Annual Report and Accounts 2020 Delivering for the long term At a glance Who we are Regional portfolio coverage We are a listed UK real estate investment trust (REIT) specialising Value of property in the development of, investment The number of properties within each value range is shown in the location marker. in and management of, a portfolio of primary care, diagnostic and 0 > £10 million treatment buildings across the UK. 0 £5 – 10 million 0 £1 – 5 million 0 < £1 million Portfolio activities FY 2020 Properties Rent roll 576 £108.9m Properties acquired Disposals 28 19 Developments completed Developments on site 4 15 SCOTLAND & NI 0 2 16 4 Expanding our portfolio NORTH EAST 8 16 88 13 NORTH WEST 12 6 25 11 A Crouch Vale Medical Centre Rothbury Community Hospital South Woodham Ferrers Morpeth A new community hub providing This modern, purpose-built facility space for community healthcare with huge support from the rural MIDLANDS services alongside general practice community it serves, providing a GP – including community nursing, surgery and additional inpatient and 6 16 52 11 stroke rehabilitation, physiotherapy, outpatient services in partnership specialist services for children and with Northumbria Healthcare NHS people with long term conditions, Foundation Trust. and sexual health services. WALES 0 8 36 16 E D C SOUTH EAST SOUTH WEST 5 15 70 20 5 5 25 13 Pinfold Surgery Headingley Medical Centre Leeds Leeds A modern medical centre within Home to two practices serving GP super-partnership Health Care almost 22,500 patients, this building LONDON First, which serves more than in Leeds grows our relationship with 30,000 patients in West Yorkshire. the teams in the Woodsley Primary 4 8 51 5 This innovative group of GP Care Network. The site sits near the practices has partnered with us university in an area popular with to provide specialist management students, and the building is also for three of its surgery premises. the base for the local MP. Contents Portfolio analysis Portfolio analysis Portfolio analysis Strategic report by capital value by region by occupier covenant Highlights of the year 2 How we deliver our purpose Total Total Total Total Total Total 16 Chairman’s statement Number of value value Number of value value rent roll value properties £m % properties £m % £m % 18 COVID-19 – our response 20 CEO statement < £1m 96 61.6 3 North 182 799.1 38 GPs 73.7 68 24 Our market £1 – 5m 363 899.4 43 South 226 736.1 35 NHS body 18.7 17 26 Our strategy £5 – 10m 76 494.4 24 Midlands 85 360.0 17 Pharmacy 8.7 8 30 Our key performance indicators > £10m 41 638.2 30 Wales 60 141.1 7 Other 7.8 7 34 Our business model 576 2,093.6 100 Scotland 23 57.3 3 108.9 100 38 Our impact & NI 50 Our environmental impact 54 Principal risks and uncertainties 576 2,093.6 100 60 CFO review Operational highlights 66 Compliance statements – Current rent roll grown by 6% to £108.9m Governance – On site with 15 developments around the UK 68 Chairman’s introduction – Acquisition of development pipeline and team of primary care developer GPI to governance – Strategic investment in latest fund created by established proptech investor PI Labs 70 Our governance framework – 32 lease re-gears completed, covering £2.9m of existing rent roll 72 Board of Directors – Launch of our social impact strategy, sixbysix 75 Key Board activities – Assura Community Fund established with £2.5m contributed from proceeds of placing 80 Nominations Committee in April 2020 Report 82 Audit Committee Report 84 Directors’ Remuneration Report Financial highlights 102 Directors’ Report 104 Directors’ Responsibility 2020 2019 Change Statement Financial performance EPRA earnings per share (Note 6) 2.8p 2.7p 3.7% Financial statements Profit before tax £78.9m £84.0m (6.1)% 105 Independent Auditor’s Report 112 Consolidated income Net rental income £103.7m £95.2m 8.9% statement Dividend per share 2.75p 2.65p 3.8% 113 Consolidated balance sheet Property valuation and performance 114 Consolidated statement of Investment property £2,139m £1,979m 8.1% changes in equity Diluted EPRA NAV per share (Note 7) 53.9p 53.3p 1.1% 115 Consolidated cash flow statement Rent roll £108.9m £102.7m 6.4% 116 Notes to the accounts Financing 131 Company financial statements Loan to Value (“LTV”) ratio (Note 22) 38% 34% 4ppts Undrawn facilities and cash £238m £287m (17.1)% Additional information Weighted average cost of debt 3.03% 3.24% (21)bps 137 Appendices 139 Glossary 141 Corporate information EPRA summary table 2020 2019 EPRA EPS (P) 2.8p 2.7p EPRA NAV (P) 53.9p 53.3p EPRA NNNAV (P) 52.7p 52.5p EPRA NIY (%) 4.69% 4.73% EPRA ‘topped up’ NIY (%) 4.73% 4.78% EPRA Vacancy Rate 1.6% 1.5% EPRA