Annual Report and Accounts 2021 DELIVERING WITH PURPOSE AT A GLANCE WHO WE ARE We are a listed UK real estate investment trust (“REIT") specialising in the development of, investment in and management of, a portfolio of primary care, community, diagnostic and treatment buildings across the UK. 2021 Portfolio analysis Portfolio analysis Portfolio analysis HIGHLIGHTS by capital value by region by occupier covenant Total Total Number Total Total Total Total Number of value value of value value rent roll value properties £m % properties £m % £m % < £1m 78 48.8 2 North 190 878.6 36 GPs 80.3 66 £1 – 5m 393 1,001.3 41 South 232 861.7 36 NHS body 20.8 17 £5 – 10m 91 606.1 25 Midlands 104 465.8 19 Pharmacy 9.6 8 > £10m 47 758.5 32 Wales 58 140.6 6 Private 4.8 6.4 5 609 2,414.7 100 Scotland 25 68.0 3 providers & NI Other 4.6 4 609 2,414.7 100 121.7 100 Operational highlights – Over £290m invested in portfolio growth during the year – Acquisitions, developments and asset enhancements grow rent roll by 12% to £121.7m – 12 developments completed (benefitting over 170,000 patients) and a further 16 currently on site – Development capability further boosted by acquisition of pipeline and team of primary care developer Apollo – 31 lease regears completed, covering £2.8m of existing rent roll – £300m, 10-year Social Bond successfully launched in September 2020 and £185m equity raise completed in April 2020 – Assura Community Fund established with initial £2.5m contribution and over £800,000 distributed to eligible projects Financial highlights 2021 2020 Change Financial performance Net rental income £112.0m £103.7m 8.0% Profit before tax £108.3m £78.9m 37.3% IFRS earnings per share (Note 6) 4.1p 3.1p 32.3% Adjusted EPRA earnings per share (Note 6) 2.8p 2.8p – Dividend per share 2.82p 2.75p 2.5% Property valuation and performance Investment property £2,453m £2,139m 14.7% Diluted EPRA NTA per share (Note 7) 57.2p 53.9p 6.1% Rent roll £121.7m £108.9m 11.8% Financing Loan to Value (“LTV”) ratio (Note 22) 37% 38% (1)ppt Undrawn facilities and cash £272m £238m 14.3% Weighted average cost of debt 2.47% 3.03% (56)bps EPRA summary table 2021 2020 EPRA EPS 2.7p 2.8p EPRA NTA 57.2p 53.9p EPRA NRV 63.2p 59.7p EPRA NDV 56.0p 52.7p EPRA NIY 4.55% 4.69% EPRA ‘topped up’ NIY 4.56% 4.73% EPRA Vacancy Rate 1.3% 1.6% EPRA Cost Ratio (including direct vacancy costs) 15.5% 12.6% EPRA Cost Ratio (excluding direct vacancy costs) 14.5% 11.5% See pages 66 and 67 This page includes a number of financial measures to describe the financial performance of the Group, some of which are considered Alternative Performance Measures as they are not defined under IFRS. Further details are provided in the CFO Review, notes to the financial statements and the Glossary. REGIONAL PORTFOLIO COVERAGE Value of property The number of properties within each value range is shown in the location marker. 0 > £10 million 0 £5 – 10 million 0 £1 – 5 million 0 < £1 million Northgate Medical Centre Pontefract We carried out extensive SCOTLAND & NI refurbishment work here to create a new mezzanine level, adding two 1 3 17 4 extra consulting rooms and more office space. We also installed solar panels and LED lighting NORTH EAST throughout the building to reduce Leeds Student Medical Centre energy consumption. Leeds 10 22 90 17 Serving almost 40,000 patients NORTH WEST Jubilee Health Centre in the heart of Leeds’ student Wallington, Surrey community, this centre provides 12 6 25 8 This key hub for health services in mental health services and ‘Linking South London provides not just Leeds’, a wellbeing coordinator general practice, but also services helping isolated local people. The from Epsom and St Helier University practice’s priorities also include Hospitals NHS Trust and South eating disorders, sexual health West London and St George’s and gender identity issues. MIDLANDS Mental Health NHS Trust. 9 21 63 11 WALES 0 8 36 14 SOUTH EAST SOUTH WEST 4 17 74 9 6 5 30 13 Properties LONDON 609 5 9 58 2 Rent roll £121.7m Developments Properties on site acquired 16 50 Developments Disposals completed 12 29 The pandemic has made the whole world reconsider the role of buildings and space for health and wellbeing. With this in mind, we’re taking a fresh look at our purpose for the post-COVID world. Patients have always been the end users of our buildings, but the long-term social impacts of the pandemic prompted us to look even more deeply at the role we can play through the buildings and spaces we create and care for. With our commitment to social impact, we’re in a unique position to support and collaborate with local health systems and health services through extensive partnerships as they build back beyond COVID-19 – with patient experiences, reducing