstrengtheneditspositionastheleading
privatehealthcareproviderintheUK.The
Grouphasbroadeneditsgeographical
coverageandimproveditsperformance
throughthestrategicacquisitionsofCity
MedicalandFitzroySquareincentral
London,TheThornburyRadiosurgeryCentre
inSheffieldandTheWoodlandsprivate
hospitalinDarlington.
FinancingTheoperatingcompanyhasnetdebtof
£180m,lessthantwotimesheadlineEBITDA.
Inadditionundrawnfacilitiesof£69m
remainavailable.Thereisnorefinancing
requireduntil2013.
Capital projectsTheGrouphascontinuedtosetasidea
significantproportionoffreecashflowfor
improvementsintheinfrastructureofthe
business,investing£45mduring2008/09.
TheGroupundertookabalancedportfolioof
schemes,focussingonthefollowing:
nimprovingand/orextendingclinical
services
nimprovinghospitalinfrastructure
nenablingbusinessprocessthrough
improvedIT.
General Healthcare Group 9
RevenuegrowthwasdrivenbyariseinbothNHSandinsuredcaseloadmorethancompensatingforafallinself-pay
volumes.Efficiencyinitiativesimplementedduringtheyearhaveensuredthatmarginhascontinuedtoexpand.
Therentreceivedbytheproperty
companyownedbytheGrouphas
increasedby5%perannum.Thisis
madeupof2.5%annualincrements
withintheleasesplusthepositive
impactofanincreasednumberof
propertieswithintheportfolio.
Thecompanyhascontinuedtogrowtoplinerevenuestrongly.Anincreasingproportionofthisisfallingtothebottomline,
deliveringEBITDAgrowthof13%intheyear.
2009 2008 Growth
Total cases 261,195 246,589 5.9%
£’m £’m %
Revenue 832 773 7.6%
Headline EBITDA 94 83 13.3%
EBITDAmargin 11.3% 10.7% 0.6ppts
Profitbeforetax 35 25 40.0%
Profit after tax 36 22 63.6%
Operatingcashflow 128 131 (2.3%)
Property company
Operating Company
Revenue9008007006005004003002001000YR05/06 YR06/07YR07/08 YR08/09
632 689 773 832
EBITDA1009080706050403020100YR05/06 YR06/07YR07/08 YR08/09
43 62 83 94
EBITDA margin12
10
8
6
4
2
0YR05/06 YR06/07YR07/08 YR08/09
6.8% 8.99% 10.7% 11.3%
130
125
120
115
110
105
100YR05/06 YR06/07YR07/08 YR08/09
110 113 121 127
10%
30%
Annual Report 2008/0910
GP engagement
“ ”Our company is an efficient business that continues to have significant opportunity and potential.
General Healthcare Group 11
FeedbackfromGPshasunderlinedtheimportanceofaneasyreferralprocessfor
theirprivatepatients.Asaresultofthiswehavelauncheda‘GPHotline’giving
doctorsatotallysecureandeasywayofreferringtheirpatientstoaBMIhospital
usingeitherwebortelephone.
BMIHealthcare’snationalGPHotlinestreamlinesthereferralprocess,providing
significantbenefitsforbothpatientsandGPs.
Whereasthetraditionalreferralprocesscantakeuptoaweektosecurean
appointment,BMIhasreducedthistimetotwohoursviathenewservice.
Bearinginmindtheoverflowingin-traysinmedicalpracticesacrossthecountry,
thisreductioninpracticeadministrationtimehasbeenwelcomedbyGPs.
Followingaconsultation,aGPcanphoneBMI’sNationalEnquiryCentreand
dictateareferrallettertoaprofessionallytrainedadvisor,whowillthenmakea
courtesycalltothepatient.
Thefasttrackingsystemprovidespeaceofmindforpatients,whocanrelax
knowingthattheirdiagnosisisunderwayandaconsultationisbeingarranged.
ThemedicalknowledgeofBMIadvisors,coupledwiththeirpracticeexperience,
allowsthemtounderstandthepressuresfacingGPsandhasresultedinafast
andefficientservice,whichmeetstheneedsofGPsandtheirpracticestaff.
The Primary Care TeamAPrimaryCareTeamhasbeenestablishedwithin
BMIHealthcaretobuildstrongrelationshipswith
GPswhoplaythepivotalroleinreferringpatients
toBMIconsultants.The10,500GPpracticesinthe
UKaresegmentedandtargetedbytheteamwitha
viewtodevelopingongoingactivitytostrengthen
thereferralpathwaytoBMIhospitals.
Thekeyfocusistopromoteourhospitalservices
andrelevantconsultants,theteamengageswithGPs
andpracticemanagerstoactivelyreferpatientsto
BMIhospitals.ChooseandBookisanotherareathat
isdiscussedandGPsareveryoftenkeentoselect
usasaprivateproviderofNHSservices,duetoour
lowinfectionratesandthefactthatpatientscareis
ledanddeliveredbytheconsultants.
AlargepartoftheworkofthePrimaryCareTeam
isgettingconsultantstoengageandnetworkwith
localGPs,asthiswillsupportandgeneratefurther
referrals.Aprogrammeofeducationaltalksis
conducted,withbothin-surgerymeetingsandlarger
seminarsbeingheld.Otherhealthcareprofessionals
arealsovisited,suchasphysiotherapists,
optometristsanddentists,andwehavedeveloped
someexcellentreferralpathwaysintoourhospitals
fromthesealliedgroups.
Withastrongstrategicfocusinthecomingyear,
targetedsellingofourcoremessagesandfurther
enhancementstotheGPandconsultantinterface
weareveryconfidentthatthePrimaryCareTeam
willbeaninstrumentalpartofthesuccessof
BMIHealthcarein2009/10.
Dr John Tobias, Elmwood Medical Centre
”“ I have been using the GP Hotline for the last three months or so. It has
enabled me to arrange an appointment for my patients with a consultant of my choice within minutes of seeing the patient, in an extremely efficient way. I know that one telephone call will generate the appointment, the referral letter and the patient contact/notification. It’s a ‘one-stop shop’ solution for me.
