HealthInvestor November issue by investorpublishing

HealthInvestor UK November 2020 vol 17 • no 8

essential reading for the healthcare business

Active duty Ruth Smith and her all-female leadership group share ACG’s plans for growth

Life in the fast lane

Cyber security

Care concerns

Alantra report details growth of specialist care firms

Viral threats keep on coming

Annual ‘State of Care’ report analysed

primary care • secondary care • social care • IT • infrastructure • markets • policy ISSN 1742-884X

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UP FRONT

MANAGING DIRECTOR Vernon Baxter – +44 (0) 20 7104 2001 vernon.baxter@investorpublishing.co.uk HEAD OF DIGITAL TRANSFORMATION Sarah Hyman – +44 (0) 20 7104 2008 sarah.hyman@investorpublishing.co.uk REPORTER AND SUBEDITOR Charles Wheeldon – +44 (0) 20 3762 2556 charles.wheeldon@investorpublishing.co.uk SALES MANAGER Grace Mackintosh – +44 (0) 20 7451 7067 grace.mackintosh@investorpublishing.co.uk SENIOR EVENTS MANAGER Nicola Jones – +44 (0) 20 3746 2613 nicola.jones@investorpublishing.co.uk EVENTS MANAGER Gabriele Gineviciute – +44 (0) 20 3746 2615 gabi.g@investorpublishing.co.uk MARKETING EXECUTIVE Anum Hussain – +44 (0) 20 7104 2000 anum.hussain@investorpublishing.co.uk PRODUCTION MANAGER Jeremy Harvey – +44 (0) 20 7451 7053 jeremy.harvey@investorpublishing.co.uk DESIGN & PRODUCTION EXECUTIVE Craig Williams – +44 (0) 20 3762 2254 craig.williams@investorpublishing.co.uk PUBLISHER Harry Hyman FOLLOW US ON TWITTER @HealthInvestor

HealthInvestor is published 10 times a year by Investor Publishing Limited, Greener House, 66-68 Haymarket, London, SW1Y 4RF. The content of HealthInvestor is for your general information and use and is not intended to address your particular requirements. In particular the content does not constitute, nor does it purport or intend to constitute any form of advice, recommendation, representation, endorsement, promotion or arrangement by HealthInvestor Ltd and is not intended to be relied upon by readers in making (or refraining from making) any specific investment or other decisions. Appropriate independent advice should be obtained before making any such decision. Any agreement made between you and any third party named or otherwise referred to in the HealthInvestor publication is at your sole risk and responsibility. Any information published in HealthInvestor may have ceased to be current by the time you read it. Those responsible for the publication of HealthInvestor and/or the authors of articles contained therein may on occasion have an interest in the shares or options, futures or contracts for differences relating to shares in companies referred to in the publication. Such interests are disclosed on an issue by issue basis to the extent required under the Financial Services and Markets Act 2000 (Financial Promotions) Order 2001.HealthInvestor is a trademark of Investor Publishing Limited © Investor Publishing Limited 2019

ISSN 1742-884X

Shelter from the storm

n a year of profound challenges – across both society and the investment world – resilience has arguably been the most valuable commodity in 2020. Covid-19 and our attempts to control it have torn apart business plans, stymied growth and left organisations in a permanent state of flux as they react to ever-changing circumstances. In this environment, firms that have been able to block out the noise and focus on their core proposition have commanded a premium – and in the world of UK health and social care, nowhere is this more apparent than the specialist care sector. In our November issue, we hear from the all-female management team of Active Care Group (page 24) – one of the fast-growing investor-backed groups looking to consolidate and further professionalise this specialist care sector. In a month that saw the acquisition of Exemplar Healthcare by Ares Management Corporation, Heathcotes Group team up with Civitas Investment Management and Envivo Group and Outcomes First Group acquire Bryn Melyn Care, we publish an exclusive report from the investment bank Alantra (page 32)

that details the 50 fastest growing specialist care firms. What’s clear from the 2020 report is the essential nature of the care provided by these operators. Societies are often judged by how they care for their most vulnerable individuals – and as the pandemic shifted our criteria for how that is defined, the specialist care sector’s performance has been exemplary. What also comes through in the analysis is the growing importance of technology and how it is used. 2020 may well be remembered as a watershed moment in terms of our relationship with technology – particularly in relation to how businesses function and teams communicate with each other. There have been a number of pioneers in health and care – organisations that have embedded technology into their processes and their value proposition – but as we (hopefully) come out of the pandemic it is clear this will have to be norm, rather than the exception. n

Vernon Baxter, managing director, Investor Publishing

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HealthInvestor UK • November 2020

CONTENTS

news Politics and policy

Exclusive: Alantra Specialist Care Fast 50 EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

6-8

ALANTRA SPECIALIST CARE FAST 50 Rank 1

Acute care Social care Real estate Medical technology

9-11 111-12 13-16 17-19 20-23

Technology

Activity

93.6

East Midlands

Experienced provider of residential care for adults with learning disabilities and associated complex needs

57.4

West Midlands

Innovative provider of specialist education and care for children, young people and adults with special needs

50.5

South West

Specialist care provider for individuals with forensic backgrounds, learning difficulties and mental health needs

Central

Supporting young adults with learning disabilities, complex needs, mental health conditions and problems with addiction

Greater London

Specialist schools for children with autism

5 6

Heathcotes Group*

2 Year CAGR (%) Region

Aurora Care & Education Bradbury House

Covid-19

Company

2 3

Glenholme Healthcare

49.2

Eagle House Group

39.0

Cornerstone Healthcare

36.1

South West

Horizon Care & Education

33.0

West Midlands

Dolphin Homes

32.0

South West

Orbis Education & Care

The Esland Group

31.8

Specialist nursing homes focused on caring for people with complex neurological, physical and mental health needs Market-leading provider of specialist care for children and adolescents Specialist care provider for adults with learning difficulties, challenging behaviours and complex health needs

Wales

Provider of schools, residential homes and facilities for children and adults with a diagnosis of autism

30.4

East Midlands

Behavioural management specialists who deliver bespoke, individualised packages of care to young people

Cuerden Care

27.9

North West

Specialist care for complex dementia and mental health needs

Harbour Healthcare

26.9

North West

Specialist residential services, including mental health care and young person's disability care

Compass Community

26.2

East Midlands

Krinvest Care

24.3

Greater London

Thomas Owen House

23.3

North East

Specialist nursing care home providing high quality, continuing care for people who have long term mental health problems

Select Health Care

22.8

West Midlands

Diverse range of specialist care centres providing 24-hour care for mental health, learning disabilities or brain injury needs

Witherslack Group

21.9

North East

Provider of specialist education and care for young people with social, emotional and mental health needs

Precious Homes

21.6

Greater London

Empowering people with learning disabilities, autism and other complex needs

Midway Care

21.6

West Midlands

Provider of services for people with learning disabilities and associated complex needs

Accomplish Group

21.3

West Midlands

Kisimul Schools Group

20.8

East Midlands

Hatzfeld Care

20.3

East Midlands

Residential care for adults with varying needs such as Asperger's, Schizophrenia or eating disorders to age-related illnesses or dementia

Exemplar Health Care*

20.2

North East

Leading provider of specialist nursing care for adults with complex needs and challenging behaviour

Eleanor Health Care

19.6

Greater London

Provider of a range of care services including residential care homes, supported living facilities and mental health care

New Forest Care

19.1

South West

Residential childcare service to children and young people with complex needs (social, emotional, mental health and behavioural)

Kedleston Schools

19.1

East Midlands

Holmleigh Care Homes

18.9

West Midlands

Sonnet Care Homes

18.4

South East

High-end residential nursing care for the elderly and complex dementia patients

Pebbles Care

17.8

North East

Provider of residential care and education for young people

Bramley Health

17.5

Greater London

Specialist health and social care provider supporting individuals with complex and challenging needs