health inequalities and a net zero carbon health service at the heart of their mission. DELIVERING WITH PURPOSE Our purpose is to create outstanding spaces for health services in our communities. Our ambition is to be the number one listed property business for social impact. Strategic report Governance Financial statements Additional information CREATING OUTSTANDING SPACES Strategic report Highlights of the year 2 How we deliver our purpose Creating outstanding spaces 5.9m Supporting our people Our buildings serve 5.9m people across the UK. Collaborating with our communities Read more on pages 2 and 3 Performing for our shareholders 10 Chairman’s statement 12 COVID-19 – our response 14 CEO statement 18 Our market 20 Our strategy 26 Our key performance indicators 32 Our business model 36 s172 statement 38 Our impact SUPPORTING OUR PEOPLE 52 Our environmental impact 55 Task force on climate-related financial disclosures 56 Principal risks and uncertainties 62 CFO Review 82% 68 Compliance statements of eligible team members joined the Share Incentive Plan. Governance 70 Chairman’s introduction to Read more on pages 4 and 5 governance 72 Our governance framework 74 Board of Directors 77 Key Board activities 82 Nominations Committee Report 85 Audit Committee Report 87 Directors’ Remuneration Report 106 Directors’ Report 108 Directors’ Responsibility Statement COLLABORATING WITH OUR COMMUNITIES Financial statements 109 Independent Auditor’s Report 116 Consolidated income statement £800k 117 Consolidated balance sheet distributed to health-improving 118 Consolidated statement of charity projects. changes in equity Read more on pages 6 and 7 119 Consolidated cash flow statement 120 Notes to the accounts 135 Company financial statements Additional information 141 Appendices 143 Glossary 145 Corporate information PERFORMING FOR OUR SHAREHOLDERS 2.8p Dividends paid during the year. Read more on pages 8 and 9 Assura plc Annual Report and Accounts 2021 1 CREATING OUTSTANDING SPACES Better patient experiences and access to healthcare for everyone As our research with Dimensions’ #MyGpAndMe campaign completed, our new medical centre building in Cinderford, Gloucestershire opened its doors with a focus on neuro-inclusive design for people living with conditions such as dementia. 2 Assura plc Annual Report and Accounts 2021 Strategic report Governance Financial statements Additional information This report marks an exciting new phase in the work Dimensions has led to support better outcomes for people who have a learning disability and autism in primary care. The buildings in which we all access healthcare can both help and hinder our engagement with health services and, as this report shows, it is vital that primary care buildings meet the needs of all patients.” Steve Scown Dimensions CEO 5.9mpeople are served by our buildings across the UK 80% 74% of GPs say their premises of patients feel very or somewhat aren’t fit for future needs confident to go back to primary care (The BMA) buildings after lockdown (Patients Association survey for Assura) Assura plc Annual Report and Accounts 2021 3 SUPPORTING OUR PEOPLE Sharing in success and giving back In a year when many businesses were forced to furlough and lose staff, close offices and mothball plans, we launched our Share Incentive Plan, giving all staff the chance to benefit from the company’s success and support their personal plans for the future. 4 Assura plc Annual Report and Accounts 2021 Strategic report Governance Financial statements Additional information I think it’s a fabulous way to save and invest in your Company, the matched shares from the Company are very generous and I look forward to the benefits in a few years’ time!” Debbie Chalcraft Group Compliance Manager 82%of eligible team members joined the Share Incentive Plan Outstanding Indicative employee engagement levels in pulse survey with Best Companies 83% of team members fed back in our first Mind Workplace Wellbeing Index survey Assura plc Annual Report and Accounts 2021 5 COLLABORATING WITH OUR COMMUNITIES Led by local Our Assura Community Fund launched in May and set out on its mission to distribute millions of pounds in funding and reach one million people through health-improving projects by March 2026. With support from our partners at Cheshire Community Foundation, we invited applications from projects working around our buildings across the country, finding those which are making a unique difference to health in their community. 6 Assura plc Annual Report and Accounts 2021 Strategic report Governance Financial statements Additional information We are so grateful for your pledge to support our psychological wellbeing service for young care leavers in Warrington.