Annual Report 2008/0912
Theinsuredmarkethasproventoberobustinaverychallengingeconomicclimate.BMIcontinuedtogrowitsinsuredrevenueinthe
financialyeartoSeptember30thandalsogrewitsmarketshare.
BMIprovideshealthcareforpolicy-holdersofeveryinsurerinthemarket:companiessuchasAIG,Aviva,AxaPPP,Bupa,Cigna,CS
Healthcare,PruHealth,SimplyHealth,StandardLifeandWPA,amongothers,coverover70%ofourbusiness.Ourdeservedreputationfor
qualityhealthcareandoutcomesmeansthatBMIisthepremiumhospitalproviderofchoicefortheinsurancemarket.
BMIalreadyprovidesmoreservicestoPMIcompaniesthananyotherhospitalgroupandin2008/9hasmadestrongprogressindeveloping
relationshipswithanumberofthekeygroups.Tobuildonthispositionwearefocussingonensuringthatourproductofferprecisely
matchestheirrequirementsandrepresentsthehighestqualityoutcomes.Wehaveworkedcloselywithinsurerstoassistthembymanaging
theirclaimsrisk,providingqualityperformancemeasuresandimprovingthepatientjourney.
Comprehensive coverage:
Private Medical Insurer relationships
General Healthcare Group 13
BMI’sgrowingnetworkofhospitalsandclinicsisalsoparticularly
attractivetoInsurersbyenablingthemtooffermembersa
consistentlyhighqualityserviceonanationalbasis.Our
acquisitionstrategyisinpartdrivenbyadesiretocloseany
remaininggapsinournationalcoverage.Thisisparticularly
apparentinLondon,wherewehavegrownourinfrastructureto
include14hospitalsandclinicswithintheM25.
BMIHealthcareisincreasinglyknownfornotonlyourtraditional
secondarycaremarket,butthecompleteend-to-endclinical
service,fromfirst-linediagnosticsandearlyinterventionthroughto
surgicaloutcome.
Ourextensivenationalfootprintandstrongclinicalfocushas
alsoallowedustoenternewcorporatemarkets.Forexample,the
expansionofourIntelligentHealthproductrangeallowsusto
supportemployers,eitherdirectlyorviatheirinsurerorbroker,
byofferingprimarycare,healthassessments,physiotherapy
andemployeehealthriskmanagementcapabilities,aswellas
clinically-evidencebasedwhiplashrehabilitationpathwaysforthe
medico-legalmarket.
IncreasinglyinsurersarealsolookingtoBMItoprovidenational,
tailorednetworksfortheircustomers,wherebecauseofourreach
andflexibleproductoffer,largebusinessescanrelyonusforatotal
healthcaresolution.
Case study
Working with Honda’s HR team and the group’s Insurer,
BMIHealthcarehascreatedabespokesolutiontomeetallits
corporatehealthcarerequirementsincluding:
nFullservicecapabilitycentredaroundthehighqualityfacilities
oftheBMIRidgewayhospital
nSimplifiedbookingforHealthScreening
nRapidaccesstodiagnosticandoutpatientconsultations
nExcellentemployeetreatmentandminimaldisruptionto
employeeandemployeralike
nCorporateratesreflectiveoftheBMI-centricnatureof
relationship
Honda recognises that private healthcare is a valuable benefit for employees, whatever the economic climate.
Ourinvestmentinfacilitiesandequipmentishighlyinfluencedby
theneedsofourInsurancepartnersandtheirclients.Allparties
willshareinthebenefitstopatientcareandcasemanagement
fromover£25mofnewimagingandsurgicalequipmentandmore
than£8minsystemsandprocessdevelopment,during2008/9
alone.
“ “
Bishops WoodHospital
The Garden Hospital
The Clementine ChurchillHospital
The King’s Oak Hospital
The Cavell Hospital
The Blackheath Hospital
The London Independent Hospital
MaryleboneConsulting
Rooms
Fitzroy SquareHospital
City Medical
Princess MargaretHospital
The RunnymedeHospital
The KingstonHospital
Shirley OaksHospital
The SloaneHospital
Chelsfield ParkHospital
Fawkham Manor Hospital
General Healthcare Group 15
BMIHealthcareisproudtobeabletoclaimitis‘TheConsultants’Choice,’
withmoreconsultantschoosingtoworkinourhospitalsthananyother
independentprovider.Consultantsconsistentlyrateusbetterthanthe
competitioninkeycategoriessuchasthequalityoffacilitiesandnursing
staff.*
Aspartofourcommitmenttoprovidingexcellentequipmentandfacilities
weregularlyconsultwithourdoctorstoensureweareinvestinginthe
supportservicestheyneed.
Anexampleofoursupportandinvestmentisintherecentopeningofthe
firsthi-techoperatingtheatreofitskindinstalledatBMIMountAlvernia
Hospital.
TheStrykeri-suitetheatreopensasthesecondstageofa£6mdevelopment
atMountAlvernia,andfeatureswidescreenhigh-definition(HD)monitors,
HDimagingcapabilitiesandisthefirstinEuropetouse“shadowless”
lamps.
TheHDmonitorsintheoperatingtheatreenablesurgeonstoseefromevery
anglewhenoperatingandthehigh-techinstallationallowssurgeonsto
performnewer,morecomplexsurgerykeepingupwiththelatesttreatments.
Thetheatreisfuture-proof,allowingforupgradestokeepupwiththevery
latestadvancesinsurgeryandMrIainJourdan,ConsultantSurgeonatBMI
MountAlvernia,saidofthei-suite:“Iamveryimpressedwiththisnew,state-
of-the-arttheatre.Everythingisintegratedand,veryimportantly,mobile,
whichallowssurgeonstoperformmoreefficientlyandtothehighestlevel.”
ElieenScrase,ExecutiveDirectorofthehospital,commented:“Weare
pleasedtobeleadingthewayinsurgeryandtechnologyinSurrey.”
