November 2017 Care UK s Health Care business Jim Easton - CEO
Care UK s Health Care business overview Largest independent provider of NHS services, delivering more than 18m patient interactions p.a. Geographical locations Service offering in 3 key business areas Primary care Provision of NHS primary care services including GP and walk-in services UK s largest provider of out-of-hours services and NHS 111, with c.24% and c.27% shares of these markets respectively Launching three innovative primary care initiatives leveraging existing infrastructure to enhance patient care and widen access to NHS services London Secondary care Operates 9 treatment centres with a focus on elective surgery, Clinical and Treatment Services (CATS) and fixed and mobile diagnostic units 80,000 procedures delivered for NHS patients in the past year Exceptional clinical outcomes: 2 treatment centres and 1 CATS rated Outstanding by the CQC and 100% success rate in treatment centre contract retention Offender health care Primary care Secondary care Offender health care Largest UK provider of offender health services, providing care in 43 prisons and 2 immigration removal centres (IRC), as well as providing support at a sexual assault referral centre Following the successful re-procurement of healthcare in prison contracts and new contract wins, Care UK continues to develop market leading position with pipeline of further opportunities 2
Highly optimised surgical centres enable the growing volumes of NHS elective work to be undertaken rapidly, at high quality and profitably within NHS tariff and now offer a self pay option at attractive prices to patients. Overview Care UK operates 9 treatment centres with a focus on providing elective, planned surgery Treatment centres have exceptional clinical outcomes Care UK has two treatment centres which have been awarded an outstanding rating by CQC Shepton treatment centre is the first independent sector surgical hospital to be awarded an outstanding rating by CQC on every element of inspection 88% of Care UK s locations received an Outstanding or Good rating by the CQC 2 Service offering Care UK treatment centres undertake a combination of inpatient and outpatient procedures Supports patient choice and provides essential capacity, at NHS tariff prices, to CCGs Patients are referred for treatment by their GP and then choose to come to Care UK treatment centres using the NHS e-referral Service (formerly Choose & Book) Treatment centres cover a variety of specialties, including orthopaedics, endoscopy, urology, gynaecology, ophthalmology, oral surgery and general surgery Most centres also offer diagnostic imaging, such as X-rays and MRI, CT and ultrasound scans Strategy Treatment centres have a strategically important role to play in enabling the NHS to manage waiting times for planned surgery efficiently and effectively Strategy has been to consolidate and secure the long term future of each treatment centre and ensure long term earnings by focusing on: Delivering consistently high quality elective procedures Pursuing opportunities where the resources required to deliver sustainable, high quality services are matched with the appropriate funding envelopes As waiting times in the NHS increase, opportunity to enter growing self-pay market Ability to charge higher price (and remain competitive against large private hospital operators ) whilst maintaining strong profit margin Patient satisfaction 1 Friends and Family Test based on would recommend scores for patients having day surgery 98.4% 98.4% 98.4% 95.0% 95.0% 95.0% Jun-15 Aug-15 Oct-15 Care UK average NHS average Care UK treatment centres (examples) Shepton Mallet Treatment Centre Emersons Green Treatment Centre 3
In a market in which the mainstream NHS is struggling, and will continue to struggle, to meet elective demand and the self pay market is growing, with insufficient competition on price point The NHS Market Both NHS list size and wait times growing NHS unable to respond in its core capacity because their beds are full for much of the year with emergency patients Recent budget commitment of additional resources to arrest decline have been matched by requirement in the NHS Planning Guidance to prevent further deterioration will require somewhere in the order of 300,000 more procedures than in 2017/18 Providers with protected elective capacity are likely to be in high demand We have both a direct to customer offering, and are developing innovative partnerships with NHS providers to provide a significant part of their elective workload Service offering 4
Similarly, the scale and optimisation of our integrated urgent care business is allowing us to provide innovative new services into the rapidly opening primary care market Integrated urgent care Self-care Operates four urgent care centres, 11 out-of-hours GP services, and a significant number of NHS 111 contracts through five clinical call centres serving c. 11 million people Handle c.27% of NHS 111 calls nationally and provides out-of-hours GP services to c.24 % of the population in England First NHS contract for fully integrated urgent care, covering a population of nearly 5 million across the West Midlands Services relieve pressures on acute hospitals and are increasingly integrated across unscheduled care systems First provider to meet the new standards for the procurement of more joined up out-of-hours and NHS 111 services Patient with a healthcare need Accident and Emergency Pharmacy visit 111 phone call Contacts GP Patient undergoes symptom check online or via telephone Out-of-hours clinic Consultation (phone or face-to-face) with Care UK nurse or GP in setting outside the GP surgery Care is prescribed, or patient is referred to other services Specialist appoinments 5
And that same scale infrastructure and expertise allows us to support and optimise a rapidly growing offender health business Healthcare expenditure on prisoners is about twice the per capita figure for the English population as a whole Independent sector provision of offender healthcare An excess driven by the high levels of physical and mental ill-health and drug abuse in the prison population Since April 2013, responsibility for commissioning all healthcare services for prisoners and people in secure institutions in England has been transferred from CCGs to NHS England 10 Health and Justice host area teams within NHS England now commission these services on behalf of the 27 area teams across England At the time that PCTs (forerunners to CCGs) took over the commissioning role, the great bulk of prison healthcare was provided in-house by staff employed directly by HM Prison Service Between 2006 and their abolition in April 2013, PCTs outsourced a substantial proportion of prison healthcare services to independent sector healthcare providers Independent sector healthcare providers now supply more than half the total Care UK is the market leader with 37% of services registered with CQC in England 43% 10% Care UK Mitie Care & Custody Not-for-profit Care UK 3% 2% G4S 5% Virgin Care NHS 37% The independent sector currently operates c.60% of the offender healthcare market 6
And that same scale infrastructure and expertise allows us to support and optimise a rapidly growing offender health business Overview Care UK is the largest provider of healthcare services to prisons and other parts of the justice system Care UK s services encompass Young Offenders Institutions and immigration centres as well as all categories of adult prisons Care UK s ability to configure primary care, substance misuse and mental health services in an effective, recovery centred model has underpinned rapid growth within this service Care UK s win rate in contracts for Offender Health services since 2015 is 80% Prison health care Care UK operates 43 prison services offering all of the health services any community needs in one place and with a single team. Services include: Reception health checks, GP and dentistry services Help with substance misuse, chronic or long-term conditions, podiatry, physiotherapy and optometry Benefits of the prison health care services include: Compliance: services comply with all relevant Department of Health and HMPPS 1 policies Service user involvement: care planning model involves the service user in their recovery Access: services meet the operational and regime hours of the prisons Immigration Removal Centres (IRCs) Care UK provides health services to 2 IRCs (The Verne, Dorset, and Campsfield House, Oxfordshire) IRCs are primarily used to hold individuals suspected of visa violations, illegal entry or unauthorised arrival, and those subject to deportation and removal in detention until a decision is made by immigration authorities Sexual assault referral centres Care UK operates the Solace sexual assault referral centre Victims of rape or sexual assault are supported in the immediate aftermath of an attack, and throughout their journey of recovery Nationwide presence 7