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Integrated Approach INTEGRATED APPROACH NMC Health plc Annual Report and Accounts 2017 NMC Health plc Annual Report and Accounts 2017 NMC Health is one of the world’s top 10 healthcare operators by market value. A member of the coveted FTSE-100 index, NMC’s geographic reach spans across 13 countries through 129 own or managed facilities. The Group operates two business lines, Healthcare and Product Distribution, which are divided into five business verticals: I-SPECIA MULT LTY M A T E R N N IT O I Y T & U F B I E R R T T S I I L D I T Y O P E E R A R T A IO C N E S M O & H M & AN M A ER GEM -T ENT LONG Read more about our vertically integrated brands p2 I. Overview II. III. IV. V. Company Highlights I. Overview 2 At a Glance 8 Value from Acquisition Strategy NMC focuses on underserved medical services and geographies within the countries it operates in and will continue to utilise organic and inorganic 10 Joint Chairmen’s 2017 Report to Shareholders growth strategies to address these opportunities. II. Strategic Report 14 Chief Executive Officer’s Review $1.6bn 17 Financial Summary and Highlights £7.1bn 18 Business Model 20 Our Strategy FTSE 100 company – 2017 Group revenues (US$) market capitalisation of £ 21 Business Overview £7.1bn at end February 2018 24 Financial Review 26 Management Evolution 28 Risk Management 1,539 $353.4m 32 Corporate Social Responsibility III. Governance Licensed beds 2017 Group EBITDA (US$) 38 Board of Directors 40 Senior Management Team 41 Corporate Governance Report 58 Directors’ Remuneration Report 2017 129 13 78 Directors’ Report IV. Financial Statements Own and managed facilities (51 own Operations across 13 countries 82 Directors’ Statements facilities and 78 managed facilities) 86 Independent Auditor’s Report 94 Consolidated Income Statement 95 Consolidated Statement of Other Comprehensive Income 96 Consolidated Statement c.1,400 +5.7m of Financial Position 97 Consolidated Statement of Changes Doctors Over 5.7m patients in 2017 in Equity 98 Consolidated Statement of Cash Flows 99 Notes to the Consolidated Financial Statements 146 Statement of Financial Position 147 Statement of Changes in Equity c.14,000 +108,000 148 Statement of Cash Flows 149 Notes to the Financial Statements Staff Over 108,000 distribution stock keeping units V. Other Information 160 Shareholder information Read the annual report and much more on our website: www.nmchealth.com NMC Health plc Annual Report and Accounts 2017 1 Overview At a Glance Our Business REGIONAL CLUSTERS DELIVERING ENHANCED PERFORMANCE The NMC Group continues to operate and manage its businesses through its two primary divisions, Healthcare and Distribution. Business verticals Clusters NMC has developed specialised verticals Prior to 2017, operational decisions for improved control of the day to day within the broader healthcare delivery NMC’s multi-specialty hospitals and clinics operations, allowed a better use of platform with specialisation-specific were made by the senior leadership delegated authorities and ultimately, capabilities and brands. team and key decisions regarding day enhanced performance. to day operations were elevated to the corporate office. NMC’s success in its During the development of the cluster geographical expansion, as part of the concept in H2 2017, the cluster leadership capability building and capacity growth was rigorously evaluated to ensure that strategy, resulted in a previously very the right team was in place. In addition to effective organisational structure, which the Healthcare Division and individual was difficult to maintain operationally. facility performance monitoring, Cluster This was particularly evident through the specific key performance indicators have Multi-specialty increasing cross relationships and patient been developed and assigned to each Network referral processes which were developed Cluster General Manager with the to cross utilise brands and businesses for additional brief of ensuring an appropriate the benefit of our patients which in turn structure in place to facilitate cross has improved the efficiency and use of business cooperation in developing each of our assets. each business. Therefore, within the UAE and the broader The Management team believe that this GCC, operational clusters were created on has enhanced both cost synergies and a geographic basis with more responsibility, revenue enhancement projects which Maternity accountability and business control have been in place across the Group. & Fertility placed in the hands of a new General Manager appointed for each cluster. This change has resulted in better facilitation of real-time decision making, Long-term & Home Care Other Middle East & North Africa 12+ facilities 900 beds Operations Europe & Management 4 countries 15 facilities 50+ doctors 4 countries Products & Consumables 2 NMC Health plc Annual Report and Accounts 2017 I. Overview II. III. IV. V. RAK Umm Al Quwain Sharjah NMC has created regional clusters to aid the process of centralisation of key services to benefit from our Dubai strong