“Ournewergonomictheatrewillallowsurgeonstoperformmorecomplex
surgeries,whichmeanspatientswillbeofferedthelatesttreatments
availableandthehigheststandardofhealthcare.”
* Source ORC research June 2007
I have treated private patients at BMI The London Independent Hospital for 10 years and can wholeheartedly recommend it. The cardiac catheterisation suite is a state-of-the-art facility with expert, helpful and friendly staff. Their positive and flexible attitude helps me and, more importantly, provides an excellent environment for my patients.
Dr Charles KnightConsultantCardiologist
“
”As part of our commitment to providing excellent equipment and facilities we regularly consult with our doctors to ensure we are investing in the support services they need.
“”
General Healthcare Group 17
After64-year-oldadvisoryteacherGeoffMartelofGuernseywas
diagnosedwithlocalisedprostatecancerinthesummerof2008,he
knewhewantedtofindtheprocedureandsurgeonthatwouldprovide
himwiththebestpossibleoutcome,sohetravelled150milestobe
treatedbyMrChrisEden,ConsultantUrologistatBMITheHampshire
ClinicinBasingstoke.Today,Geoff’scancerisinremission,andheis
praisingMrEdenandthehospitalfortheexcellenttreatmenthereceived
torestorehishealth.
Geoff ’s story: “My GP was astounded by my recovery”Duringaroutinecheckupin2008Geoffreceivedablood
test,whichrevealedahighProstateSpecificAntigen(PSA)
reading,anearlyindicatorofprostateproblems.Geoff
thenunderwentaseriesoffollow-upbloodtestsand
examinations,whichconfirmedapositivecancerdiagnosis.
Geoffknewhehadtomakesomeseriousdecisionsabout
histreatment.Hewaspleasedtofindhewouldbealikely
candidateforlaparoscopicradicalprostatectomy(LRP),the
minimallyinvasiveproceduretoremovetheprostategland.
Geoffhadreadthat,comparedtotraditionalopensurgery,
LRPofferedgreaterpatientcomfort,shorterrecoverytimes
andreducedbleeding.
Geoff’sdaughter,aphysiotherapist,recommendedhelook
intoseeingMrChrisEden,whohadsuccessfullytreated
someofherclients.Afterspeakingwithanotherpatientwho
wasfullofpraisefortheurologist,Geoffwascertainthat
MrEdenwasthesurgeonhewanted.
Geofffeltitwouldbewellworthpayingtobetreated
privatelyandhewenttoseeMrEdenatTheHampshire
ClinicinMay2009.Geofffeltimmediatelyreassuredbyhis
knowledgeandlongexperienceinperformingLRPsandtwo
weekslaterGeoffreturnedtothehospitalforhisprocedure
andwasextremelypleasedwiththecarehereceived.
“EverythingwentjustasMrEdensaiditwouldandevenat
theprecisetimes,”saidGeoff.“ThestaffatTheHampshire
Clinicwerealsoexcellent.Nothingwastoomuchtrouble
andtheirattentiontodetailwasamazing.Theyexplained
everythingthatwentonbeforeandaftertheprocedure–I
couldn’tfaultathing.”
Geoffwasalsosurprisedathowquicklyhestartedfeeling
betterfollowinghisprocedure:
“Thescarshadhealedwithintwoweeksand,now,you
wouldhardlynoticeathing.Iwasupandwalkingaround
within24hours.Iactuallyfeltmorediscomfortandpain
duringandaftermybiopsythanIdidaftertheoperation.I
wasabletodomostthings,includingwalkingmostmornings
andevenings.”
Geoffreturnedtoworkonlytwoweeksandtwodaysafter
surgery.“Mydoctorwasastoundedbymyrecoveryandwas
delightedwhenhesawmelookingsofitandraringtoget
backtowork!”
Today,Geoff’scancerappearstohavebeencuredwithonly
a1%chanceofitreturninginthefuture.“Ifeelrelieved,and
verypleasedtohavebeenseenbyMrEden.”
“
Mr Chris Eden, Consultant Urologist BMI The Hampshire Clinic
The staff at The Hampshire Clinic were also excellent. Nothing was too much trouble and their attention to detail was amazing. They explained everything that went on before and after the procedure – I couldn’t fault a thing.
“
Annual Report 2008/0918
AstheUK’slargestsupplierofacutesurgicalservices,BMIHealthcare
hasbeenattheforefrontofthedrivetoimproveclinicalandnon-
clinicalstandardsacrosstheindependentacuteprovidersector.Ithas
calledforandcontributedtoregulationinapositiveway,improved
itsreportingprotocolsandwelcomestheopportunitytodemonstrate
itscommitmenttohighqualitypatientcareandcontinuous
improvements.
Quality accounts
“ ”Our patients have a justifiable expectation of the highest quality, safe and effective service.
General Healthcare Group 19
Duetothenatureofhealthcare,complicationsareunavoidablein
somecasesbutwestrivetoensurethatwehavereducedthistothe
minimum.
Thefollowinggraphfortherateofunplannedre-admissionand
unplannedreturnstooperatingtheatredemonstrateanongoing
yearonyearreductioninanyadverseincidents/complications.
Overallthesereadmissionandreturntotheatreratesarearound
halfthelevelsexperiencedintheprivatesectorasawhole*
Patient SatisfactionEmphasisonclinicalexcellence,patientcareandoverallqualityhasledtoBMIrecordingmarketleadingcustomersatisfactionscoresinindependentsurveysruninallofourhospitals.SimilarsurveysarealsorunintheNHSandtheresults
BMIreceivedsatisfactionsurveysbackfrom43,584inpatientandday-casepatientsinthelast12months.Thiscomparesto72,000acrossthewholeoftheNHSreceivedbyNHS.
Satisfactionwithoverallquality–NHS75.6% BMI98.4%
Ouroverallratingofourcareandourintentiontorecommendscoreshavebothimprovedyearonyearinsertnumbersandsource.
Notonlydowemonitorqualityforthepurposeofongoinganalysis
andimprovement,buttheresultsarealsousedtomonitortheeffect
thatanychangesinserviceorcorporatecostefficiencydrives,which
areasdemonstratedbelow.