Leading provider of fostering services, children’s residential care and schooling Independent rehabilitation service for people with complex mental health needs including acquired brain injury

Specialist support for adults with autism, mental health needs and acquired brain injuries Specialist education and residential care for children or young adults with autism and associated learning disabilities

Provider of care, education and support services for children with emotional, behavioural and learning disabilities Provider of essential residential care, supported living and domiciliary care services to adults with a varied range of disabilities and challenges

Continue to 31-50

HealthInvestor UK • November 2020

▶ 35

Alantra Specialist Care Fast 50 32 The latest Alantra Specialist Care Fast 50, published annually by global mid-market investment bank Alantra, reveals a robust sector, with operators proving resilient during the Covid-19 pandemic

Women in management Clean air for social care 38 Technology in the care sector is a growing trend, but as climate awareness intensifies and we learn to live with coronavirus, its use will become increasingly important. Naeem Walji, principal at 4th Wave Technology, distributors of clean air technology, discusses how new technologies can improve the lot of care home residents

Cyber security

Atop the glass ceiling 24 Kindness is at the core of the culture being built by the all-women management trio driving specialist healthcare business Active Care Group. HealthInvestor talks to the trio about their plans for the business, and overcoming challenges for women in healthcare management

Hospital construction

Covid is not the only virus 44 While coronavirus has caused the healthcare industry all manner of pain, the viruses spread by cybercriminals also remain a constant threat, warns Keith Glancey, systems engineering manager, Western Europe at Infoblox, an IT automation and security company based in California’s Silicon Valley

Hospitals for the future 40 With the government committing £3.7 billion to building 40 new hospitals by 2030, the infrastructure supporting the overburdened UK health system needs to be adaptable to meet overwhelming demand, says Tony Wells, managing director of offsite construction firm Merit

finance Deals The month’s latest transactions

executive moves 46

Executive moves

HealthInvestor UK • November 2020

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NEWS

Politics and policy

Care leaders react to CQC annual State of Care report The Care Quality Commission has published its annual State of Care report which examines trends, shares examples of good and outstanding care, and highlights where care needs to improve. This year’s report starts by considering the quality of care prior to Covid-19 before subsequently examining the impact of the pandemic and the response of the system. It notes that 80% of adult social care services were rated as Good and 5% as Outstanding (in 2019 the figures were 80% and 4% respectively). However, among mental health services the level of poor care in inpatient wards for people with a learning disability and/or autistic people continued to rise, Also, the overall proportion of services rated as Inadequate rose from 4% to 13%, emphasising the need to deliver on the Transforming Care target to reduce the total number of patients with a learning disability and/or autism within inpatient units by 35%. Professor Martin Green, chief executive of Care England, the representative body for independent providers of adult social care, said: “Although this year’s State of Care report makes a raft of important recommendations including a new deal for the adult social care workforce, it is disappointing to note that the

report is predominantly a narrative of events which spanned the Covid-19 pandemic, as opposed to a critical reflection of what must change. This is underscored by the lack of internal reflection from CQC as to its handling of the crisis.” “The Covid-19 pandemic has demonstrated the interdependence of the health and social care system and the organisations that operate across the system. The regulator must now reflect upon its own role and look to facilitate the delivery of safe, quality and sustainable Covid-19-proof care in the future.” Dawn Hodgkins, director of regulation at the Independent Healthcare Providers Network, added: “We welcome the CQC’s State of Care report which shows that almost 90% of independent acute services are rated Good or Outstanding with clear improvement over the last year in all of the CQC’s key domains – demonstrating the sector’s commitment to providing the best possible patient care. “As the CQC rightly highlights, it’s vital that both Covid and nonCovid patients are able to access the care they need. Patients should be absolutely reassured that the independent health sector is open for business, and that if you’re concerned about your health, you shouldn’t hesitate in coming forward and getting the care you

Ian Trenholm, CQC

need.” The King’s Fund, the charity working to improve health and care in England, also issued a statement. Its chief executive Richard Murray said: “The most concerning aspect of this new report is that few of its findings come as a surprise. Health inequalities were already widening before the pandemic and for several years this report has provided an annual warning to governments about the crisis in adult social care. Yet still we wait for the government to act on the long-standing promises of reform.” The Care Provider Alliance brings together the 10 main national associations which represent independent and voluntary adult social care providers in England. The chair of the organisation Kathy Roberts said: “Care providers are to be congratulated

for their remarkable achievements: 85% have achieved a Good or Outstanding CQC rating despite the huge pressures they have faced, but they cannot be taken for granted. “Covid-19 has revealed, more starkly than ever, the lack of parity in the support given to the NHS and that given to social care. Paradoxically it has also highlighted the absolute inter dependence of the two systems. CQC’s report provides clear evidence and recommendations for improvement. “Through the Care Provider Alliance’s work with care services, the NHS, central and local government, we have seen how working together as equal partners – sharing expertise and experience – makes a real difference. As the alliance of the main trade associations working across the adult social care sector, the CPA is calling for: a long-term funding and support solution to ensure that the social care market is sustainable; an equal place for care providers at local and national planning and decision-making, alongside our health and local authority colleagues; and recognition and reward for our highly-skilled care workforce. “In return, the CPA and our members will continue to work constructively with our colleagues across government and social care national agencies. We strongly welcome CQC’s rigorous and valuable report and recommendations.”

More patients choose to go private The continuing coronavirus crisis and lengthening NHS waiting times is causing more people to pay for private treatment according to a report in The Guardian. Data shows that more people are self-funding treatment or buying private health insurance. Compare The Market revealed an average 40% increase in yearon-year private health insurance

sales over the past seven months. Kamran Altaf, the company’s head of life insurance, said: “We believe that during a time of considerable uncertainty, many customers value the additional reassurance private healthcare can bring.” Insurance company VitalityHealth also reported increased inquires and sales, and London private hospital group HCA Healthcare said some self-

pay surgeries had doubled from last year. Independent Healthcare Provider Network chief executive David Hare said: “I think it’s a fairly general trend across the country that more patients are looking to fund their own care, and I don’t think that should come as a huge surprise. There’s been a steady growth in that over recent years anyway and we know that

it is becoming more challenging to get prompt access to care in the NHS.” Tim Gardner from The Health Foundation thinktank said: “Covid-19 has not impacted everyone equally, and there is clearly a risk that the backlog in routine hospital treatment is going to add to those inequalities if some people are able to get treatment faster because they’re able to pay.”

HealthInvestor UK • November 2020

NEWS

Politics and policy

Social care needs to fill more than 100,000 vacancies The adult social care sector in England needs to fill around 112,000 job vacancies on any given day according to a new report published by Skills for Care, the strategic body for workforce development in adult social care in England. Using data provided by employers to the Adult Social Care Workforce Data Set (ASC-WDS), the annual ‘The state of the adult social care sector and workforce in England’ report showed there had been a slight reduction in job vacancies, but employers still needed to find thousands of new workers. Skills for Care chief executive Oonagh Smyth said: “Any reduction in the number of vacancies is welcome, but we need to attract more new recruits who have the right values to fill posts that offer long-term careers where you can make a difference in people’s lives every single day. “Once people have discovered the personal satisfaction on offer in social care, we need to keep them by investing in pay, their professional development, and creating clear career pathways. We cannot miss this opportunity so we must continue to invest in our front line staff and dedicated leaders and managers who have made such a difference in keeping people safe and well during the pandemic. “We will use the quality information in this report to make long-term workforce decisions informed by solid data in what is a critical period of change for a workforce bigger than the NHS.” Minister of state for care, Helen Whately, said: “We cannot thank our care workers enough. They have worked tirelessly through the pandemic to give compassionate care to our loved ones. No one should underestimate the skills and commitment of care workers. I welcome this report giving us more insight into our social care workforce. It underlines the

