OUR MISSION IS TO IMPROVE THE QUALITY OF LIFE OF RENAL PATIENTS SUSTAINABILITY REPORT 2018
Contents Care delivery approach
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Sustainability at Diaverum
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Environment 6 Environment, our KPI performance
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Best practice
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Social 9 Social, our KPI performance
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Employee-related disclosures
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Governance 12 Governance, our KPI performance
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Supplier code of conduct
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Key company policies
15
d.ACADEMY 16 Enterprise risk management
DIAVERUM AB SUSTAINABILITY REPORT 2018 HYLLIE BOULEVARD 39, SE-215 37 MALMÖ, SWEDEN, PHONE +46 46 287 30 00, INFO@DIAVERUM.COM, WWW.DIAVERUM.COM, COMPANY REG. NO 559140-5344
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2
3.5 million people in the world suffer from Chronic Kidney Disease Stage 5 and the number is growing rapidly
7,500
850
3.5
82%
Million inhabitants on this planet.
Million people with Chronic Kidney Disease Stage 1-5.
Million people with Chronic Kidney Disease Stage 5 (ESRD*) by 2020, expected to increase by one million in 2030.
As a result of diseases such as diabetes and hypertension, mostly lifestyle-related.
* End Stage Renal Disease.
Diaverum is a leading global provider in renal care services and the largest independent provider in Europe
376
35,000
Clinics.
Patients.
11,000 5.3 Healthcare professionals.
Million treatments annually.
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Care delivery approach We believe that every dialysis patient deserves to live a fulfilling life! That is why our care delivery approach is based on each patient’s entire life situation. How can we ensure the best standards of care? What is the best treatment? Which additional services are needed? How can our patients be empowered to live the most fulfilling life possible? These are the questions which constantly drive our daily care efforts to enhance the quality of life for each individual patient. This is what distinguishes the Diaverum way of service delivery and defines our life-enhancing renal care.
and sustainability. While our core service is haemodialysis, we provide a range of renal care services, from preventive care to transplantation. As a signatory of the UN principles for responsible investments, Diaverum's sustainability is driven by the initiative and commitment of our owners, Bridgepoint, and the board of directors. Our corporate social responsibility initiatives promote actions that have an impact on the well-being and quality of life of the population worldwide.
At Diaverum, our mission of delivering life-enhancing care also extends to our commitment to corporate social responsibility
Peritoneal
Prevention
Haemodialysis
dialysis
Home care
Coordination
Transplants
Offering preventive care for CKD3 CKD4 patients. This includes dietary support, education, social, and family support, and medication management.
In clinics, worldclass haemodialysis treatment, and vascular access services to achieve the best treatment results.
Allows removal of toxins and excess fluid from the body via a dialysate fluid inserted in the abdominal cavity.
Home dialysis enables patients to dialyze longer, and more frequently in the comfort of their home; drives medical results and quality of life.
Patient care coordination, built around the patient, to manage comorbidities like diabetes or cardiovascular disease.
Owning and operating transplant centres performing kidney, pancreas, and liver transplants, pre and post transplant followup and process.
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Sustainability at Diaverum Our approach
The KPIs are set biennially based on the results of a materiality assessment. The participants in this materiality assessment are chosen to reflect a well-rounded sample of internal and external stakeholders. Additionally, Diaverum undergoes regular external audits for corporate social responsibility during yearly ISO audits in selected countries. The results of these are published by our external auditors in an independent report which focuses on Diaverum corporate and country CSR KPIs performance. MATERIALITY MATRIX A materiality assessment enables Diaverum to conduct a reasonable set of ESG initiatives and KPIs in order to be an even more responsible health-care provider that respects its stakeholders' interests.
Patient focus
Regulatory compliance IMPORTANCE FOR DIAVERUM'S BUSINESS
Sustainability at Diaverum is driven by our corporate social responsibility (CSR) initiatives which rely on environmental, social, and governance (ESG) performance indicators. Diaverum’s focus on ESG makes our initiatives holistic and helps us measure our impact on the environment, our employees, and society as a whole.
Water
Energy Employment practices
Training and education Anti-corruption
Occupational health and safety Data Protection
Waste Access to healthcare and affordability
Supply Chain Management
Whistleblower process
GHG
Diversity
Equal salary for women and men
Biodiversity
Environment Social Governance
IMPORTANCE FOR DIAVERUM'S STAKEHOLDERS
INPUT FOR MATERIALITY MATRIX Employee opinions Questionnaire to representatives from different departments. ESG Audit input In all 13 ISO countries, an ESG audit was performed by Bureau Veritas. Audit topics were similar to the ISO 26000 standard. Stakeholder interviews Interviews with external stakeholders.