Newinitiativeshavebeenundertakeninnursing,wherea
recruitmentdrivehasledtoincreasingthenumberofemployed
nursesandswitchingawayfromAgencynursesaswellasthe
introductionofsmarterworkingpractices.Thishasledtoimproving
patientsatisfactionscoresoverthelast9monthsof2008/09.
Duringthesameperiod,wehaveachieveda5%pointincreasein
satisfactionwithourcatering,wherenewmenusandpresentation
havebeenintroducedandhavebeensupportedbystaffawareness
andtraininginitiatives.
“”
BMIhasbuiltupacomprehensivemulti-disciplinaryclinical
governanceframeworkencompassinglocalhospitalandcorporate
levelsinorderto:-
nEnsurethesettingofstandardsinlinewithregulationandthe
latestevidencebasedprotocols.
nSupportimplementationwithskilledstaffwhoundertake
ongoingprofessionaldevelopmentandinvestmentinequipment
andenvironmenttokeepupwithfastmovingtechnological
developmentsinhealthcare.
nMonitorallaspectsofservicedeliverybycollectionofpatient
feedback,clinicaloutcomeandadverseincidentdata
nAnalyseandreviewthedatatofacilitatetheplanningand
implementationofappropriateactionsforimprovementandthe
minimisationofanyrisksidentified.
Over three quarters of patients rate their consultants and over two thirds rated their nursing and overall care as excellent.
Complications
0.500
0.450
0.400
0.350
0.300
0.250
0.200
0.150
0.100
0.050
0.000
0.443
0.402
0.266
0.1810.1870.201
0.011 0.009 0.007
2006/2007 2007/2008 2008/2009
BMI Healthcare complications per 100 patients
Re-admissionwithin31days
Unplannedreturntotheatre
DVT
October2008-September2009Source: Howard Warwick patient satisfaction survey
Excellent
Verygood
Good
Fair
Poor
Patient satisfaction overall rating scores100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Consultant
Nursingcare
Accom
modation
Catering
Qualityofcare
Valuefo
rmoney
Annual Report 2008/0920
infection prevention & control
Environmental cleanliness is an important factor in infection prevention and our patients rate the cleanliness of our facilities highly.Prof. Duncan Empey GroupMedicalDirector
“ Cleanliness
”
Clean as a whistle:
General Healthcare Group 21
Hospital acquired infectionInfectionpreventionremainsakeyconcernforpatients.An
opinionpollcarriedoutinAugust2009forBMIHealthcareshows
thatcleanlinessandhygienearethebiggestconcernsforthepublic
inreceivingtreatmentinNHShospitals.Fearsoverriskofhospital
acquiredinfectionandsuperbugssuchasC.DifficileandMRSA,as
wellasgeneralhospitalcleanlinessnowtopthelistofconcernsfor
prospectivepatients(29%),followedbystandardsoftreatmentand
care(26%)andthenwaitinglists(20%).
TheCOMRESpollwasconductedusinganentirelyopenquestion
andthepublicwereaskedtonametheirbiggestconcernsabout
beingtreatedinanNHShospital.
EffectivenessBMIHealthcare,incommonwithotherprovidersofacute
healthcareintheindependentsector,notonlyfocusesonthe
immediacyofservicedeliverybutalsoonitscontributionto
thegrowthanddevelopmentofahighqualityhealthsystem
intheUK.Throughacommitmenttoaprogrammeofclinical
governance,BMIHealthcareremainsaccountabletopatients,
theirdoctors,otherhealthcareagenciesanditselfforthescope
andstandardofthecareitdelivers.
EveryBMIhospital/facilityhasalocalframeworkthroughwhich
clinicaleffectiveness,clinicalincidentsandclinicalqualityare
monitoredandanalysed.Whereappropriate,actionistakento
improvecontinuouslythequalityofcare.Thisisthroughthework
ofamultidisciplinarygroupandtheMedicalAdvisoryCommittee
ineachhospital.Atcorporateleveltheclinicalgovernanceboard
hasanoverviewandensuresthatthereiscorporatelearningand
qualityimprovement.
GeneralHealthcareGroupinitiatedaclinicalindicatorproject
in2007.Thisisnowajointdevelopmentinconjunctionwithall
otherindependentsectorproviders,theDepartmentofHealth,the
CareQualityCommissionandtheNHSInformationCentre.
Range of infections in NHS vs. BMI Healthcare*
Clostridiumdifficilecasesper1,000beddays
MRSAbacteraemias(bloodinfection)casesper10,000beddays
* BMI - Reported via corporate surveillance reporting mechanism (Oct 2008 to Sept 2009)
NHS - Health Protection Agency (May 2008 to April 2009)
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
Clostridium difficile per1,000beddays
MRSA bacteraemiasper10,000beddays
NHS 0.79cases
BMI 0cases
NHS 0.52cases
BMI 0.09cases
Low High Low High
Annual Report 2008/0922
Magnet for the best: our people
9,200 dedicatedpermanenthealthcareandsupportstafflookingafterpatients
acrossthecountry
Quality of care and attention to patients is a key differentiator between us, the NHS, and our competitors.
“ “
Care
General Healthcare Group 23
Everymonthnearly14,000peopleare
engagedinemploymentwithGHG.
Thesearemainlylongtermpermanent
staffand‘bank’staffonpart-timeadhoc
hours,whomayhavealong-standing
relationshipwiththecompany.Justover
halfofouremployeeshaveaclinicalrole,
asnurses,pharmacists,physiotherapistsor
radiographers,andthemajorityoftheothers
areinrolesdirectlyassistingourpatients,
forexampleinreceptionorhousekeeping.
Ourstaffarethereforeatthecentreofthe
patientexperienceand,assuch,shapethe
waythecompanyisperceived.Theyprovide
thecare,commitment,professionalismand
servicethatunderpinourpositionasthe
leadingprivatehealthcareproviderinthe
UK.
