BRINGING THE BEST OF THE NHS TO INDIA

January 2018 BRINGING THE BEST OF THE NHS TO INDIA Available, Affordable, Accountable Healthcare for All IN THIS ISSUE... IUIH s far reaching programme Laying the first Foundation Stones Events in quarter 1 2018

Contents INDEX PAGE 1. Front Cover 1 2. India today and the next 10 years 3 3. IUIH Programme Background 5 4. IUIH Programme 6 5. IUIH Medicity 7 6. IUIH Foundation Stone Nagpur 9 7. IUIH Foundation Stone in Amaravati 11 8. IUIH Medicity Design Nagpur 13 9. IUIH Boards (UGH + IUHP) 15 10. IUIH Construction start at Nagpur 17 11. IUIH Hyderabad 19 12. Key IUIH Events in Quarter 1 2018 20 2

India today and the next 10 years India is Unrecognisable Today - India 2007-2017 The change in India over the last decade, particularly over the last three years under Mr Modi, has been dramatic. There are impressive macro numbers. The GDP has almost doubled from $1.2 trillion to $2.5 trillion since 2007. The GDP per capita has increased by around 60%. And FDI into India in 2017 is double what it was 10 years ago. Taken together with the Goods and Services Tax, which brings all business-to-business transactions online, the growth in mobile usage, digital ID records, and wider financial inclusion have changed the way people, businesses and government in India function. These transformations lay the foundation for a compelling, digitally-led India of the future. In 2007, there were 10 million mobile phone users in India. Today there are one billion, and rising. In 2007, no Indian had an ID card. Today, almost 1.2 billion Indians have a digitally-driven biometric ID card. 1.2 billion and, as the young population continues to grow, still rising. This project Aadhar was only initiated in 2009. In 2007, few people outside of India s cities had bank accounts, but due to the Jan Dhan scheme launched in only 2014, an additional 300 million Indians now have a bank account. Today there are 1 billion phone users 1.2 billion ID card holders and 300 million Indians with a bank account Reference: Things you might not know about emerging India Kevin McCole, COO, UK India Business Council 3

India today and the next 10 years cont... The Next 10 years - New India 2017-2027 Anniversaries are also a time to look ahead, so where will India be 10 years from now? According to Morgan Stanley, India will have a $6 trillion dollar economy within 10 years making it the third largest, in the world. The same report also predicts that India s consumer sectors will grow from $500 million today to $2 trillion within the decade. Much of this growth will be digitally-driven via the trio of transformations earlier enhanced financial inclusion, smart phone penetration, and the Aadhar scheme. Internet penetration in India will double in the next 10 years, meaning over 900 million Indians will be online by 2027. Most of them will be online and on the move of the billion mobile subscriptions in use today, 300 million are smart phones. This will be 700 million in 2020. It is no surprise that, after the UK, India is BT s second biggest market. It employs a staggering 27,000 people across the country. This Digital India is already driving expansion in e-commerce, fintech, healthcare, manufacturing, and education. Digital disruption Industry 4.0 is exciting for India. bullet train is due to be up and running by 2022. And, despite the competition from bullet trains, more people will be travelling by air. In 2007, there were 96 million air passenger journeys in India. This year there will be over 220 million. And, by 2027, it is estimated that there will be 700 million passenger journeys per year. Clean tech will also be a major growth driver in India. The Government of India predicts that 57% of the country s electricity capacity will come from renewable sources by 2027. And, by 2030, only electric vehicles will be on India s roads. India has transformed itself in the last 10 years, and the foundations are in place for another transformation over the next 10. The future will be one of digitallyled disruption, new possibilities, stronger UK-India partnerships, and growing prosperity in both countries. Many more Indians will be online, and many more will be on the move. The Ahmedabad-Mumbai In the next 10 years IUIH Programme aims to develops 11,000 NHS quality beds across India to provide world class Healthcare to 400 Million Indians. This document highlights the progress made in last 6 months of the IUIH programme. 4