Our CSR performance CSR KPIs in Diaverum are set based on the results of the biennial materiality assessment. Our CSR KPIs are measured and monitored on a regular basis in all Diaverum countries, internally in countries that are not ISO certified, and through external auditing in countries with ISO certifications. We maintain a two-tiered approach towards our Key Performance Indicators, KPIs, in all countries. The aim of adopting this approach is to ensure we foster an environment which encourages and embeds sustainability into the organisational
culture. Categorizing the KPIs as must-haves and nice-to-haves ensures that the countries report on essential indicators, while giving them the opportunity to enhance their reporting with nice-to-have KPIs. In 2018, we digitized the CSR KPI data collection process by introducing the CSR KPI data collection web tool. The web tool has made the process of monitoring our CSR performance considerably more efficient and the transparency of country level data has improved the CSR culture in Diaverum.
Our key performance indicators
Environment
Social
Governance
• • • •
• • • •
• Supply chain management • Code of conduct and anti-corruption policy • Quality management system ISO 9001 • Legal register • Data protection.
Environmental management system ISO 14001 Energy consumption Water consumption Waste management.
Patient satisfaction Employee engagement Patient education programme Employee training and education.
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Environment Approach As a service provider, Diaverum has a medium to low environmental impact, since the most environmentally impacting activities are limited to water and energy consumption for dialysis. That being said, we constantly regulate and monitor our resource consumption by maintaining minimum standards of resource consumption at clinics as well as all our offices. Activities 1. A comprehensive materiality assessment was carried out to update existing and identify new CSR ESG KPIs. The assessment was completed by internal and external stakeholders and included existing factors as well as new environmental factors. 2. All critical suppliers to Diaverum are audited on the basis of the supplier code of conduct. This code defines the standards that Diaverum expects its suppliers to uphold and contains a dedicated section on environmental performance and sustainable resource consumption. In addition, a section in the supplier code of conduct is dedicated to the corporate social responsibility of Diaverum suppliers. Environmental KPIs 1. ENVIRONMENTAL MANAGEMENT SYSTEM Implementation of the ISO 14001:2015 standard. 2. ENERGY CONSUMPTION Measured in kWh per treatment. 3. WATER CONSUMPTION Measured in m3 per treatment. 4. HAZARDOUS WASTE Measured in kilograms.
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Environment, our KPI performance Energy consumption, Water consumption, Diaverum countries ISO 14001:2015 kWh/treatment m3/treatment Argentina (HQ only) Brazil Chile China (no treatments yet) France Germany Hungary Italy Kazakhstan Lithuania Poland Portugal Romania Russia Saudi Arabia Spain Sweden United Kingdom Uruguay
Hazardous waste, kg
16.5 1.8 – 8.0 0.7 0.3 6.1 0.5 1.7 – – – 13.3 0.3 1.3 45.0 – 1.3 5.7 3.6 1.3 14.7 0.8 1.8 – – – 8.8 0.7 3.4 6.6 0.5 1.2 10.6 0.4 4.4 8.1 0.4 1.2 14.0 0.5 1.4 30.0 6.0 4.4 11.7 0.5 0.1 14.4 0.5 5.9 16.1 0.6 1.5 13.4 0.4 –
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Best practice Reduction in resource consumption in Argentina The head office in Argentina was renovated in 2018 with a special focus on reduction of resource consumption, i.e., electricity and paper. A comprehensive evaluation of the office space was carried out to identify areas for improvement while at the same time an awareness campaign was initiated in the office to encourage employees to go digital. The campaign focused on the ecological impacts of resource consumption.
The Argentinian team expects to see a considerable reduction in the consumption of electricity and papers as well as a positive change to the office environment thanks to the remodeling of open spaces. Way to go, Argentina!
Before...