AtGHG,wearecommittedtocreating
aworkingenvironmentthatattractsand
retainstalentedindividuals,engages
andmotivatesthemtodelivertheirbest,
providesrecognitionforcontribution,
providesexcellentandongoing
developmentopportunitiesandensuresthis
isachievedwithahealthyregardforwork-
lifebalanceandindividualwellbeing.
GHGiscommittedtopromotingequalityof
opportunityforallitsemployeesandaims
tocreateaculturewherestaffrespectand
valueeachother’sdifferences.Weseekto
removeanybarriers,biasordiscrimination
thatpreventindividualsfromrealising
theirpotentialandcontributingfullytothe
company’sperformance.
Ourcurrentmanagementtraining
programmesincludesessionsonfair
selectionandmanagingdiversity.Inthe
autumnof2009,wewillbelaunching
specifictrainingondiversityinconjunction
withenhancedtrackingofequal
opportunitydata.Wehavealwaysprovided
flexibleworkingarrangementstoenable
ustoappealtopeopleinaswidearange
ofpersonalcircumstancesaspossible,
andthisremainsakeystrengthwithinour
employmentproposition.
Oursuccessisinextricablylinkedwiththe
knowledgeandexpertiseofouremployees,
anddespitethecurrenteconomicpressures,
weincreasedourlevelofinvestmentin
traininganddevelopmentlastyear.
Wecreatedanddeliveredaground-
breakingprogrammeforourHealthCare
Assistants(HCAs),whichblendsclassroom
andpracticaltrainingforallnewand
recentrecruits.Thisprogrammeensures
thatourHCAsareequippedtoprovidea
consistentlyhighstandardofpatientcare,
whileenablingRegisteredNursestofocus
onclinicalsupport.
Inlatesummer2009,wecommenced
deliveryofaportfolioofnationalnursing
trainingprogrammes.Theseincludecross-
trainingintheatreskillstoprovidethe
opportunityforwardnursestodevelopin
thisarea,returntopracticeprogrammes,
andongoingprofessionaldevelopment
seminars.
During2008/09,wedeliveredover2,000
daysofmanagement,leadershipand
commercialdevelopmentprogrammesfor
middlemanagement.Theseprogrammes
aredesignedtosupportthesignificant
organisationalchangeunderwayand
tofacilitateasharedcultureacrossthe
UKbusiness.Thiscontinuesandwillbe
expandedfurthertoprovidearelated
programmeforsupervisors.
Atseniorlevels,wewillbelaunchinga
leadershipdevelopmentprogrammewithin
twoyearstosupportouraimoffilling
themajorityofseniorvacanciesthough
successionanddevelopment.
Wehavebeguntoimplementonline
mandatoryclinicaltraining,whichprovides
therequiredtheorycomponentthrough
aseriesofonlinemodules,togetherwith
classroom-basedpracticaltraining.This
givesemployeesflexibilityoverwhenthey
completetraining,andensuresconsistency
ofstandardsandautomatedmonitoringof
compliance.
Qualityofcareandattentiontopatients
isakeydifferentiatorbetweenus,the
NHS,andourcompetitors.Customercare
willthereforebeamajorareaoffocus
in2009/10.Intheautumnof2009we
willlaunchanintegratedprogrammeof
initiativeswhichbringstogethertrainingin
customercareskills,operatingstandards
andcarepathwaysforallhospital-based
staff.Thiswillbecomplementedbya
nationalawardprogrammeforteamsand
individualsthatrecognisesexceptional
deliveryofcustomerserviceorpatientcare.
“ Our staff are at the centre of the patient experience and, as such, shape the way the company is perceived.”
Annual Report 2008/0924
Corporate social responsibility
GeneralHealthcareiscommittedtocorporatesocialresponsibility
andthisiscarriedthroughinallouremploymentpolicies,
environmentalpoliciesandourinteractionswiththelocal
communitiesaroundourhospitals.
Health & SafetyHealthandsafetypoliciesareintegratedintoallGroupoperations
toensurethesafetyandwellbeingofouremployees,patientsand
theirvisitors.Healthandsafetycommitteesoperateinallbusiness
unitswiththefollowingtermsofreference:
nInstigate,developandimplementmeasuresdesignedtoensure
workplacehealthandsafety
nMonitorcompliancewithOccupationalHealthandSafety
legislation,regulationsandcodesofpractice
nFormulate,reviewanddisseminatepoliciesandprocedures
relatingtohealthandsafety,whicharetobecarriedoutor
compliedwithwithintheworkplace
nMonitorincidentstatisticsandspecificreportsasnecessary
nProvideriskassessmentsofmajorsafetyhazardsanddevelop
appropriatemitigationofexposuretorisks
nEnsurereadinessforfireandalliedperilexposures.
Sponsorship
Charities and fundraising TheGroupsupportedmanycharitableorganisationsthrough
sponsorshipandfundraisingefforts,includingwalks,marathons,
golftournaments,coffeemorningsandfancydressdays.Toensure
thatourhospitalsmaintainstrongtieswiththeirlocalcommunities,
manyofourcharityeventsarelocallyfocused,andweencourage
ourstafftobeactivelyinvolved.
Corporate sponsorshipAtacorporatelevel,ouroperatingcompany,BMIHealthcare,
supportedthefollowingorganisationsandcampaigns:
The Royal College of Surgeons (RCS)isEngland’sleadingsurgicaland
educationalorganisationandreceivesworldwiderecognition.
BMIHealthcarehasagreedtoprovidesponsorshipoverthreeyears
tosupporttraininganddevelopmentprogrammesofferedbythe
Collegetothenextgenerationofconsultantsurgeons.
Royal College of General Practitioners (RCGP)isanacademic
organisationforgeneralpractitionersintheUK.
In2008/09,BMIHealthcaresponsoredtheannualNationalPrimary
CareConference,anationalshowcaseforthecollege,general
practiceandprimarycareandworkedwiththeRCGPstodevelopa
seriesofeducationalseminarsdeliveredbyourconsultants.
