TOGETHER WE CARE 2021 CLINICAL SERVICES REPORT CONTENTS MEDICLINIC’S CORE PURPOSE IS TO ENHANCE THE QUALITY OF LIFE 25 2 COVID-19 overview Introduction 8 About Mediclinic 8 At a glance 9 Committed to clients 10 Highlights Better ways to connect Mediclinic’s healthcare Employees keep clients at the heart of all landscape Mediclinic does. That is the commitment 11 Unique but united behind putting Patients First. 20 Value equation index 34 Better ways to connect 25 Patient experience 34 Better ways to unlock value Better ways to care 36 Clinical performance Klinik Hirslanden, Switzerland 44 Clinical outcomes Better ways to unlock value The Group is dedicated to partnering with 58 Facility focus all its stakeholders and forging long-term relationships. 59 Partnerships 36 61 Assurance 63 Clinical ethics summary 65 Glossary of terms 67 Contact details Better ways to care Superior clinical performance is essential to achieve Mediclinic’s purpose of enhancing the quality of life. ABOUT THIS REPORT Mediclinic International plc (‘Mediclinic’ or the ‘Company’) is proud to publish a Clinical Services Report annually as part of a suite of reports in respect of both the 2020 calendar year and 2021 financial year. The reporting suite listed below is available on the Group’s website. 2021 Annual Report and Financial Statements 2021 Clinical Services Report 2021 Sustainable Development Report 2021 Modern Slavery Statement 2021 Notice of Annual General Meeting SCOPE The goal of this Report is to provide Mediclinic stakeholders with an overview of the most important clinical performance characteristics across its divisions in Switzerland, Southern Africa (South Africa and Namibia) and the United Arab Emirates (‘UAE’) (collectively, the ‘Group’) for the 2020 calendar year, unless stated otherwise. Mediclinic reports on its material issues at a Group level, but also discloses information on divisional initiatives and performance, as this is the level at which data is collected. This Report does not include information on initiatives undertaken by Spire Healthcare Group plc, a leading private healthcare group based in the United Kingdom and listed on the London Stock Exchange (‘LSE’), in which Mediclinic holds a 29.9% interest. APPROVAL Mediclinic’s Clinical Performance and Sustainable Development Committee approved this Report on 19 May 2021. SHARE YOUR VIEW Mediclinic welcomes the opinions of its stakeholders. Please contact Dr René Toua on tel: +27 21 809 6500 or email: [email protected] with queries or suggestions. 2021 CLINICAL SERVICES REPORT MEDICLINIC INTERNATIONAL PLC 1 COVID-19 OVERVIEW The important role of large corporates in modern society was already widely recognised before the emergence of the COVID-19 pandemic, and must be emphasised even more at this time. Each business today plays a vital role in supporting livelihoods – of its employees, the communities it serves and the national economies in which it operates. Healthcare is unique that, during this time, it has been the industry around which national responses have been designed. It has been, and continues to be, centre stage – what the industry does during this time will define it for decades to come. MEDICLINIC’S RESPONSE The Group continues to fulfil an essential role in combatting the pandemic. As an international healthcare services provider, Mediclinic prioritises the safety of its employees and patients; the continuity of its operations; and its support of and collaboration with the relevant health authorities. COVID-19 IN NUMBERS COVID-19 patients 27 000+ treated in hospital 60+ 105m 1.3m 2 900% 10+ international examination gloves masks/month used increase in use of new internal professional sourced in 2020, during COVID-19 isolation gowns engagement channels societies and 35 million more waves, up from during pandemic’s across the Group to epidemiology than in an 360 000 masks/ peak compared with support continuous experts consulted average year month pre-pandemic normal operations communication EMPLOYEES VACCINATED 48% AT 31 MARCH 20211 increase in absenteeism hours, Hirslanden Mediclinic Southern Africa Mediclinic Middle East mainly due to COVID-19 quarantine periods and illness ±35% ±29% ±85% Note 1 Percentage applicable to eligible employees. 