HealthInvestor UK • November 2020

challenge for social care employers to recruit and retain staff – and the importance of investing in training and career opportunities. “Recognising the recruitment challenge, we have run a national recruitment campaign highlighting the important work care workers do and launched the ‘Join Social Care’ online recruitment tool. We’re also working with DWP to promote adult social care careers to jobseekers. “We are supporting care providers through the pandemic with the costs of pay for staff required to self-isolate and so no care worker should lose income as a result of the requirement to only work in one location, with the £1.1 billion infection control fund. As we come through the pandemic I want to see

evermore appreciation of the care workers we rely on to look after the most vulnerable in our society.” The report also reveals the percentage of days lost to sickness in adult social care across England during the pandemic increased to 7.5% between March and August compared to 2.7% pre-Covid-19. The staff vacancy rate for employers updating ASC-WDS data between March and August was 7%, down from the pre Covid-19 rate for those employers which was around 8.6%. CQC chief inspector of adult social care Kate Terroni said: “We welcome Skill for Care’s report. For years, we’ve been calling for a better funding settlement for adult social care. Last year, we warned

that the continuing lack of a longterm sustainable solution for adult social care was having a damaging impact on the quality and quantity of available care. “Our latest ‘State of Care’ report makes clear that these issues need to be urgently addressed and also calls for a new deal for the care workforce, which develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training, and supports appropriate professionalisation. “We’re committed to ensuring safe, effective, compassionate and high-quality care and are working with the Department of Health and Social Care and others to support the care system through winter.”

NEWS

Politics and policy

Unison says Covid-19 vaccine roll-out must not involve private firms Public service union Unison called on the government to ensure the roll-out of any Covid-19 vaccine is managed entirely by the NHS and public bodies, adding that it opposed the involvement of private firms and the use of unqualified staff. In its response to a consultation by the Department of Health and Social Care on changes to medicine regulations, the union has raised concerns about allowing non-healthcare professionals to administer any vaccine. Unison stated that any mass vaccination programme must be delivered and supervised by healthcare professionals. Unison also called for some experienced groups such as operating department practitioners to be added to the list of health professionals who can administer vaccines. Sara Gorton, Unison head of health, said: “The government’s use of private companies to run test and trace has been a disaster.

Any more mistakes on that scale will simply allow the virus to continue to spread. Ministers can’t fail the nation again, they must do things differently and keep any programme within the NHS and public health bodies. “The public needs total confidence that any vaccine is going to be safely given, and any follow-up managed properly by the NHS. At the start of the pandemic, thousands of ex-health workers offered to come back to the NHS and help in its hour of need. But some were never contacted. “Now is the time to ensure their expertise is put to good use in administering any vaccine. The government should be planning for this now to avoid any repeat of the test and trace shambles. In the meantime, ministers should also be doing all they can to ensure there’s a high uptake of the flu jab and that it’s widely available to minimise the impact on the NHS over the next few months.”

Bupa’s Paula Franklin to join Black Women in Leadership Network

The Black Women in Leadership Network (BWIL) has appointed Bupa Group’s chief medical officer Dr Paula Franklin (pictured) to its advisory council. Launched in July this year BWIL is a network of black female professionals with a mission to increase the representation of competent black women in leadership and decision-making positions in corporate organisations across various sectors in the UK. BWIL says it will harness the experiences of senior black female leaders, decision-makers and the expertise of its network, partners and alliances to inspire and empower the next generation of black female leaders. Along with the other members of the advisory council, Franklin will play a key role in providing guidance to the BWIL board and

management team and in attracting new members to the network. Dr Franklin said: “Given the year we’ve had, there is no better time to prioritise the leadership development of black women in the UK. I am delighted to support BWIL Network in transforming the narrative and setting an example for women at all stages of their careers.” Abi Mustapha-Maduakor, co-founder of BWIL added: “We’re delighted to have Dr Paula Franklin on board as an advisory council member. We look forward to her guidance and counsel as we develop BWIL further. I’m especially glad that our members will be able to be influenced by a woman whose career is an example of dedication to excellence and inspirational leadership.”

HealthInvestor UK • November 2020

NEWS

Covid-19

Boots UK has launched an in-store Covid-19 testing service, offered to those without Covid-19 symptoms. The service is already available in 10 stores located in London, Birmingham, Manchester, Edinburgh and Glasgow for customers travelling to the UAE, with plans to roll out a wider service to more than 50 stores across the UK over the next few weeks. Boots stated that depending on demand and feedback, the launch may extend to 200 stores over the coming months. The service is available as a private pre-flight testing service for customers who require a test before travelling abroad, or for people who plan to visit their families.

boots-uk.com/media-centre

Boots stores launch Covid-19 testing service

Seb James, managing director of Boots UK and Ireland said: “Boots has supported the government’s Covid-19 testing programme from the very start and offering this

new in-store service is the next step in our efforts to fight against the pandemic. We hope that by offering this testing option in local community stores, Boots

can help ease pressure on the NHS and the government by providing additional access to testing and crucial reassurances for people across the UK.”

Covid-19 drug to be trialled in care homes Researchers at the University of Oxford are starting a new study to explore the effectiveness of the anti-tumour necrosis factor (anti-TNF) drug adalimumab as a treatment for patients with Covid-19 in care homes. The AVID-CC trial, which will be conducted by Oxford Clinical Trials Research Unit (OCTRU), will enrol up to 750 patients from community care settings throughout the UK. Residents of care homes were particularly hard hit by the first wave of Covid-19 in the UK and other countries. Research has identified limited treatments that are effective for patients in hospital with Covid-19, but no effective treatments have yet been identified for those in community care settings, many of whom may have severe symptoms. Anti-TNF drugs have been in widespread use for more than 20 years for a range of inflammatory conditions. Recent studies of patients with Covid-19 have shown that patients already taking anti-

HealthInvestor UK • November 2020

TNF drugs for inflammatory bowel disease and inflammatory arthritis are less likely to be admitted to hospital. The same was not observed for patients taking other anti-inflammatory drugs. The availability of biosimilar versions of biological treatments has been an important step forward in driving down costs, making the anti-TNF treatment affordable and accessible if the trial is successful. “The observed potential of anti-TNF drugs has prompted us to conduct a study in patients in community care to see whether treatment with the anti-TNF drug adalimumab reduces the progression to severe or critical disease or death in Covid-19 patients,” said Duncan Richards, professor of clinical therapeutics at the university of Oxford. “We think anti-TNF drugs could be an important treatment for Covid-19 and are very grateful for the support of the Covid-19 therapeutics accelerator, which will allow us to find out. I would also like to thank Sandoz for provision

of adalimumab. We are also looking forward to working with Sensyne Health to collect additional information on patients’ clinical status through their app. Subject to the necessary approvals we hope to start recruiting patients soon.” The study will be delivered by hospital at home teams around the UK. Hospital at Home is a relatively new service in which hospital-based teams reach out into the community to deliver more complex treatment interventions while avoiding the need for admission to hospital. This study sits therefore in a unique niche between the existing national platform therapeutic studies Principle (primary care) and Recovery (hospitals). Prof Dan Lasserson, professor of acute ambulatory care at the university of Warwick who also works as a clinician in a Hospital at Home service for Oxford University Hospitals NHS Foundation Trust, said: “This is the first drug trial designed for Acute Hospital at Home services and it could not come at a more important time.