IUIH Programme Background IUIH PROVIDING HEALTHCARE FOR 400 MILLION PEOPLE ACROSS INDIA 11k BEDS 5k DOCTORS 25k NURSES 400k EMPLOYEES The Indo UK Institute of Health (IUIH) Programme intends to provide Affordable, Available and Accountable Healthcare to 1 billion people in India. On 12th November 2015, the British Prime Minister, Mr. David Cameron, and the Prime Minister of India, Mr. Narendra Modi, signed a historic Health Collaboration Agreement to support the development of 11 IUIH Medicities across 11 states in India. The vision is for each IUIH Medicity to be a centre of excellence which will attract patients from all over India and abroad. At full development, each IUIH Medicity will offer patients world-class services, clinical expertise in a modern, technology-led hospital, a medical college, a nursing college, a post-graduate training centre, a global standard research and development centre and medical manufacturing facilities. Patients below the poverty line will have access to free healthcare with 20% of the bed capacity being eventually intended to be allocated for this purpose. The government also supports the vision to develop Indo UK Clinics that will provide Primary Care, Diagnostics, Pharmacy and Pathology services to support the Indian SMART city programme. Find out about Smart city programme The IUIH facilities will have global expertise both in operations and research from their collaboration with the UK National Health Service (NHS), partnerships with leading international healthcare industry companies and international partners in research, education, manufacturing and healthcare delivery. 5

IUIH Programme UK GLOBAL HEALTHCARE UIHW UIH IUIT IUC IUHP Workforce Progamme Strategic Company IT Programme Clinics Programme Medicity Programme UK INDIA HEALTHCARE WORKFORCE PLANNING Will provide workforce to clinics and hospitals. Each hospital of 1000 beds would generate around 5,000 direct jobs and around 25,000 indirect job opportunities, with the wider Medicity ecosystem creating even more job opportunities. UK INDIA HEALTHCARE Provides strategic leadership, consulting, design, and delivery teams to the IUIH Programme. INDO UK INFORMATION TECHNOLOGY IUIH understands the importance of the effective use and management of technology in a modern health environment in order to be able to deliver a safe, efficient and cost-effective healthcare system and is currently developing a Framework to ensure a comprehensive digital strategy. IUIT will provide Information and Technology services to the IUIH Programme and will also capture, manage and analyse the data. INDO UK CLINICS Will provide primary care, diagnostics, pathology and pharmacy services to 1 billion people in fully integrated facilities and operated with the highest NHS standards and clinical governance processes. INDO UK INSTITUTE OF HEALTH Will provide hospital services through eleven 1,000-bed hospitals, in addition to a health eco system to support the health economy. 6

IUIH Medicity The vision for IUIH is to create a health ecosystem. Each fully developed IUIH Medicity will comprise a self-sustainable township, training medical manpower, generating jobs and ensuring overall development of the region. The IUIH Medicity Nagpur is divided into seven distinct zones housing different elements of the Medicity: Find out more about IUIH Medicity Design 01 02 03 HEALTHCARE DELIVERY ZONE Trauma Centre, Tertiary Hospital, Day Surgery Centre, De-addiction Centre, NHS e-health, Integrated Medicine Centre and a Medical Mall. EDUCATION AND TRAINING ZONE Medical College, Post Graduate College, Nursing College, Allied Health Professionals Training Centre, Simulation Centre and a Conference Centre. CLINICAL SUPPORT SERVICES ZONE centres for Diagnostic Imaging, Pharmacy, Sterilization and Decontamination, Pathology Laboratory, Catering, Medical Supplies, Pharmaceutical Supplies, Blood Bank and Storage & Distribution. 04 MANUFACTURING & TECHNOLOGY ZONE specific areas for Medical Technology, Pharmaceutical, Health Technology, Health-related IT, Medical Devices and Implants. 05 RESEARCH & DEVELOPMENT ZONE an Incubator Hub besides centres for Physics and Biomedical, IT Big Data and Medical Supplies Development. 06 COMMERCIAL ZONE a Hospital Hotel, Wellness Centre, Retail Area, Accommodation Area, Laundry Area and Nursery Area. 07 ADMINISTRATIVE ZONE the offices for the Medicity Administration, Recruitment Services, Property Services, Estate Management, Transport, High-class, Accommodation and a Helipad. 7