Cost Ratio (including direct vacancy costs) (%) 12.6% 12.5% EPRA Cost Ratio (excluding direct vacancy costs) (%) 11.5% 11.4% See pages 64 and 65 Delivering our purpose for the long term Our purpose is to create outstanding spaces for health services in our communities. We aim to be the UK’s number one listed property business for long-term social impact. How do we do that? Delivering our purpose Strategic report Governance Financial statements Additional information We bring insight and expertise Page 2–3 We offer a full service Page 4–5 We are the partner of choice Page 6–7 for the long term We design best in class, greener buildings Page 8–9 We innovate to create space fit for the future Page 10–11 We have financial strength Page 12–13 Assura plc Annual Report and Accounts 2020 1 How we deliver our purpose We bring insight and expertise Whether we’re bringing together many different organisations around a new surgery scheme, helping a group of practices with their premises strategy or creating more clinical space for a long-term occupier, our deep knowledge and experience of delivering for GPs and the NHS is what we’re known for. 2 Assura plc Annual Report and Accounts 2020 Strategic report Governance Financial statements Additional information Giving us a 12m 80% long-term view people aged of GPs say their premises 65 and above in aren’t fit to meet of our market the UK future needs Specialist support for a super-partnership Our acquisition of three surgery sites with West Yorkshire-based Health Care First, which serves more than 30,000 patients, means our management expertise can work for this practice group at scale. “The traditional model of general practice is changing and for our future planning, it was time to look at solutions to manage our premises as a group. This will mean we have a simple communication pathway on all our premises needs and challenges, helping us not just to maintain the status quo but also to take advantage of opportunities to improve our buildings with the best possible partner.” Dr Avi Biswas, GP Looking to the future of eye health on Teeside The ground-breaking new eye health clinic at our North Ormesby Health Village is a prime example of how space in our buildings is being used to help patients reach extra health services alongside general practice, and GPs to build their partnerships with other clinicians and services. Newmedica’s first integrated eye clinic and surgical centre opened its doors with the aim of improving eye health services in the community and helping to reduce waiting times for people needing essential NHS treatment for sight-loss conditions. “Eye operations don’t necessarily need to be in big hospitals, which is why we have created this specialist unit. We are very proud of our new facility” Darshak Shah, Managing Director at Newmedica Assura plc Annual Report and Accounts 2020 3 How we deliver our purpose continued We offer a full service Our in-house skills to design, build and manage mean we see our buildings from all angles: inside and out. We look at how they can work harder and better for everyone. 4 Assura plc Annual Report and Accounts 2020 Strategic report Governance Financial statements Additional information More consulting Only Helping practices rooms is the most popular building seize opportunities improvement request in our 50% annual occupier survey Creating space in Cornwall of practices say their “It’ll make a huge difference to how we’re premises are suitable able to work – for so many years we’ve had for present needs visions of expanding and improving our practice… and now we’re finally going to have really high quality work space.” Dr Michelle Wells, Launceston Medical Centre After acquiring this medical centre at the heart of a busy Cornish community, we’re adding ten new consulting rooms, a bigger waiting area and space for staff across health and care to work together. Launceston Medical Centre Expansion for a key community health centre in the heart of Cornwall. Assura plc Annual Report and Accounts 2020 5 How we deliver our purpose continued We are the partner of choice Relationships are everything in a sector where decisions and approvals can take time, but the end results can transform patient experiences. We collaborate to get the job done, whatever the challenge. 6 Assura plc Annual Report and Accounts 2020 Strategic report Governance Financial statements Additional information Staying the 312m 58 course GP appointments GPs per 100,000 delivered in 2019 population in England The brand new surgery for the Gloucestershire market town of Stow-on- the-Wold fits seamlessly into the landscape, thanks to its bespoke design.