...after
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Social Approach At Diaverum, part of our mission is to add positive value to our social impact through improving the lives of both patients and employees. We do this especially through ‘the Touch’ process, to improve patient care, and through the ‘My Opinion Counts’ surveys for our employees. Activities 1. Carrying out the ‘My Opinion Counts’ surveys twice a year, which measure employee engagement. The results from the surveys highlight points of further investment and development. The process runs concurrently with the patient satisfaction surveys. We believe that there is a strong correlation between engaged employees and satisfied patients. 2. Kaizen awards for clinics showing great results in ‘the Touch’ process. Diaverum’s values and the Touch programme are both based on encouraging employee involvement. The purpose of kaizen is to improve processes and increase the value for our patients and staff. The kaizen awards reward clinics that truly embrace the kaizen spirit. Employee-related disclosures In order to conform to the EU directive 2014/95/EU on non-financial disclosure, Diaverum has initiated employee-specific data collection. In 2018, the focus has been on collecting baseline data to get an accurate picture of employee-related affairs within Diaverum. The data collected in 2018 will be used to further improve employee-related disclosures at Diaverum. Diaverum is highly committed to offering equal employment opportunities, maintaining high levels of employee engagement, and offering training and education oppurtunities in all countries where we operate. Social KPIs 1. PATIENT SATISFACTION Measured through the patient satisfaction surveys carried out bi-annually. 2. PATIENT EDUCATION Patients at Diaverum must be offered access to the d.ACADEMY. 3. EMPLOYEE ENGAGEMENT Measured through the patient satisfaction survey, on a five-point scale. 4. WORKFORCE BY COUNTRY A baseline measure for the workforce/gender ratio across the group has been carried out for improved employee related disclosures. 5. GENDER RATIO BY COUNTRY A baseline measure for the workforce/gender ratio across the group has been carried out for improved employee related disclosures. DIAVERUM AB SUSTAINABILITY REPORT 2018 HYLLIE BOULEVARD 39, SE-215 37 MALMÖ, SWEDEN, PHONE +46 46 287 30 00, INFO@DIAVERUM.COM, WWW.DIAVERUM.COM, COMPANY REG. NO 559140-5344
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Social, our KPI performance Diaverum countries
Patient satisfaction, %
Patient education programme
Employee engagement
Employee, training, and education, %
Argentina 87.4 3.46 90.1 Brazil 88.7 3.68 100.0 Chile 90.1 3.89 100.0 China – 4.06 75.0 France 82.9 3.57 100.0 Germany 88.6 3.42 100.0 Hungary 92.8 3.72 100.0 Italy 92.6 3.86 100.0 Kazakhstan 94.4 4.09 100.0 Lithuania 95.1 4.08 100.0 Poland 90.1 3.49 100.0 Portugal 94.5 3.94 100.0 Romania 96.2 4.18 100.0 Russia 92.9 3.76 80.0 Saudi Arabia 95.7 3.70 88.0 Spain 88.6 3.65 100.0 Sweden 89.1 3.54 80.0 United Kingdom 86.9 3.65 98.5 Uruguay 90.6 3.42 81.0
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Employee-related disclosures N EDE SW
INA
UNITE
ENT A RG
URUGUAY
D KIN
G D OM
Our workforce by country
BR A
AIN SP
ZIL
CHI LE CHIN
A
FRANCE
SAUDI ARABIA
N GERMA
HUN
Y
GA R
Y
RU S
SI A
AND P OL
PORTUGAL
ZA
LI T
NIA
HU
MA
KA
RO
AN IA
KH
ST AN
LY ITA
Gender ratio by country
80
60
40
20
Male Female UA Y
M DO
UG UR
KI NG
ED EN
D
SP AIN
SW
UN IT E
SA
UD IA
RA
BI A
IA SS
NI A MA RO
RU
AL UG
PO
RT
ND LA PO
AN IA HU
LI T
ST AN
LY
KH
ITA
ZA KA
Y AR NG HU
MA
NY
CE AN FR
CH IN A
CH ILE
ZIL BR A
GE R
AR
GE N
TIN
A
0
DIAVERUM AB SUSTAINABILITY REPORT 2018 HYLLIE BOULEVARD 39, SE-215 37 MALMÖ, SWEDEN, PHONE +46 46 287 30 00, INFO@DIAVERUM.COM, WWW.DIAVERUM.COM, COMPANY REG. NO 559140-5344
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Governance Approach Through policies that apply to internal and external stakeholders, Diaverum ensures that the highest standards and respect for human rights are maintained in all of Diaverum’s business transactions. As service providers, we pay particular attention to our third party and external stakeholders, to ensure we do not do business with an entity/person that may act in breach of our company’s code of conduct. We monitor our performance with respect to human rights mainly through our supplier code of conduct and different human resources policies which are binding for all our employees. Activities 1. All critical suppliers to Diaverum are audited on the basis of the supplier code of conduct. This code evaluates suppliers on the basis of traceable, social, and ethical performance. 2. Dedicated policies, such as anti-harassment, equal employment opportunities, and anti-bribery, are fully implemented, company wide. 3. GDPR is fully implemented in all Diaverum countries and data protection officers have been identified at a country level. The implementation was ensured through trainings that were carried out by the chief data protection officer in the corporation as well as in all countries. As a result, all our employees understand the effects that GDPR has on our daily business activities and the importance of compliance. Social KPIs 1. CODE OF CONDUCT/ ANTI-CORRUPTION POLICY Monitored through the acknowledgement receipts database on the intranet. 2. QUALITY MANAGEMENT SYSTEM Implementation of the ISO 9001:2015 standard. 3. LEGAL REGISTER All countries must ensure that the management teams are aware of changes in local laws and regulations. 4. DATA PROTECTION Implementation of the GDPR.