We need to determine the best treatments for Covid -19 that can be given to older people with frailty who are in care homes or living in their own homes. This grant from the Covid -19 Therapeutics Accelerator not only helps us determine whether anti-TNF drugs could improve outcomes, but the trial itself will help the development nationally of acute hospital at home services.” Adam Gordon, professor of care of older people at the university of Nottingham, and consultant geriatrician, said “We have seen lots of examples, earlier in the Covid pandemic, of older people in care homes being disadvantaged regarding access to treatments simply because of where they live. This study is an exciting opportunity to open up promising treatments to this most vulnerable and underserved group of people. It is an important step forward as we investigate how to manage Covid, and more generally in terms of bringing research to the frailest older people.”

NEWS

Covid-19

PocDoc launches ten-minute ten-quid Covid test Digital healthcare business PocDoc is launching a workplace Covid-19 testing service which it says is 98.8% accurate, targeted at employers who want to test their workforce for the virus. The finger prick test produces results in 10 minutes and the cost is £10 per test. The test reveals the presence of early-onset antibodies, or if the person has been free of Covid-19

up until five to seven days prior to the test. Each test provides an individual with a unique QR code that is uploaded to the PocDoc cloud, providing information for employers. The tests are manufactured in the UK by BioSure and are CE marked and approved by the Medicines and Healthcare products Regulatory Agency. The testing, however, must be administered by

a healthcare professional, which can be provided by PocDoc if the organisation doesn’t employ one in-house. PocDoc founder and chief executive Steve Roest, said: “Everyone is aware of the extent of the testing problem and we believe we have found a solution – just register on the website and we will arrange to come round and test your teams. We are also

encouraging the government to take up our offer to use our service and we hope that public health bodies will take up our offer to share our data to help the national effort. Our service is quick, reliable and safe and extremely costeffective – you can get tested, store, track and evaluate data and return employees safely and securely to the workplace, all for as little as a tenner a head.”

Oxford University spin-out secures £400k government grant to help Covid fight Navenio, a provider of locationbased technology that supports workforces, has received a £400,000 grant from the UK government and Innovate UK to help address the impact of Covid-19 on hospitals. Navenio’s technology allows the monitoring of workforces via smartphone and can be used to help address logistical issues associated with managing Covid-free areas in acute settings. Ian Campbell, executive chair of Innovate UK said: “With Covid-19 still an ever-present challenge in the UK, businesses like Navenio have stepped up to the challenge and produced technology which aims to solve these issues.”

Tim Weil, chief executive of Navenio, said: “We are delighted to have received this funding from UKRI and Innovate UK. With Covid-19 still presenting significant challenges to healthcare systems this funding will help us to continue dramatically improving patient flow within hospitals around the UK by prioritising tasks for individual teams. With Covid-19 cases rising it is crucial that hospitals are prepared and have access to the best technology to assist them during these tough times.” Navenio was spun out of the University of Oxford in 2015 and currently has a team of more than 60 people.

Nursing home workers demand a shield against Covid-19 Nursing homes workers’ labour unions from all over the world joined forces on 1 October to demand a ‘shield against Covid-19’ to improve and protect the care sector workers and the people they care for. Christy Hoffman general secretary of UNI Global Union, said: “Nursing home workers and their unions from every corner of the planet are rising their voices to demand dignity on the job and the tools and resources to

build a shield against Covid-19. We have seen first-hand how the

coronavirus is sweeping through nursing homes, killing residents at

unprecedented rates and infecting caregivers too. “It is heart breaking and frustrating, but we know that we can do better at keeping them safe if caregivers have the right tools and support. Governments and employers around the world now have an opportunity to improve working conditions in long-term care by partnering with care unions and instilling a new level of humanity and dignity to the sector.”

HealthInvestor UK • November 2020

NEWS

Acute care

Medica acquires Global Diagnostics Ireland for €16m UK-based teleradiology firm Medica has acquired Global Diagnostics Ireland from private Irish healthcare group Centric Health for an initial cash consideration of ¤16 million. Medica acquired its Irish counterpart on a cash-free and debt-free basis in a move that the business said would “expand its customer base” and help it diversify into ophthalmology, where Global Diagnostics Ireland has a 50% market share for the provision of diabetic retinopathy screening services on behalf of the Irish health service. Dr Stuart Quin, chief executive of Medica Group, said in a statement: “This highly complementary acquisition of Global Diagnostics Ireland aligns with, and significantly accelerates, our strategy to diversify Medica’s geographic reach, service offering and customer base, while being strongly accretive to earnings. Caroline Byrne, who will join the Medica executive team as managing director, Ireland, commented: “We are excited to join forces with Medica and think it will benefit all our stakeholders. Ireland’s

teleradiology market is attractive and evolving at a pace whereby we will benefit from the processes, systems and clinical governance expertise that Medica brings. In addition to the strong business rationale for both parties, we also

see a close cultural fit between our two organisations and we look forward to continuing to develop the company for the benefit of our clients and their patients.” GDI, based in Balally, Dublin was established in 2007 to operate

diagnostic managed services, including teleradiology reporting services to support the successful growth of Centric Health’s primary care business. The company now operates at more than 50 clinical sites within Ireland, employing a team of over 140 people nationwide working alongside more than 20 Irish Medical Council certified specialist radiologists. The Irish radiology services market represents over ¤500 million of spend and demand for radiology is increasing at around 8% per annum. For the financial year ending 30 June 2019, GDI reported revenue of ¤7.4 million, an increase of 16% on the prior year, adjusted EBITDA of ¤1.5 million and profit before tax of ¤1.2 million. Alpha Helix Corporate Finance, the UK healthcare-focused advisor led by Gordon Hamilton, worked on behalf of Medica Group as exclusive buy-side corporate finance advisor on the deal. Investec also advised on the transaction.

Advanced Oncotherapy raises £7.7m

Compass Pathways closes IPO

Proton therapy specialist Advanced Oncotherapy has announced a £7.7 million equity fundraise through direct subscription. The developer of proton therapy systems said it would use the funds to strengthen its balance sheet and help progress its “Light” system so that it is fully operational with a “230MeV beam” by 2021. The latest fundraise brings the total raised by the company in 2020 to £22.6 million. The issue price represents a discount of 13% to the average closing middle-market price of an ordinary share over the past 30day period and the subscription

London-based mental healthcare company Compass Pathways has closed its initial public offering of 8,625,000 American Depositary Shares for $17 per ADS, raising $146.6 million.

HealthInvestor UK • November 2020

shares will represent, in aggregate, approximately 7.7% of the company’s enlarged issued share capital. Nicolas Serandour, chief executive of Advanced Oncotherapy, said: “We are pleased to announce this additional fundraising and we thank our new and existing shareholders for their support of the company. As we highlighted at our recent investor day, despite the delays caused by the Covid-19 pandemic we have made strong progress with construction in Daresbury and remain on track to have a fully operational Light system with a 230MeV beam, which is required to treat patients, in 2021.”

Cowen, Evercore ISI and Berenberg acted as joint bookrunning managers for the offering. Canaccord Genuity was lead manager and H.C. Wainwright & Co was co-manager for the offering.

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Acute care

Black Country Pathology Services delivers lab network Black Country Pathology Services (BCPS) has pushed ahead with an initiative to create a laboratory network to serve four trusts and delivered a go-live for its CliniSys laboratory information system. Wolverhampton-based BCPS was formed in response to a report by Lord Carter of Coles, which recommended that NHS laboratory services should be reorganised into a regional ‘hub and spoke’ model to improve quality and efficiency. It is developing a pathology network for four trusts: The Dudley Group, Sandwell and Birmingham, Walsall Healthcare, and The Royal Wolverhampton. Staff were TUPE transferred into the new organisation in October

2018, and since then the network has been running programmes of work to procure new equipment, modernise logistics, and build a new pathology extension at New Cross Hospital in Wolverhampton. In November 2018, it also decided to deploy CliniSys WinPath Enterprise as a single laboratory information management system to support communication and to standardise ways of working between the central lab in Wolverhampton and ‘hot labs’ that will handle local tests for hospitals in the network. BCPS is aiming to contribute £5 million of savings to the £200 million savings identified by the Carter Report.