IUIH Medicity cont... HEALTHCARE DELIVERY CITY CENTRE ADMINISTRATION & COMMUNITY SERVICES EDUCATION AND TRAINING COMMERCIAL ZONE CLINICAL SUPPORT SERVICES RESEARCH AND DEVELOPMENT MANUFACTURING AND TECHNOLOGY Vision Affordable, Available, Accountable Healthcare for all 8

IUIH Foundation Stone in Nagpur IUIH Medicity will change the face of MIHAN and turn Nagpur into a global medical tourism hub On Sunday August 13 2017, the Honourable Chief Minister of Maharashtra, Mr. Devendra Fadnavis, unveiled the foundation stone of the Indo UK Institute of Health (IUIH) Medicity that is being developed in 151 acres at MIHAN-SEZ, Nagpur. Speaking at the occasion, Mr. Fadnavis said, The IUIH Medicity is poised to change the face of MIHAN and turn Nagpur into a global medical tourism hub. Medical procedures that cost Rs 50 lakhs in the US and the UK can be conducted for Rs 5 lakhs here and that is the scope and capability we need to leverage. He also appreciated the fact that the IUIH Medicity will generate direct and indirect employment for around 100,000 people in the region. He urged the IUIH management to speed up work and implement the first phase by 2019 and for all the three phases to be delivered in the next 7-8 years, ahead of the 10-year schedule. Addressing the gathering at the ceremony, Ms. Jane Grady, Deputy Director, Trade, Economics and Prosperity, British High Commission India said, The NHS is the best integrated healthcare system in the world. Through IUIH, we are excited to bring to India the UK s expertise in training, innovation and delivery. This ambitious project will see NHS standards of care supporting the healthcare needs of the people of Maharashtra. It will also show 9

IUIH Foundation Stone in Nagpur cont... people the willingness of UK s health sector, the NHS as well as the private sector which is world class too, to work with India. In his welcome address, Dr. Ajay Rajan Gupta, MD and Group Chief Executive Officer, Indo UK Institute of Health informed those present that, IUIH Medicity Nagpur will be the logistical hub, the centre of supply chain management for all the 11 IUIH Medicities. We are also developing a data analytics centre here that will process clinical information for all Medicities. We will also conduct clinical research, genetic research and stem cell research at the Nagpur facility. research at the Nagpur facility. Later in the day, while addressing a press conference, he said that it will take 7 years for all the three phases to be completed however phase 1 which consists of a 250-bed hospital will be ready by 2019. On being asked about the business viability, he added that PricewaterhouseCoopers has conducted the feasibility study and this project is not just for the local population but targeted at medical tourists from across the world too. The procedures here are expected to be at least 30% cheaper than elsewhere in the world. 250 bed hospital will be ready by 2019 10

IUIH Foundation Stone Amaravati With IUIH Medicity Amaravati, the new state capital, gets its largest investment in health sector. On Wednesday August 16 2017, the Honourable Chief Minister of Andhra Pradesh, Mr. Nara Chandrababu Naidu and Ms. Anupriya S Patel, Minister of State, Ministry of Health and Family Welfare, Government of India, unveiled the foundation stone of Indo UK Institute of Health (IUIH) Medicity that s coming up in 150 acres at Amaravati, the new state capital, with an investment of Rs 1600 crores. Mr. Naidu began his address by thanking the farmers who gave the land for the new state capital which is attracting global talent and investment into projects like the IUIH Medicity. He said that IUIH Medicity Amaravati will make the new state capital a medical tourism destination. He thanked Lord Robert Kerslake, former Chairman, King s College Hospital and Dr. Ajay Rajan Gupta, MD and Group CEO of IUIH, for agreeing to make the Amaravati facility the headquarters for all 11 Medicities being developed in India. He added that with this project, Amaravati gets its largest investment in health sector. In her address, Ms. Patel stressed the need for developing innovative research programmes in healthcare that will promote India s medical tourism potential further. We are hopeful of a bright future as the UK s NHS is one of the finest healthcare systems in the world. I am glad that Andhra Pradesh has got the UK s expertise in training, research, innovation and clinical delivery, the forefronts of any modern healthcare system, she said. medicities 11 in India 11