growth over the past few years. Abu Dhabi Al Ain Sharjah & Northern Emirates 20 facilities 379 beds 345 doctors Abu Dhabi 13 facilities 722 beds Dubai 643 doctors 9 facilities 206 beds 442 doctors Oman 12 facilities 127 beds Saudi Arabia 90 doctors 8 facilities 800+ beds 5 cities NMC Health plc Annual Report and Accounts 2017 3 Overview At a Glance Strategy FUTURE GROWTH DRIVEN BY WELL–DEFINED STRATEGY NMC focuses on underserved medical services and geographies within the countries it operates in and will continue to utilise organic and inorganic growth strategies to address these opportunities. Our strategy is built on three key tenets Capacity Build Capabilities Focus Geographic Expansion 2015 Strategy Update 2017 Strategy Update • Accelerate the establishment of Centres of Excellence ADDITION OF NEW VERTICALS in key specialities within existing hospitals. Addition of new verticals focused on highly underserved • Increase participation in the growing UAE medical segments in the UAE and wider GCC and further tourism industry and establish NMC as a destination development of Centres of Excellence. of choice. • Grow NMC’s medical specialty offering and clinic TARGETING WIDER EMERGING MARKETS network within the UAE and maximising Expanding the healthcare business’ target market from operational synergies. the GCC to wider emerging markets. • Establish a strategic presence outside the UAE with leading global medical institutions to enhance and FERTILITY TO BE DEVELOPED AS A GLOBAL BUSINESS expand technological know-how and medical expertise. Fertility to be developed as a global business taking • Increase NMC’s footprint in Saudi Arabia and the broader advantage of substantial growth opportunities. GCC via organic initiatives and acquisitions. RAPID ADOPTION AND DEPLOYMENT OF TECHNOLOGICAL INNOVATION Rapid adoption and deployment of technological innovation via both organic initiatives and acquisitions. 4 NMC Health plc Annual Report and Accounts 2017 I. Overview II. III. IV. V. Our Growth Story 2014 2017 Growth 1 13 1,200% Number of countries 310 1,539 396% Number of licenced beds 12 129 975% Number of own & managed facilities 4.60 28.85 527% Share price £ NMC Health plc Annual Report and Accounts 2017 5 Overview At a Glance Where We Operate ENHANCING OUR GEOGRAPHICAL FOOTPRINT Denmark Copenhagen Slovakia Piestany United Arab Italy Emirates Bergamo Abu Dhabi Modena Al Ain Monza Dubai Sharjah Umm Al Quwain Spain Barcelona Madrid Colombia Brazil Kuwait Jordan Bogota São Paulo Egypt Saudi Arabia Al Khobar Jeddah Oman Muscat Yemen Socotra Colombia Denmark Slovakia 1 1 1 Brazil Spain Italy 4 3 3 Key to number of facilities Own and Operation & Management Own Operation & Management 6 NMC Health plc Annual Report and Accounts 2017 I. Overview II. III. IV. V. UAE Oman Egypt Kuwait 96 6 8 2 Saudi Arabia Yemen Jordan 2 1 1 JORDAN KUWAIT EGYPT SAUDI ARABIA UAE OMAN YEMEN 129 13 c.1,400 Facilities Operating in 13 countries Doctors +5.7m c.14,000 Patients Employees NMC Health plc Annual Report and Accounts 2017 7 Overview Value from Acquisition Strategy Post-acquisition Integration and Synergy Benefits IDENTIFYING AND DEVELOPING SYNERGIES THAT FOSTER VALUE CREATION Our approach to integration has been Our approach to integration has been to: to bring in greater operational efficiencies simple yet effective. • communicate our values; and improving patient experience. • give a new direction to the acquired We recognise that each entity has its entities; and NMC continues to encourage and support own focus areas and has developed and • focus on identifying synergies in the entrepreneurial drive that has made updated its unique business model over specific areas that are not disruptive each of our businesses and brands a the years to suit its specific business to the business. success in their own marketplaces by requirements. Becoming a part of a larger allowing them the managerial freedom group like NMC opens the resources and This has allowed our entities to mutually to identify and pursue win-win synergies know-how of the wider Group to the share their knowledge and best practices with the wider Group. entity while it continues to focus on what it does best. COST SYNERGIES By developing specialised verticals within RESOURCE INTEGRATION OPERATIONAL SYNERGIES THROUGH the broader healthcare delivery platform, AND OPTIMISATION SHARING TECHNICAL KNOWLEDGE NMC has been able to integrate gradually NMC has established a rigorous program AND STANDARDISED PROTOCOLS with all its acquisitions thus providing to achieve optimum resource sharing Capitalising on Eugin’s R&D activities and sufficient time for growth and synergy. including back office integration in HR, excellence in medical management, NMC Finance, IT, fleet and facilities, and medical has integrated the technical know-how NMC’s collaborative approach to operations to ensure full value potential by sharing protocols and analysing results integration provides operational is achieved. across all clinics. This has given enhanced autonomy to the acquired entities.
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