Blue Zinc IT acquires Australian distributor Belfast-based Blue Zinc, a provider of solutions to the musculoskeletal (MSK) and mental health markets, has acquired Baulkham Hills, New South Wales-based Collab IT, the sole distributor of Blue Zinc’s TM3 suite of products in Australia, and has taken over full support to its

existing 150 clients in Australia. TM3 is a clinic management product for the allied health industry. Blue Zinc also offers enterprise solutions including Caseflow, a workflow and pathway management solution allowing enhanced control and

management of complex pathways and multidisciplinary teams, and Pronto, a network management and electronic data interchange tool to allow bookings, invoicing and outcomes data to flow on a real time, systemic basis. Under the transaction, all of Collan IT’s staff and support resources are transferred to a wholly owned subsidiary Blue Zinc IT (Australia). Blue Zinc says the acquisition supports its strategic expansion and global commitment to the healthcare sector. Blue Zinc’s chair KP Doyle said: “Australia represents a fantastic opportunity for Blue Zinc. We estimate the market for physiotherapy and musculoskeletal is at least the size and scale of the UK private market. The amount of spend and physio clinics per capita is well in excess of the UK and we hope to emulate our UK success in becoming the provider of choice for MSK practitioners in Australia, as we have done in the UK.” Jeremy Allen, client services director at Blue Zinc will become

board sponsor responsible for Australia. He said: “By wholly owning the distribution and support, we have been able to invest in our suite of products to better serve the Australian market. I am genuinely excited to bring new offerings to Australia such as our state-of-the-art TM3 practice management, classes management and TM3 Connect modules. This deal is a clear message to the healthcare market that we are here to help all practitioners, clinics and hospitals at a time when they and their patients need it most and on an international scale. We are also looking forward to releasing new MediPass features within TM3.” James Relph, Blue Zinc Australia general manager has transferred from Collab IT to lead the local team. He said: “Becoming fully paid up members of the Blue Zinc team is really exciting for us – we’ve had the chance to get a sneak preview of what we’re going to be able to offer and feel the wealth of new functionality will be well received by the market by both existing and new clients.”

HealthInvestor UK • November 2020

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Social care

Ares acquires specialist care firm Exemplar Private equity firm Ares Management Corporation is acquiring Exemplar Health Care from pan-European mid-market private equity firm Agilitas. Financial details of the transaction were undisclosed. Agilitas backed the buyout of Exemplar in July 2016. Exemplar provides personcentred, specialist nursing highacuity care to individuals living with complex physical and mental health needs in the UK. The company’s homes are based across Yorkshire, Humberside, the Midlands, and the Northeast and Northwest of England, and look

after adults living with mental health conditions, neurodisabilities, complex dementia, autism and learning disabilities, as well as those suffering from brain injury, spinal injury and stroke. Liam Goddard of Agilitas said: “It has been a pleasure to work with the Exemplar team and to help them have such a positive impact on the lives of so many people. The dedication of the Exemplar staff to their calling has been particularly evident in this challenging year.” John Whitehead, chief executive of Exemplar Health Care, added: “We want to thank the Agilitas team for their important contributions to

Exemplar’s work, and their relentless support of our mission to make every day better for those in our care and for their loved ones. We are now excited to begin the next step in our journey with the support of our new sponsors at Ares.” Martin Calderbank, managing partner at Agilitas, said: “Our investment in Exemplar is a clear example of our focus on supporting companies that answer fundamental human or planetary needs. The partnership between Agilitas and Exemplar has been one that was formed on having a joint, rigorous approach to the pursuit of care quality. We are

proud to say that under Agilitas’s stewardship Exemplar’s care became even better, and, through this transformation, the company has improved the lives of many people.” Advisors to Agilitas included: Macquarie Capital (sell-side corporate finance); Pinsent Masons (sell-side legal, and legal/regulatory due diligence); PwC (sell-side financial due diligence); Connell Consulting (sell-side commercial due diligence); Grant Thornton (sale and purchase agreement accounting support); Ashurst (fund legal); EY (fund tax) and Deloitte (sell-side tax).

Outcomes First Group acquires Bryn Melyn Care Children’s services provider Outcomes First Group has acquired Bryn Melyn Care (BMC) from its founder Brendan McNutt and three minor shareholders. BMC provides therapeutic residential care, independent education, and integrated clinical services for children and young people with multiple and complex needs. Established in 1985, it delivers specialist services for young people aged 7-18, from

crisis and assessment placements, through to long-term placements and preparation for independent living. The acquisition extends Outcomes First Group’s portfolio by 27 specialist residential care homes; one independent day school, one specialist home for those with learning disabilities, autism and associated behavioural needs; and two specialist residential schools. Richard Power, managing

director for Outcomes First Group education and residential division said: “I am delighted to welcome the Bryn Melyn Care team into our group. Their excellent reputation and their approach fits very well with our own proposition and vision of building incredible futures for vulnerable children and young adults in the UK by empowering them to be happy and make their way in the world. Throughout our journey, we have joined forces with

many established specialist schools and residential care homes. Bryn Melyn is a particularly exciting addition to our Outcomes First Group family.” Bob Yetzes, chief executive of BMC added: “We are very pleased to be joining Outcomes First Group, an organisation whose values and vision mirrors our own. Together we will make an even greater difference to the lives of the vulnerable children we educate and care for.”

Cera Care acquires Mears Care Scotland London-based home care innovator Cera Care has acquired Mears Care Scotland, which will add more than 1,000 staff and 12 offices in Scotland to Cera Care’s operations. The deal saw Mears Groups domiciliary care arm in Scotland integrated into Cera Care with immediate effect. As a result of the acquisition, Cera Care is creating 500 new jobs in Scotland – the vast majority of which are care roles and recruiting is taking place now with a particular focus on Dunoon, Coatbridge, East Kilbride,

HealthInvestor UK • November 2020

Prestwick, Ellon, Perth, Glasgow, Alloa, Stirling, Clackmannanshire, Bathgate, Dalkeith and North Berwick. This multimillion-pound acquisition continues Cera’s growth since it launched less than four years ago and the 500 new roles in Scotland are part of a wider drive to recruit 10,000 new staff across its entire UK business. In the first half of this year, the company provided almost two million inhome care visits. Since its inception Cera Care has raised more than $90 million in

debt and equity funding to support the company’s rapid national expansion, and it has grown into one of the largest healthtech companies in Europe. Ranpreet Grewal, finance director at Cera Care, said: “The first half of this year has reaffirmed how vital social care is across the UK as a whole. Ultimately, we want to provide as many people as possible with access to our technology. “This deal means we are able to create hundreds of roles across Scotland to help put people back to

work, provide best-in-class support to the country’s elderly community and further support of the NHS during a time of unpresented pressure. “We had set ourselves the aim of establishing a national footprint in Scotland earlier this year, and this acquisition marks a huge achievement for everyone at Cera Care. The infrastructure and talent we have been able to bring in as a result of this deal provides us with an ideal platform from which to continue our growth in Scotland and the rest of the UK.”

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Social care

Ashberry Healthcare completes MBO Care provider Ashberry Healthcare has completed a management buyout from former owners Rosegarth Investments by three members of its existing executive team. The sale was completed on 7 October. Chief executive Nigel Denny, alongside chief operating officer Susan Lovelace and chief finance officer Gary Cottrell, have acquired 100% ownership of the business and property. Denny said: “With full ownership of the business, the senior management team can now concentrate on developing our strategy as a provider of dementia residential services, operating homely, individually styled accommodation with personalised care delivered by trained and passionate staff. All three owners will continue to be hands-on, regularly visiting our homes and supporting our staff.”