IUIH Foundation Stone Amaravati cont... Delivering the welcome address, Dr. Ajay Rajan Gupta, MD & Group CEO, IUIH, said, It is notable that King s College Hospital, established in 1840, with nearly 200 years of legacy is stepping outside the UK for the first time and setting up operations in India. Besides the 1000-bed hospital, we shall have a medical college, a nursing college, research & development centre for stem cells, robotics, oncology and allied specialities. Mr. Bharat Joshi, British Deputy High Commissioner, Chennai, said, The NHS has been rated as the best healthcare system in the world when compared to healthcare systems in several countries including USA, Australia, Canada, France and Germany. We wish to share our expertise with India especially in terms of creating smart healthcare; designing and managing healthcare facilities; putting information systems in place for best possible patient care, and ensuring the highest quality of service. Rt Honourable Andrew Mitchell, Member of Parliament, UK; Lord Robert Kerslake, former Chairman, King s College Hospital, London; Mr. Kamineni Srinivas, Minister of Health and Medical Education, Government of Andhra Pradesh and Mr. Haden Spicer, First Secretary, Department of International Trade, British High Commission in India were other important guests present at the occasion. 05. 12

IUIH Medicity Design Nagpur INDIA STATE OF MAHARASHTRA CITY OF NAGPUR MIHAN 3rd largest state by area in India Wealthiest state in the country Area: 307,713 sqkm Population: 112.3 million (2011 census) Winter capital of Maharashtra 3rd largest city in the state Largest city in central India Area: 217.6 sqkm Population: 2,406 million (2011 census) MEDICITY - NAGPUR Site Location 13

IUIH Medicity Design Nagpur cont... 14 12

IUIH Board of Directors A Board has been set up with a functional focus, bringing expertise in key areas needed to deliver the Programme at the pace and scale required. IUIH has a team of 32 full time equivalents across the UK and India to support it and are actively recruiting to meet the go-live programme. DR AJAY GUPTA Group Chief Executive Officer A Consultant Orthopaedic Surgeon with 20 years experience. He has extensive healthcare policy, management and research experience, being an advisor to various government agencies. Awards include in 2011, Young Entrepreneur Award for Healthcare Excellence across UAE. In 2012, Achievers Healthcare Award in India for contributions to Affordable Healthcare. In 2013, Young Scientist Award for Universal and Affordable Healthcare. In 2014, Medical Maestro Award by Mr Richard Harrington, Vice Chairman of the Conservative Party at the House of Lords, London. DR MOHAN KAUL Independent Non Executive Director An influential and well-connected policy adviser, business leader, social entrepreneur and academician. He served as United National Adviser and Senior Commonwealth Diplomat and was the founding Director General and CEO (latterly Chairman) of the Commonwealth Business Council established by the Commonwealth Heads of Government (CHOGM). He has also been on Presidential Advisory Councils of 6 African countries, including Nigeria and Ghana. He worked as Professor and latterly as Dean of the prestigious Indian Institute of Management Ahmedabad. HOWARD LYONS Independent Non Executive Director As the first Managing Director of Healthcare UK, he realised international contracts for UK Organisations worth over 5billion in value.he also has public and private sector healthcare expertise in operational management, business planning and strategic health reform. Clients include the World Bank, European Union and the United Nations. 15