Wellbeing of Women (WoW)raisesmoneytoinvestinmedical
researchandtosupportthedevelopmentofspecialistdoctorsand
nursesworkinginthefieldofreproductiveandgynaecological
health.WoWwasBMIHealthcare’sofficialcharitypartnerthisyear.
General Healthcare Group 25
Our UK business supported charitable organisations through sponsorship and fundraising efforts, including walks, marathons, golf tournaments, coffee mornings and fancy dress days.
“ Support
Other sponsorship and fundraising eventsInaddition,hospitalsprovidedongoing,
adhocsupporttoschools,children’shospices
andassociationsforthedisabled.
Thecharitiessupportedduringtheyearincluded:
n ActionMedicalResearch
n BritishArtsFoundation
n ChildreninNeed
n Delta,thenationalcharityfordeafchildren
n KentAirAmbulance
n LemonTreeFoundation,Africa
n NationalBlindChildren’sSociety
n NorthLondonHospice
n SaintLuke’sCheshireHospice
n SportRelief
n WarwickshireandNorthamptonshireAir
Ambulanceservice
n WhiteLodgeCentreinChertsey
Hospital initiativesBMIHealthcarehospitalssupporteventsonthenationalhealthcarecalendar
thatraiseawarenessofspecificillnessesorhealthconditionsandoftenprovide
earlydiagnosisscreeningopportunities.Theseincludedhypertension,hip
replacementtherapy,stress,allergies,prostatecancer,cervicalandbreast
cancers,coronaryarterycalcium,molesandotherskinblemishes.
Patient support groupsBMIHealthcarehospitalshostedandorganisedsupportgroupsforpatientswho
haveundergonecancertreatmentsaswellascosmeticandobesitysurgery.
UpFront,abreastcancersupportgroupbasedatBMITheChilternHospital,
wasestablishedinJanuary2005bytwospecialistbreastcarenursesandfive
womenwhohadbreastcancer.Currentlytherearewellover200membersfrom
thesurroundingareawhoattendgroupsupportsessions.
Aspecialeventwasheldthisyeartomarkthefirstanniversaryoftheweight
losssurgerypatientsupportgroupsatBMIChelsfieldParkHospitaland
BMITheAlexandraHospital.Thesewereamongthefirsthospitalstolaunch
patientsupportgroupsinconjunctionwiththeUK’sleadingpatientassociation
forweightloss,theBritishObesitySurgeryPatientAssociation(BOSPA).
“
Annual Report 2008/0926
Environmental initiatives
Environmental initiatives Duringthelastyear,GHGincreaseditsfocusonthedirectandindirectimpactour
businesshasontheenvironment.In2008/09,welaunchedagroup-wideinitiative
todeliverexcellenceacrossprocurementandsupplychainmanagement,facilities
management,propertydevelopment,cateringandhousekeeping.Centraltothis,
isourcarbonmanagementprogramme,EcoNomics,whichinvolveschanging
businesspracticesacrossourhospitalsandoffices,affectingallstaff,toreduceour
impactontheenvironment.
General Healthcare Group 27
Ourinitialfocushasbeenonenergyinitiatives,howeverthe
programmewillcover:
n Energy
n Waste
n Water
n PurchasingandLogistics
n AssetManagement&CapitalInvestment
TheCarbonTrust,commissionedlastyeartoreviewthecarbon
emissionsofourbusiness,estimatedourtotalcarbonfootprintat
42,419tonnes.Thiswasprimarilycomposedofenergyusedinour
hospitals.Thisworkhasprovidedaclearfocusintheshorttermto
reduceourenergyconsumptionthroughTheBigTurnOffinitiative,
whichhasbeenthemainfocusofactivitythisyear.Inthemeantime,
furtherplanningandresearchcontinuestoshapeabroaderstrategy
for2009/10andbeyond.
Corporate Asset Management and Capital Investment Strategy
GHGownsandoperatesmorethan67privatehospitalsand
treatmentcentres,aswellasancillaryofficesandbuildings.
Maintenancestandardsofthesepropertiesarebeing
improvedtoincorporatecarbonmanagement,inparticular
withregardtoenergyandwater.Wearedevelopinglong-
termplanstoreviewthewayinwhichheatingandcooling
systemsareoperated,aspartofastrategytoreplacethem
progressivelywithmoreenergyefficientsystemsand
renewableenergysources.
Ouroverridingaimistoincorporatecarbonreduction
measuresintoourcorporateassetmanagementandcapital
strategy,withthefollowingkeyobjectives:
n Buildcarbonassessmentintolifecyclecostsfor
replacementoradditionalcapitalplantorequipment
n Ensurebuildingsoperatetominimumcarbonefficiency
standards
n Developcapitalreplacementprogrammetosupportthe
objectivesofthecarbonmanagementprogramme
n Providesufficientfundingforspecificinvestments
intechnologyinsupportofthecarbonmanagement
programmeunderthecontroloftheGreenPolicyProject
Manager
n Ensureourbuildingsmeetcurrentenvironmental
legislativerequirements
n Ensurenewbuildingsandrefurbishmentsarecarriedout
toBREEAM‘excellent’criteriatominimisetheircarbon
impact.*
*BREEAM(BREEnvironmentalAssessmentMethod)istheleadingandmost
widelyusedenvironmentalassessmentmethodforbuildings.Itsetsthe
standardforbestpracticeinsustainabledesignandhasbecomethedefacto
measureusedtodescribeabuilding’senvironmentalperformance.
Our overriding aim is to incorporate carbon reduction measures into our corporate asset management and capital strategy.
“ “
CarbonThe‘BigTurnOff’hascreatedinitialfocusandactionacrosstheestate.
Inorder,however,toreduceourimpactontheenvironmentsignificantly,
andmeetourtargetsandfuturelegislation,ourfocusin2009/10willbe
ondeliveringthewiderstrategy.Changingstaffbehaviourwillcontinue
tobefundamentaltoourcarbonmanagementsuccess.
Annual Report 2008/0928
Corporate governance
Corporate governance philosophy TheGroupacknowledgesthat,inreturnforitslicencetooperate,itis
subjecttotherulesandconstraintsofsocietyandstakeholderimperatives.