Ashberry Healthcare operates seven care homes comprising: Broomy Hill and Holmer Court, in Hereford; Heathercroft and Meadowview in Warrington; Moorhouse in Hindhead; and Allt-Y-Mynydd and Blaenos House in Carmarthenshire. Denny said: “I would like to thank Gary Cottrell who has worked tirelessly alongside me in delivering this transaction whilst Susan Lovelace has continued the day-to-day running of our operations. “We would like to acknowledge the support of our corporate commercial lawyers, Tees Law, for their diligence in getting this deal across the line and Joe McDermott from Albright Dene for his advice and action in resolving some complex property issues.” Connell Consulting conducted commercial due diligence on the MBO.

Care at Home buys Westminster Homecare Home care provider Care at Home has acquired Westminster Homecare for an undisclosed sum. Care at Home was founded in 1993 and has grown organically and through a series of acquisitions providing services under several brands including Care at Home Services, Beech Tree Total Care, and Domus Live-In Care. With this latest acquisition Care at Home now employs more than 3,700 staff operating from 28 branches delivering home care, and also provides care in 18 extra care facilities. Deborah McDowell, owner and chief executive of Care at Home Services, said: “This acquisition

significantly expands the areas in which we are providing care and we will be continuing to seek opportunities to expand the areas we serve and range of care services we provide.” Care at Home Services was advised by Healthpartners Services, MHA MacIntyre Hudson Corporate Finance, CDI Global, and GMG Business, and debt financing was provided by ThinCats. Westminster Homecare was advised by Oaklins Smith & Williamson and law firm Hatstone. Care at Home has appointed Westminster Homes’ managing director Patrick Carter to its board.

iCAPS Enterprises takes on third Bluebird Care franchise

iCAPS Enterprises, which operates Bluebird Care domiciliary care franchises in Mendip and Ferndown, has taken on a third franchise, Bluebird Care Swindon. iCAPS, owned by husband and wife team Masen and Selvie Naidoo (pictured) , purchased the Bluebird Care Mendip office in 2014 and the Ferndown franchise in 2017. Katrina Simms, operations director and registered manager at Bluebird Care Swindon, said: “The transition to iCAPS Enterprises has been seen as a positive step for the Swindon business. We have a team of passionate and caring care professionals who take pride in the critical service they provide. “We are excited to be part of a growing organisation which strives

to deliver the best possible care for its customers. We are looking forward to working closely with the team in Mendip and Ferndown, as it brings exciting opportunities for our team to further develop their careers and skills and I look forward to working closely with Masen and Selvie.” Masen Naidoo, added: “Selvie and I are really excited to welcome Katrina and her team to the iCAPS family. She has built and leads a strong and caring team most of whom have been in the Swindon business for over five years. Over the forthcoming months, we look forward to integrating the teams and best practises to provide our customers with the best possible Bluebird Care experience.”

Vivo Care Choices fined for care failure Vivo Care Choices was fined almost £220,000 at Chester Magistrates’ Court on 23 October after pleading guilty to charges brought by the Care Quality Commission. The prosecution relates to Vivo Care Choices’ failure to provide safe care and treatment, which exposed an 89-year-old woman to significant risk of avoidable harm while resident

at Curzon House, a care home in Saltney, Chester. Injuries the woman sustained during a fall at the home were cited on her death certificate as a contributing factor. Vivo Care Choices has pleaded guilty to breaching Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

HealthInvestor UK • November 2020

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Social care

Hallmark hosts virtual opening for Hutton View facility Hallmark Care Homes used live streaming to open its £12 million new care home in Hutton View, Essex on 30 October. Restrictions around Covid-19 and the need for social distancing precluded a physical ceremony, with the care group using a specialist broadcast company to facilitate an event to promote the opening of the home and to host a panel discussion on dementia care. Around 300 local businesses and care professionals logged on to hear from Avnish Goyal and Hallmark’s managing director Ram Goyal, in what the company claims is the first ‘live-streamed’ opening of such a facility in the UK. Hallmark Care Homes managing director, Ram Goyal said: “I am proud of everyone who has been involved in the building and opening of the care home, including the Savista Developments team and the team involved in the grand launch. “We are looking forward to making Hutton View a part of the

The café at Hutton View Care Home community providing high-quality care for residents in the future, enabling them to live life to the full.” Chair of Hallmark Care Homes and chief executive of Savista Developments, Avnish Goyal said:

“We are delighted to have completed our second Savista project to the highest standards, incorporating the latest technology and ideas not only from the sector but from our teams and our recent innovation challenge.

“We are continuing to innovate with our pipeline of projects and we will continue to raise the bar by creating beautiful environments that enhance the quality of life for older people.

Look Ahead acquires Essex Complete Care acquires Amegreen Complex Care specialist care provider The Look Ahead charity has acquired specialist care provider Kingswood Care Services which operates five residential units in Essex. Look Ahead provide specialist care, support and accommodation services to people with a variety of needs across London and the Southeast. A charitable housing association, it currently delivers more than 20 specialist services for people with learning disabilities, including those with high and complex needs in residential care, supporting living and communitybased facilities. Kingswood Care Services is the second acquisition that Look Ahead has made in the learning disabilities sector within the

HealthInvestor UK • November 2020

past 12 months. Look Ahead says its ongoing acquisition strategy will complement its organic growth in the sector, and enable the organisation to continue to expand its learning disabilities and complex needs services across London and the Southeast. Chris Hampson, chief executive at Look Ahead said: “There is a clear fit between Look Ahead and Kingswood in terms of client gro up, service ethos and, crucially, our values. Essex is a new geographical area for Look Ahead for the provision of learning disability services and we look forward to developing close relationships with customers, their families and commissioners.”

Complete Care Holdings, a subsidiary of MC Care Holdings, has acquired Amegreen Complex Homecare, which is backed by healthcare specialist private equity investor Apposite Capital. The combined businesses provide complex homecare services to adults and children with long-term spinal injury, acquired brain injury, respiratory and other neurological conditions. The acquisition expands the geographical reach of Complete Care adding services in the Home Counties and London. Complete Care’s focus of operations up to now has been in the Midlands, Northwest and Wales. MC Care Holdings chief executive Jonathan Vellacott said: “I am

delighted to have completed the acquisition of Amegreen Complex Homecare, the fifth acquisition by MC Care Holdings. It further underpins our position as one of the largest UK providers of nurse-led complex care at home in partnership with clinical commissioning groups and the individuals we care for.” MC Care Holdings consists of Complete Care Holdings, a national provider of nurse-led complex care at home, Noble a live-in provider, and MiHomecare a domiciliary care provider. Amegreen Complex Homecare was advised by MSNI Consultancy and Spratt Endicott Solicitors. Complete Care Holdings were advised by Anthony Collins Solicitors.

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Social care

Aedifica acquires East Sussex care home European healthcare real estate investment trust Aedifica has acquired a 60-bedroom care home in Hailsham, East Sussex, due to be completed in the first quarter of next year, from luxury care home developer Hamberley Development, which is backed by Patron Capital. Under the deal Hamberley’s operating company, Hamberley Care Homes, will lease back the building from Aedifica for 25-years. The home will have en suite bedrooms, a cinema, café, bar area, a hair and beauty salon with nail bar, luxurious lounges and landscaped gardens. Additional features include a Covid-19 secure visitation suite, in-built thermal imaging technology in the entrance lobby (to ensure all visitors to the home, including staff, have their temperature taken daily) and an optimised ventilation system which ensures air in public spaces is replaced every 15 minutes. The home will also have hand washing and hand sanitising stations throughout for staff, residents and visitors. The new development will be

Hamberley Care Homes’ twelfth home. It also has a development pipeline of sites in Basingstoke, Bedford, Brampton, Bristol, Bromsgrove, Camberley, Cambridge, Dorking, Eastleigh, Enfield, Edwalton, Keynsham, Southampton and West Byfleet. The group says is also actively acquiring land and existing operating businesses and has more than £180 million of equity capital allocated for healthcare investment. Last month Hamberley Development sold its newest care home, the 69-bedroom Richmond House, in Ampthill, Bedfordshire, to Aedifica in a sale and leaseback transaction.