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Governance, our KPI performance Diaverum countries
Code of conduct anti -corruption policy
Argentina Brazil Chile China France Germany Hungary Italy Kazakhstan Lithuania Poland Portugal Romania Russia Saudi Arabia Spain Sweden United Kingdom Uruguay
Quality management system Legal register Data protection
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Supplier code of conduct Responsibility through our supply chain As one of the world’s leading renal care providers, Diaverum wants to offer attractive services without compromising on quality, service requirements, human rights, working conditions, or the environment. This is reflected in Diaverum’s evolving relationship with its suppliers. The Diaverum code of conduct for suppliers is based on the principles of international standards such as the Universal Declaration on Human Rights, the core conventions of the International Labour organisation (ILO), the OECD guidelines
for multinational enterprises, and the ten principles of the UN Global Compact. The code of conduct stipulates the minimum requirements that Diaverum’s suppliers must respect and fulfill within their own operations and within their supply chain. In 2018, all of Diaverum’s corporate suppliers have signed the code of conduct for suppliers!
The principles of our supplier code of conduct • • • • • • • • • • •
Compliance with legal requirements. Regular and voluntary employment. Freedom of association and right to collective bargaining. Fair and equal treatment. Fair remuneration and benefits. Decent working hours. Safe and healthy workplace. No child labour. Bribery and corruption not allowed. Caring for the environment. Implementation and monitoring.
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Key company policies Diaverum has an integrated approach when it comes to company policies. It is for this reason that many of the KPIs in our CSR programme are, in one way or the other, included in multiple policies currently in place throughout Diaverum. Company policies are made available on the Diaverum intranet for all countries and where needed acknowledgement receipts, such as the code of conduct and supplier code of conduct acknowledgement receipts, are collected and monitored to ensure the policies are read, understood, and observed by all our internal and external stakeholders. We are diligent about our impact on the environment through resource consumption and therefore have policies regarding water quality in clinics, an environmental objectives and targets policy, as well as a waste management policy, which are all applicable group-wide. As service providers, we also ensure that our key suppliers maintain an environmentally sound approach, something we include as part of our supplier code of conduct. Our social and employee matters are also governed by numerous policies such as our corporate social responsibility policy, which also governs the process of materiality assessment to ensure
our KPIs remain effective and monitored. To safeguard employees at Diaverum, we have implemented the Diaverum code of conduct, the whistleblowing policy, the anti-harassment policy, and the equal employment policy, to list a selected few. These policies ensure that the workplace is safe for all, while inculcating the values of a rich company culture. Diaverum respects globally accepted human rights and promotes them within the company through policies such as the third party integrity management and the supplier code of conduct. We have laid out our most integral values in these policies, which apply globally to all employees and external stakeholders directly involved in business with Diaverum. Governance in Diaverum is maintained through its policies on risk management, conflicts of interest, business gifts and gifts from patients, anti-corruption, and anti-bribery. These policies are integrated into the on-boarding for new employees and also refreshed through online trainings and sessions for existing Diaverum employees on a regular basis.