IUIH Boards (UGH + IUHP) cont... DAVID MCVITTIE Independent Non Executive Director David has over 30 years executive level experience within British Telecom and the NHS. He spent 11 years as CEO of Hillingdon Hospital, leading the Trust from being ranked in the bottom quartile to top quartile for performance. It was also the first District General Hospital in London to achieve Foundation Trust status. More recently, he led the merger to create London North West Healthcare Acute and Community Trust. VINAY SINGHAL Group IUIH Board Member (India) Vinay was the Group CEO of Fortis Healthcare where he erected the most modern (in 2001) 300-bed hospital in the record time of 18 months following global standards in collaboration with PHS, Boston. Vinay has worked in reputable Indian and MNC organizations and his technical experience covers Operations, Maintenance and Project Management in large industrial plants. Vinay was the CEO of the Clinton Foundation in India. Investment in 11,000 hospital beds, and ultimately 22,440 residential units, 2750 hotel keys and up to 98 million sqft. of development space 16

IUIH Construction starts at Nagpur Indo UK Institute of Health (IUIH) commences development of its first Medicity in Nagpur. On December 15, 2017, Indo UK Institute of Health (IUIH) one of the world s largest healthcare projects with an investment of Rs 17600 crores in India, announced that it has commenced the development of the first of its 11 Medicities to be built in 11 Indian states at MIHAN SEZ, Nagpur. The foundation stone was unveiled by The Honourable Chief Minister Shri Devendra Fadnavis on August 13, 2017. Find out more about construction at Nagpur PHASE 1 PHASE 2 PHASE 3 TERTIARY CARE HOSPITAL FIRST 250 BEDS Gastroenterology General - Cardiology surgery Neurology Trauma Orthopeadics Nephrology ADDITIONAL 250 BEDS Further specialities HEALTHCARE DELIVERY TO FULL CAPACITY COMMERCIAL SERVICES PHASE 1 (2-3 Years) CLINICAL SERVICES NURSING COLLEGE MEDICAL COLLEGE NHS E-HEALTH MEDICAL MANUFACTURING PHASE 2 (2-3 Years) SET-UP OF MANUFACTURING FACILITIES MANUFACTURING SUPPORT TO NEW START-UPS R&D STAFF ACCOMODATION ALLIED HEALTH TRAINING & EDUCATION COLLEGES HOSPITAL HOTEL WELNESS & HOLISTIC MEDICINE MEDICINE PHASE 3 (3-4 Years) 17

IUIH Construction start at Nagpur cont... Being built in association with King s College Hospital, London, with an investment outlay of Rs 1600 crores, IUIH Medicity Nagpur has been designed by IBI Group. Cushman & Wakefield has been appointed as project managers and its development will be carried out by Larsen & Toubro. KPMG has been appointed as tax advisors and auditors and Ernst & Young is the programme assurance partner. Dr. Ajay Rajan Gupta, Group MD and CEO, IUIH commented that, The first phase of our Medicity was slated to come up in three years. However, as our Honourable Prime Minister Shri Narendra Modi and Honourable Chief Minister of Maharashtra Shri Devendra Fadnavis want this to be fast-tracked, such that world-class healthcare is available to the masses at affordable prices sooner, we shall be ready with a 250-bed hospital by 2019 itself. We have received phenomenal support from the state government, especially the Maharashtra Airport Development Company (MADC), the special purpose company developing the Multimodal International Hub Airport at Nagpur (MIHAN). All necessary approvals as well as clearances are being expedited for us to be able to meet the timeline, informs Dr Rajdeep, Chief Operating Officer, IUIH. The feasibility study conducted by PricewaterhouseCoopers (PwC), the programme fund advisors, illustrates that IUIH Medicity Nagpur has the potential of becoming a medical tourism hub leveraging on the international passenger and cargo hub being developed at Nagpur besides serving the local population. As well as contributing to the exchequer, this will also lead to overall development of the region, in line with the government s Smart Cities initiative. Besides this, IUIH Medicity Nagpur will be the central logistics hub for the supply chain for all 11 IUIH Medicities in India. We are in talks with 40 NASDAQ listed companies who are our partners in this project and IUIH Medicity Nagpur will become the manufacturing site for medical equipment as well, in accordance with Prime Minister Modi s Make in India program, says Mr. Vinay Singhal, Board Member, IUIH. Centres of Excellence for cutting-edge medical research will be set up in IUIH Medicity Nagpur and the focus will be on clinical research analysing the patient data, genetics and stem cells. The medical college will be affiliated to one of the top UK education and training institutions and will train 100 doctors every year. 18