Tim Street, director at Hamberley Development, said: “We’re delighted to agree to this commitment with the Aedifica and Layland Walker [Aedifica’s UK asset manager] teams so soon after our first deal last month. This forward purchase agreement, for our Hailsham development, shows the strength of our reputation for delivering the highest-quality care environments, on time and on budget. “The Hailsham home will meet the very highest standards for safety and infection control and sets a new benchmark for Covid-secure care settings. We are proud to be able to deliver both luxury and safety, without

compromising on either front.” Keith Breslauer, managing director of Patron Capital, said: “We aim for our investments not just to deliver strong returns but also to have a positive impact on communities and individuals. With an ageing population and an increased focus on safeguarding older and more vulnerable people in society following the recent pandemic outbreak, our investments in the later living sector enable us to do just that. This deal reflects the exceptional quality and reputation of Hamberley’s developments and will free up funds to invest in further opportunities that are actively being sought out.”

Kingsley Healthcare announce new £12m scheme for Holt Care home operator Kingsley Healthcare has unveiled plans for a 66-bed facility in the north Norfolk town of Holt, set in a two-acre plot. Construction work on the project will begin next summer, subject to planning approval, and the group also confirmed it is submitting plans for similar level of facilities in Olney, Buckinghamshire and Norwich. Kingsley Healthcare said in a press release that it aims to double the size of the group over the next five years by deploying investment of between £150-£200 million. The Holt scheme is being developed with architects Condy Lofthouse and planning consultant Bidwells. Muj Malik, Kingsley’s chief

investment officer, said: “We have had a positive response from local stakeholders. It is important for us and our future residents that the home becomes a central part of the community. “It has always been our ambition to bring the Kingsley brand to the affluent market town of Holt which embodies everything that is wonderful about north Norfolk. We are proud to be delivering a luxury home fitting for the community. A spokesman for Holt Town Council said: “The council welcomes the proposed new care home which will provide much needed care for the elderly in our community, as well as creating many jobs for local people.”

Daya Thayan, chief executive of Kingsley, said: “As well as setting the standard for elderly care we are passionate about making a positive contribution to the communities in which we operate. “This home will generate wellpaid jobs from senior managers and nurses to chefs, support workers, maintenance and housekeepers.” Kingsley is soon to gain a further

200 beds through the opening of its 66-bedroom Brackley Care Home, a £12 million project in the Northamptonshire market town of Brackley, and the acquisition of two existing luxury homes in the Northwest and Norfolk. It will shortly be submitting plans for luxury nursing homes in Olney, Buckinghamshire and Norwich.

HealthInvestor UK • November 2020

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Real estate

US private equity firm offers to buy McCarthy & Stone American private equity firm Lone Star Funds is looking to buy Britain’s largest retirement home builder McCarthy & Stone, Construction Enquirer has reported. Dallas-headquartered Lone Star is reported to have made a £630 million cash offer for McCarthy & Stone, which built and sold more than 2,000 houses a year before the Covid-19 pandemic and has a market share of about 70%. Lone Star Europe president Donald Quintin said: “As a leading developer and manager of retirement communities in the UK, McCarthy & Stone represents an attractive opportunity in a market underpinned by clear fundamentals – a rapidly ageing population and a structural undersupply of suitable housing options for older people. “Lone Star shares the McCarthy & Stone management team’s vision for growth. With our proven experience in developing property-related businesses, we believe our partnership will enable McCarthy & Stone to accelerate its transformation, which aligns with the government’s goal of increasing the supply of attractive housing options in the UK.

“We look forward to partnering with McCarthy & Stone’s management and employees to further support the company’s ongoing transformation.” McCarthy & Stone chairman Paul Lester added: “The offer represents a compelling and attractive opportunity for shareholders to crystallise their investment in the company in the near term. It also provides a meaningful premium to the prevailing share price notwithstanding the backdrop of the wider risks posed by the political and macroeconomic environment. “We believe that Lone Star would provide a complementary partner for McCarthy & Stone’s stakeholders and along with the investment in the business that Lone Star can provide, will enable further improvements of its transformation strategy and allow McCarthy & Stone to capitalise on its growing rental and multi-tenure offering which would underpin the longterm growth of McCarthy & Stone.” Estate agent Knight Frank is understood to have advised on the offer.

Demand rising for retirement communities, says ARCO A survey of UK retirement community operators has found a ‘very significant’ increase in the number of older people enquiring about and moving to retirement communities providing care and support, such as retirement villages or extra care housing, following a survey conducted by ARCO, the trade association for operators of housing-with-care developments for older people. 85% of organisations surveyed indicated that sales and lettings in the past month were higher than in the same period last year. 55% of respondents said that sales and lettings were at least 30% higher than in 2019, with 25% saying that sales and lettings were as much as 50% higher. 65% of operators stated that the most common drivers of this increase were a desire for more company and social interaction, and older folk realising that the houses they were previously living in were not suitable anymore (also 65%). 60% of operators also indicated that demand was driven by a desire to access a support network ahead of another period of lockdown.

The retirement community sector is calling on the government to create a Housing-with-Care Task Force to help unlock barriers to the expansion of the sector, as provision of housing options with on-site care and support in the UK is currently lagging far behind other countries. Michael Voges, executive director of ARCO, said: “These figures confirm a trend our members have been observing for a long time - there is a huge gap in the UK market for aspirational living options combining both social interaction and optional support services. An ever-growing number of older people are reviewing their housing, support and care needs in the face of the current pandemic, and are seeking out retirement communities that enable them to live independently for as long as possible.” ARCO’s members include not-for-profit operators such as Anchor Hanover and fastgrowing private operators such as Audley Group and Legal & General-backed Inspired Villages Group.

Target Healthcare reports lift in profit Target Healthcare REIT, which invests in modern, purpose-built UK care homes, has announced annual profit of £31.6 million for the year ending 30 June 2020, up 5.7% from £29.9 million reported last year. The company’s European Public Real Estate net asset value (NAV) rose 0.6% to 108.1p, from 107.5p in 2019. Its NAV total return was 7% (2019: 8.1%), reflecting supportive adjusted EPRA earnings and a moderate level of capital growth. The dividend for the year

HealthInvestor UK • November 2020

increased by 1.5% to 6.68p (2019: 6.579p) and Target has proposed a 0.6% increase to 6.72p for 2021, barring unforeseen circumstances. The company has dividend cover on adjusted EPRA earnings of 76% (2019: 82%), fully covered based on EPRA earnings. The fall in adjusted EPRA earnings is primarily a result of a pause in investment activity due to Covid-19 and prudent provisioning in relation to rental income recognised from two tenants.

Target’s portfolio value increased over the year by 23% to £617.6 million (2019: £500.9 million), comprising 71 homes and two pre-let sites, including like-for-like valuation growth of 2.8%. The company signed agreements to acquire 12 assets for £117 million, at yields representative of assets of similar standard and location within the group’s existing portfolio, and completed its first property sales, with two disposals ahead of book value. Its contracted portfolio rent

increased by 21% to £39 million (2019: £32.2 million), including like-for-like rental growth of 1.5%. The number of tenants increased to 27, from 24 in 2019. The weighted average unexpired lease term was maintained at 29 years. Target also re-tenanted of six care homes in January previously leased to Orchard Care Homes to two of the group’s existing operators, resulting in no net loss in income or capital value to the group.