Anti-corruption and anti-bribery Preventing corruption and the practice of bribery is not just a statement, but an integral part of Diaverum and is fundamental to our investors. Diaverum ensures its stand against bribery and corruption through the code of conduct, which applies to all its employees, but also to third parties who perform services for or on behalf of Diaverum. The Diaverum code of conduct is a product of policies that discourage practices such as corruption and bribery. The code of conduct is deeply rooted in the organisation al culture and employees are made aware of the implications of breaches of the code when they begin their employment. Additionally, we have completed the implementation of complementary polices such as the third party integrity management and conflicts of interests policies. All employees have to acknowledge by signature that they have read and understood the code of conduct, the anti-corruption policy, and the business gifts
and gifts from patient policy and that it is their responsibility to keep themselves updated on the valid version. We ensure internal control through a monitoring plan and internal audits supported by training for employees at the management and nursing levels, appointment of compliance managers locally, and awareness building through presentations in meetings, newsletters, and circular emails. Bribery and corruption risks remain paramount for Diaverum and will be controlled through the complementary internal control and compliance auditing. We also believe in trusting our employees to voice their concerns when the code of conduct has been violated. This can be done through our whistleblowing hotline, which is monitored by the corporate quality and compliance department.
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d.ACADEMY E-learning • • •
The d.ACADEMY delivers world-class education via our virtual “web-based” courses. An integral part of the d.ACADEMY is the mandatory code of conduct e-learning. The participation rate of the e-learning is monitored globally. To ensure complete understanding of the code of conduct, our e-learning was translated into six languages in 2018!
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Enterprise risk management Enterprise risk management at Diaverum is in place since 2017. It is a strategic business tool that adds value through proactive risk identification, monitoring, and mitigation. Risk management in Diaverum is a robust and thriving mechanism which enables the identification of potential industry risks. The forward-looking nature of the mechanism effectively detects gaps in our risk management, allowing us to rapidly react to possible risk situations and take countermeasures to ensure seamless continuity of business. Diaverum uses an “umbrella approach” for enterprise risk management. A protective risk register formulated at the corporate level is cascaded to the countries as a binding element of country risk management. Diaverum’s approach allows local adaption to govern key country risks. The risk policy sets instructions across Diaverum regarding how to identify, analyze, assess, evaluate, record, and mitigate risks which affect the business functions and, ultimately, Diaverum. The risk management culture in Diaverum needs to be further strengthened to increase its benefits to the group. In 2018, we have been able to monitor, report, and mitigate our major risk areas, as well as identify risk areas that need better management in 2019. Crisis handling and renationalization of private healthcare are two such risks.
Diaverum believes in continuous improvement and sees that the risk management process will become essential in the years to come with an increased sense of risk ownership with Diaverum i.e., corporate, countries, and through external sources. The risk management and corporate social responsibility strategies in Diaverum are intertwined and have a synergizing effect. The risks defined in the global risk register become important considerations in relation to our CSR KPIs. Financial risks, such as fraud and gross misconduct, are managed through our code of conduct and anti-corruption policiy. Staff acquisition and retention is managed through multiple CSR KPIs such as employee engagement, employee training, and education. Additionally, operational risks, such as supplier evaluations, management, and referral management, are addressed through supply chain management and quality management systems in Diaverum CSR. There is an increasing need for innovative measures as per the leading trends in the healthcare industry, while emphasising issues that are key to Diaverum. We must focus on the critical risks being faced by Diaverum and act proactively to ensure business runs smoothly.
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LIFE ENHANCING RENAL CARE SUSTAINABILITY REPORT 2018 In case of any questions, please contact, Fajar Hamid Atta, specialist, risk and sustainability, e-mail fajar.hamidatta@diaverum.com phone +49 89 452 444 107, mobile +49 172 394 9068, fax +49 89 452 444 300. HEAD OFFICE Diaverum, Hyllie Boulevard 39, SE-215 37 Malmö, Sweden, phone +46 46 287 30 00, e-mail info@diaverum.com visiting address Hyllie Boulevard 35. ABOUT DIAVERUM GLOBALLY Diaverum is a global renal care provider with a clear patient focus. As one of the world’s leading renal care providers we stand for excellent medical quality, renal care services, and a patient-centred research. Being product-independent also gives us the flexibility to offer individual treatments for the individual needs of our patients and by coordinating our patients’ healthcare needs, we are improving their quality of life. At the same time we are creating value in the healthcare system by optimising the use of healthcare budgets – for the benefit of the patient, and society. Our experience in renal care dates back more than 25 years, when the first dialysis clinic was established, under the former name Gambro Healthcare, defining our Swedish roots. Today, 11,000 employees care for more than 33,000 patients in 18 countries in Europe, Latin America, Asia, and the Middle East. Diaverum has its head office in Malmö, Sweden. www.diaverum.com