IUIH Hyderabad IUIH have allotted 50 acres of land with a freehold lease. Construction is due to start at the end of 2018 with laying of the Foundation stone in early 2018. Hyderabad is the 6th largest urban agglomeration in the country and the joint capital of Telangana and Andhra Pradesh. Being a medical destination, Hyderabad has a wide catchment area and receives patients not only from Telangana and Andhra Pradesh but also from other neighbouring states such as Karnataka, Chhattisgarh, and the Vidarbha region of Maharashtra. Hyderabad has a very well-developed healthcare market and is considered to be one of the leading medical hubs in India. Medical Value Tourism (MVT) in Hyderabad is on the rise in the last 2-3 years. The city is developing as one of the leading MVT destinations in the country. 19

Key IUIH Events in Quarter 1 2018 22-25 th Jan World Economic Forum, Davos, Switzerland The World Economic Forum is a Swiss non-profit foundation, based in Cologny, Geneva. Recognized by the Swiss authorities as an international body, its mission is cited as committed to improving the state of the world by engaging business, political, academic, and other leaders of society to shape global, regional, and industry agendas. This year, the Honourable Shri Narendra Modi jo, Prime Minister of India will be in attendance. 28-29 th Jan Arab Health, Dubai Arab Health is the largest gathering of healthcare and trade professionals in the Middle East North AFrica region. The 2018 edition of the event is expected to welcome more than 4,200 exhibiting companies and 103,000 attendees from 150+ countries. 3-4 th Feb Advantage Assam The largest investment promotion and facilitation initiative by the Government of Assam. The Summit aims at highlighting the state s geostrategic advantages offered to investors by Assam. 5-8 th Feb 70 Years of NHS Innovation: Trade Mission to India To commemorate the 70th anniversary of the UK s National Health Service (NHS), Healthcare UK and the Department for International Trade will be taking a trade mission of the most innovative healthcare providers and suppliers in the NHS to India. India s healthcare market is estimated to grow to $280bn (US) by 2020, so innovation is a key healthcare priority. The UK and NHS are known for their innovation and expertise in the healthcare sector, making this the perfect opportunity to showcase the UK s leading talent. The mission will be led by Sir Malcolm Grant, Chairman of NHS England, Sarah Wilkinson, CEO of NHS Digital and Deborah Kobewka, MD of Healthcare UK. 21-22 nd Feb Uttar Pradesh Investment Summit Two day event showcasing the investment opportunities and potential in the various sectors of Uttar Pradesh. 16-18 th April CHOGM (Commonwealth Heads of Government Meeting), London The Commonwealth is a diverse community of 52 nations that work together to promote prosperity, democracy and peace. In April 2018, the UK will host the Commonwealth Heads of Government Meeting (CHOGM) when leaders from all the member countries are expected to gather in London and Windsor. IUIH Indo UK Institute of Health 1 Harley Street, London. W1G 9QD Phone: + 44 (0)203 755 0982 Email: victoria.lusher@ www.iuih.com Follow us... Designed by Somer Design IUIH is a trading name of UK Global Healthcare Limited. Registered in England and Wales No. 09800013. Registered office: 1 Harley Street, London. W1G 9QD. VAT number 247093791.