2 MEDICLINIC INTERNATIONAL PLC 2021 CLINICAL SERVICES REPORT EMERGENCY PREPAREDNESS SUMMARY The system that prepares, protects and mobilises Mediclinic during the COVID-19 pandemic WHO WHAT BOARD Clinical Performance and Sustainability Through regular reporting and consultation, LEVEL Committee and the Board, which has these bodies provide invaluable guidance to four directors with healthcare and clinical the Group Chief Clinical Officer in tailoring experience and adapting Mediclinic’s response Clinical taskforce led by the Group Chief Strategic direction and response GROUP Clinical Officer and outcome monitoring LEVEL Multidisciplinary and specialist taskforces Central coordination of task teams and clinical governance Hospital and operational response Multidisciplinary taskforces DIVISIONAL planning and management LEVEL ACTIONS • Redeploying suitable employees to support operations • Acquiring additional ventilators and other intensive care unit (‘ICU’) equipment and related consumable products • Expanding ICU capacity where possible • Establishing additional laboratory facilities • Proactively procuring critical personal protective equipment (‘PPE’) and medication • Researching and sourcing alternative mechanisms to provide oxygenation CONTINUOUS EXTERNAL STAKEHOLDER CONSULTATION Clients Governments Healthcare Investors Media Medical Professional Suppliers 24/7 call and authorities insurers practitioners societies centres, Supporting Communication online risk with testing, via live broadcasts, assessment treatment and virtual meetings tools, vaccination and online awareness strategies treatment campaigns collaborations NEW SERVICES AND INFRASTRUCTURE • Virtual care advancement • Remote patient monitoring • Polymerase chain reaction (‘PCR’) testing units and • Alternative interim facilities which admit asymptomatic additional laboratory facilities and low-acuity cases • Home delivery and drive-through pharmacy services • Vaccination centre establishment and management 2021 CLINICAL SERVICES REPORT MEDICLINIC INTERNATIONAL PLC 3 COVID-19 OVERVIEW CONTINUED Restrictions on elective procedures1 Switzerland Southern Africa COVID-19 TIMELINE The UAE 9 January 26 February 28 February First COVID-19 First COVID-19 Daily Group case admitted at case admitted at clinical taskforce Mediclinic Middle Hirslanden meetings East commence 2020 11 March 12 March 26 March 1 April • World Health Organization (‘WHO’) Online risk PCR testing First telemedicine declares COVID-19 outbreak a assessment tool service launched consultation at pandemic launched at at Mediclinic Mediclinic Middle • First COVID-19 case admitted at Mediclinic Middle East East Mediclinic Southern Africa Southern Africa 5 April 23 April 14 May 1 June Hirslanden: Hospital access control Mediclinic • Telemedicine solution launched at Mediclinic admissions screening app Middle East: Southern Africa to support affiliated doctors peak in first introduced at Mediclinic admissions peak • Mediclinic Middle East concludes agreement wave Southern Africa in first wave with national airlines to test passengers before flights 22 July 15 August 24 November 7 December Mediclinic First Mediclinic Middle Hirslanden: Vaccination roll-out Southern Africa: East employee admissions peak commences in admissions peak vaccinated as part in second wave the UAE in first wave of a clinical trial 18 December 23 December 12 January 13 January New 501.V2 First • Vaccination roll-out Hirslanden variant Hirslanden commences in Switzerland contracted to announced in employee • Mediclinic Southern operate its first South Africa vaccinated Africa: admissions peak vaccination centre 2021 in second wave 12 February 17 February 20 February 25 March Mediclinic Middle Vaccination First Mediclinic Repetitive testing East: admissions roll-out Southern Africa platform, Together peak in second commences in employee we test, launched wave South Africa vaccinated at Hirslanden Note 1 Restrictions were both self-imposed and government mandated to preserve capacity. In some divisions, restrictions were applicable to certain regions or facilities only. 4 MEDICLINIC INTERNATIONAL PLC 2021 CLINICAL SERVICES REPORT SAFETY FIRST The Group’s international perspective remains a key Multidisciplinary taskforces at Group and divisional level differentiating factor for Mediclinic. Led by the centrally enable Mediclinic to constantly re-evaluate its ongoing coordinated Clinical Services function, the Group response to the pandemic, allowing it to optimise responded efficiently and effectively to the pandemic treatment pathways for patients in order that demand and expanded upon established infection prevention and for critical and intensive care beds can be managed control (‘IPC’) programmes by leveraging Group insight appropriately. and best practices. The Group invested in a number of initiatives to support employees, affiliated doctors and communities • IPC and communicable disease emergency during this time, including establishing 24/7 client call preparedness programmes govern admission, centres and crisis control centres. containment, triage and treatment of suspected or The Group’s centrally coordinated procurement confirmed COVID-19 cases teams with global sourcing capabilities have played a • New visitation