Incombiningthetwinrequirementsofconformanceandperformance,
theGroupstrivestomaintainthehigheststandardsofdiscipline,integrity
andtransparencyinsupportinganappropriatelegal,regulatoryand
institutionalfoundation.
General Healthcare Group 29
Overall StructureThecorporategovernanceoftheGroupisledbytheBoardof
GeneralHealthcareGroup.
Thisgovernanceencompassesboththebusinessaspectsandthe
serviceandsafetyaspectsoftheGroup’sactivities,andcommittees
oftheBoardhavebeenestablishedtodealwiththespecific
componentsofthis.
TheBoardcomprisesexecutiveandnon-executiveDirectors.The
16non-executivesaregenerallyappointedbyanddrawnfromthe
Group’sinvestors,althoughthenon-executiveChairman,SirPeter
Gershon,isindependentoftheshareholders.
ThethreeexecutiveDirectorscomprisetheChiefExecutive,
theChiefFinancialOfficer,andtheGeneralCounsel.TheChief
Executiveisresponsiblefortheday-to-dayoperationsofthe
Groupanditsstrategicdevelopment.TheChiefFinancialOfficer
isresponsibleforthefinancialmanagementoftheGroupandthe
GeneralCounselisresponsibleforadvicetotheBoardandthe
executive,andfortheGroup’scompliancewithitsresponsibilities
andrelationswithexternalagencies.
TheconstitutionandfunctionoftheBoardCommitteesis
asfollows:
Audit CommitteeTheAuditCommitteeischairedbySirPeterGershon(Group
Chairman)andhasthreemembers,allnon-executivedirectors.
TheCommittee’sresponsibilitiesinclude:overallresponsibilityfor
internalandexternalauditoftheGroup’sfinancialactivitiesand
financialreporting,theappointmentandremunerationofexternal
auditors,thecompany’sinternalcontrols,andotherfinancialand
businessriskissues,includingcertaincompliancefunctions.
Executive CommitteeTheExecutiveCommitteeischairedbyAdrianFawcett(GroupChief
Executive)andcomprisestheGroup’sseniorexecutivefunctional
anddivisionalheads.ItsroleistoaddressallGroupoperational
mattersanditistheprincipleexecutivedecision-makingbody
withintheGroup.
Finance and Investment CommitteeTheFinanceandInvestmentCommitteeischairedby
VaughanFirman(ChiefFinancialOfficerofNetcareinSouth
Africa).Itsroleistoreviewpotentialcapitalinvestmentsandcapital
projects,andundertakefollow-onpostacquisitionreviews.
Remuneration CommitteeTheRemunerationCommitteeischairedbySirPeterGershon
(GroupChairman).TheCommitteereviewsandsetstheGroup’s
remunerationstrategyandsalaryandbenefitlevelsacrossthe
Group,toensurecompetitivenessofremuneration.Italsomonitors
themanagementequityarrangementsinplace.
Quality and Risk CommitteeTheQualityandRiskCommitteeischairedbySirPeterGershon
(GroupChairman)anditsroleistomonitorthesafety,effectiveness
andqualityoftheGroup’soperationalactivities.Italsomonitorsthe
Group’sregulatorycompliance,operationalconformitytointernal
policy,andthelevelofriskretainedbytheGroup.
GroupBoard
AuditCommittee
ExecutiveCommittee
Finance&InvestmentCommittee
Quality&RiskCommittee
RemunerationCommittee
Annual Report 2008/0930
ThegrowthinEBITDAhasfallendirectlytothebottomline,representedbya£16mincreaseinprofitbeforetax.Interest
andfinancechargeshaveremainedstableduetoswappingoutthevariableloaninterestrateforafixedinterestrate.The
marginalincreaseinfinancechargesisduetothefullyeareffectofthePropCodebtraisedontheprioryearacquisitionof
theex-Nuffieldhospitals.
TheGroupisdelightedtohaveproducedastrongfinancialperformanceinaclimateofeconomicuncertaintyasaresult
oftheglobaleconomicdownturn.TheGroup’sfocusfor2010andbeyondremainsoninvestmentinitsassetbaseand
serviceprovision,andonmaintainingandfurtherimprovingitsfirst-classfacilities.Thisinvestment,coupledwiththe
highestlevelsofclinicalstandards,willensurethatGeneralHealthcareGroupbuildsonitspositionasthemarket’s
leadingprivatehealthcaregroup.
Group profit and loss
2009£’m
2008£’m %
Revenue 832 773 7.6%
Group EBITDA 221 204 8.3%
Non-recurringitems (7) (6) 16.7%
Depreciation (65) (67) 3.0%
Profitonsaleofassets - 2
Interestandotherfinancecharges (132) (129) (2.3%)
Swapcosts 2 (1)
Profit before tax 19 3 533.3%
Tax (3) 8
Profit after tax 16 11 45.5%
General Healthcare Group 31
Group cash flow
TheGroupgenerated£130millionofoperatingcashflow.Thiswasnegativelyaffectedbytheworkingcapitaloutflow
experiencedduringtheyear.Thisisprimarilyduetothechangeincasemixfromselfpay(paymentupfront)toNHS
(prolongedpaymentdays).Workingcapitalwasalsoadverselyaffectedduringtheyearbythecatch-upinpayments
tocreditors,whichbuiltupduringtheintroductionoftheSharedServiceCentrein2008.Thisisnotexpectedtorecur
goingforward.
BorrowingsAttheendofSeptember2009,grossbankdebtwas£1,925.1m,withunamortisedfinancecostsof£26.7mandcashof
£40.6m–givinganetdebtpositionof£1,857.8m.Nonewdebtfacilitieswereenteredintoduring2009.
TheGrouphasundrawnloanfacilitiesof£72.7m,ofwhich£3.7misheldundrawnasguaranteesandlettersofcredit,
leavingfacilitiesof£69.0mavailabletofinanceworkingcapitalandforgeneralcorporatepurposes.
ThebankloanfacilitiesrequiretheGrouptocomplywithcertainfinancialcovenants.Thedirectors’forecastsshowthat
theGroupwillbeabletooperatewithinthelevelofitscurrentfacilitiesandwillcomplywithitsfinancialcovenants
throughouttheforecastperiod.
2009£’m
2008£’m %
EBITDA (after non-recurring items) 214 198 8.1%
Capitalexpenditure (45) (48) 6.3%
Changesinworkingcapital (39) (17) (129.4%)
Operating cash flow 130 133 (2.3%)
Nuffieldacquisition(net) (118)
Netinterestpaid (125) (124) (0.8%)
Taxpaid (3) (2) (50.0%)
Movement in net debt 2 (111)
Debtraised - 120
Debtrepaid (20) (28) 28.6%
Movement in cash (18) (19) 5.3%
Cashatbeginningoftheyear 59 78
Cash at end of the year 41 59
Annual Report 2008/0932
General Healthcare Group executive committee
Top row (L to R): PhilWieland,StephenCollier,GuyBlomfield
Middle row (L to R): JohnvonKlemperer,CatherineWard,AdrianFawcett,ProfessorDuncanEmpey
Bottom row (L to R): PhilPegler,BelindaMoore
General Healthcare Group 33
Adrian FawcettChiefExecutiveOfficer
AdrianFawcettisChiefExecutiveOfficerofGeneralHealthcareGroup.
HealsositsontheBoardoftheDepartmentofWork&Pensions.Previously,AdrianwastheChiefOperatingOfficerforPunchTavernsplc.HejoinedPunchfromInterbrewwherehewasCorporateVicePresidentoftheBelgianbrewer.
Phil WielandChiefFinancialOfficer
PhilWielandjoinedtheGeneralHealthcareGroupasGroupFinancialControllerinApril2006andwassubsequentlypromotedtoChiefFinancialOfficerinJanuary2007.
HehadpreviouslybeenemployedbyBSkyB,holdingnumerousseniorfinancepositionsincludingSupplyChainFinanceDirectorandGroupFinancialController.PhilqualifiedasaCharteredAccountantwithPwCin1998andholdsanhonoursdegreefromLeedsUniversity.
Stephen CollierGeneralCounsel
StephenCollierisabarristeremployedinthefieldofhealthcareandhasworkedwithGHGsincethe1980’s,havingpreviouslybeeninpracticeattheBar.
StephenhasagraduatedegreeinlawfromUniversityCollegeLondon,andaMastersgainedattheLSE.
Professor Duncan Empey FRCP,GroupMedicalDirector
DuncanEmpeyisaFellowoftheRoyalCollegeofPhysiciansandjoinedGeneralHealthcareGroupasGroupMedicalDirectorin2008.Priortothat,hewasMedicalDirectoratCapioHealthcarefrom2005to2007.
DuncanisHonoraryConsultantPhysiciantoBartsandTheLondonNHSTrust.He
hasheldthepostofHonoraryConsultantPhysiciantoKingEdwardVII’sHospital,SisterAgnes,inLondonsince1995.HeisalsoFoundationProfessorandDeanoftheBedfordshireandHertfordshirePostgraduateMedicalSchool.
Guy BlomfieldGroupStrategy&CommercialDirector
GuyBlomfieldjoinedGHGinOctober2007,comingfromOasisHealthcareplc.
BeforejoiningOasis,Guyheldanumberofmanagementconsultancyroles,ultimatelyasownerandManagingDirectorofImcisLtd,aspecialiststrategyconsultancywithexpertiseinpubs,franchiseoperations,apparelandfoodretailing,withMarksandSpencerplcasakeyclient.HehasanHonoursdegreeinAccountingandFinanceandanMScinCorporateFinance.
Catherine WardGroupHumanResourcesDirector
CatherineWardhasextensiveexperiencewithinHRmanagementandconsultancy.PreviousHRDirectorpositionsincluderolesatBAA,whereshewasHRDirectorforHeathrowAirport,andtheBBC,whereshemanagedmajorrestructuringinitiatives.
AsaconsultantshehasworkedforKPMGandforSHLasConsultancyDirector.
CatherinehasaBScinBiologyandanMScinOrganisationBehaviour,bothfromtheUniversityofLondon,andqualifiedasaCIPD.
Belinda MooreGroupMarketingDirector
BelindaMoorejoinedGHGinMay2007fromBritvicplcwhereshewasHeadofMarketingandOperationsfortheInternationaldivision.
BeforejoiningBritvic,BelindaheldaseriesofseniormarketingrolesinanumberofleadingFMCGandbluechip
organisationsincludingWhitbreadplc,ThomsonTravelGroup,GilletteCompanyandInternationalDistillers&Vintners.
ShealsospentsixyearsinpharmaceuticalsalesandmarketingfortheWellcomeFoundation.BelindahasanHonoursDegreeinRussianandSovietPolitics.
Phil PeglerManagingDirectorHospitalDevelopment
PhilPeglerjoinedGeneralHealthcareGroupinOctober2007.Inhiscurrentrole,ManagingDirector-HospitalDevelopment,heisresponsibleforcommercialdeliveryofnewinitiativesacrossthegroup.
PhilhadpreviouslybeenemployedbyPunchTavernsPlc,holdingnumeroussenioroperationalroles.
PhilholdsanhonoursdegreeinBusinessStudiesfromManchesterandanMBAfromBirmingham.
John von KlempererManagingDirectorHospitalOperations
JohnvonKlempererjoinedGeneralHealthcareGroupinSeptember2006asRegionalDirectorandwaspromotedtoManagingDirector-SouthDivisioninOctober2008.InJuly2009hewasappointedtohiscurrentroleasManagingDirector-HospitalOperationsfortheBMIGroup.
PriortojoiningGHG,JohnservedinasimilarpositionforNetcareHospitalGroupinSouthAfricawherehewasemployedfor16years.
JohncompletedtheExecutiveDevelopmentProgrammeattheUniversityoftheWitwatersrand,Johannesburg,in1981.
General Healthcare Group executive committee
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