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Hamberley to build neuro rehabilitation centre and luxury care home Plans to build a new 57-bedroom neurological rehabilitation centre and an 80-bedroom luxury care home in Southampton have been given the go-ahead. The new facilities will be built by Hamberley Development and work on the site is due to begin early next year, with both services being operational in the summer of 2022. Hamberley Development is the sister development company of Inspire Neurocare and Hamberley Care Homes. The neuro rehabilitation facility will include physiotherapy and medical consulting rooms, together with a therapy gym fitted with rehabilitation equipment, as well as lounges, dining rooms, cinema and a café bar. This service will be operated by Inspire Neurocare and will provide rehabilitation care, long-term care, respite and palliative care for people with brain and spinal injuries, as well as complex neurological conditions such as Parkinson’s disease and Huntington’s disease.

The adjacent care home will include 80 en suite bedrooms, café bistro, private dining room, hair and nail salon, activity room and bar, as well as a cinema, resident lounges, dining rooms and quiet lounges. Both homes have been designed with infection control and safety standards in mind, in light of the Covid-19 pandemic. Additional features include a Covid-secure visitation suite, inbuilt thermal imaging technology in the entrance lobby (to ensure all visitors to the homes, including

staff, have their temperature taken on a daily basis) and optimised ventilation systems which ensures air in public spaces is fully replaced every 15 minutes. Daniel Kay, director at Hamberley Development, said: “The Inspire Neurocare neurological rehabilitation service will be a centre of excellence that will allow us to support local NHS services and provide much-needed complex care services for local people. Rehabilitation services are becoming more and more advanced

and so it is vital that the appropriate environment exists to deliver these life-changing services. “Additionally, there is a recognised shortfall of high-quality care home beds in the local area and we are confident that our new luxury Hamberley Care Home will help meet the needs of older people in Southampton and the surrounding area. Both buildings will be of the very highest standard from a safety and wellbeing perspective and also in terms of luxury and comfort.”

Schroders and Octopus Real Estate’s retirement fund attracts capital Schroder Real Estate and Octopus Real Estate have announced the second close for their UK Retirement Living Fund (ReLF) with an additional £40 million of investment, taking aggregated equity commitments to date to £140 million. Schroder Real Estate is the property investment arm of the global investment management group, and Octopus Real Estate is an investor in UK healthcare facilities. Together they are investing in the development of new retirement villages. Schroders stated that ReLF partners with developer operators

to deliver retirement communities that provide security and social engagement, high-quality communal leisure and dining facilities, as well as bespoke care packages if required. The fund has already invested in four new retirement communities. Robin Hubbard, head of real estate capital at Schroders, said: “In an uncertain real estate market where value is hard to find, investors have been attracted to this mid to high-end segment of the UK retirement sector which is highly undersupplied, but underpinned by undeniable structural demand drivers such as

demographics, more active and higher quality lifestyle aspirations, and probably the wealthiest cohort of retirees that there ever has been or will be. “From an impact perspective, downsizing retirees will free up larger family homes and breathe life back into elderly neighbourhoods, while reducing the loneliness of the retirees who will typically lead a mentally and physically fitter life in a retirement community, thereby deferring and/or reducing the healthcare burden on the NHS.” Kevin Beirne, director retirement at Octopus Real Estate, added: “This second close for the fund is

a confidence boost for the future of retirement communities, which has been resilient in the face of the difficult conditions presented by the pandemic. We have seen the underlying strength of retirement communities and they will likely continue to show real resilience in the future. “We are delighted to be working alongside Schroders in a rapidly growing sector that will create an impact on both a fund level and a social level. We are working on a strong pipeline and are looking forward to delivering more communities in the coming months and years.”

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Assura issues optimistic update Primary care property investor and developer Assura has issued a trading update for the first half of the year to 30 September 2020. It said it has a growing portfolio of 576 properties with current annualised rent roll of £113.3 million. It has completed six developments at Stafford, Netherfield, Cinderford, Great Barr, Stourbridge and St Leonards at a combined cost of £38 million, adding that Cinderford is the UK’s first ever dementia-friendly space. Six schemes have moved onto site and 20 acquisitions have been completed for a combined cost of £80 million. A total of 26 assets have been disposed of for £23 million; 13 lease re-gears completed (£1.1 million of existing rent); and one capital asset enhancement project was completed and three are currently on site (at a combined spend of £600,000). Rent collections have been in line with normal patterns. Some rents from pharmacy and ancillary services are being paid in monthly

instalments along with some shortterm deferrals. Rental concessions totalling less than £100,000 have been agreed. Assura stated that its developments and acquisition pipeline is providing significant growth opportunities and it is currently on-site with 15 developments at a total cost of £77 million. Its immediate development pipeline totals a further £65 million and these are schemes which it expects to be on site within 12 months The immediate acquisitions pipeline stands at £90 million, which it says it would normally expect to complete in three-to-six months. It has 42 lease re-gears covering £5.5 million of existing rent roll in the current pipeline. It has a pipeline of 19 capital asset enhancement projects (with a projected spend of £14 million) over the next two years. At of 30 September 2020 Assura said its net debt stood at £1,067 million with undrawn

facilities of £300 million and cash of £310 million. Its oversubscribed social bond raised £300 million at a coupon of 1.5%. The company’s revolving credit facility facility will be reduced from £300 million to £225 million during October following the successful social bond. And Assura’s 10-year 4.75% £110 million secured bond maturing in December 2021 is to be repaid. Assura chief executive Jonathan Murphy said: “Over the last six months as a whole we have been focused on working closely with the NHS in its response to the pandemic and ensuring that primary care buildings of today and the future are more fit for purpose. With the combined challenges of winter flu season and Covid-19 on the horizon, we are speaking to our occupiers about how we can best support the services in our communities, while listening to patients to understand how our spaces can help them feel confident in accessing these services. We are

also engaging government on the clear role investment in community health infrastructure will play as part of the country’s recovery. “We are making good progress on our recently-launched social impact strategy and launched our first social bond and finance framework to fund eligible social projects and deliver against our development pipeline last month. This will further support our work in our communities through our new Assura Community Fund, which ran its first national grant round to support community health projects during this half. “It’s clear that flexible, fitfor-purpose capacity for health services in our communities will be key in the NHS’s efforts to address waiting lists and pent-up demand moving through and beyond this winter. Our strong strategic progress across all areas and resilient business model continues to position us well as the NHS’s partner of choice in these uncertain times and beyond.”

Merit launches health division Engineering and construction firm Merit has launched a new healthcare division which it states will build hospitals faster, more costeffectively and sustainably, while deploying infection control to make wards Covid-19 safe. Merit adds that Merit Health will reduce long-established building construction timelines without compromising quality. The company based in Cramlington, Northumberland says it has completed a number of projects within the health and life sciences sector, including expansion of the Cell and Gene Therapy Catapult manufacturing centre in Stevenage, and is currently working on the construction of a healthcare sterilisation facility for Northumbria Healthcare NHS Foundation Trust.

HealthInvestor UK • November 2020

A typical acute facility takes threeto-four years to build, from inception to handover. Merit says it can deliver projects in half the time. With 75-90% of the building manufactured at its factory near Newcastle, it states that a combination of its standard designs, offsite technologies and

shorter supply chains, significantly accelerates the construction process. Tony Wells, managing director at Merit, said: “The NHS will undergo a major upgrade of its estates, including the 40 hospitals programme and it’s great the government has recognised the

benefits of standardisation and the need to utilise modern methods of construction. With the innovative methods Merit employs, this can be done quicker, at lower cost, and with higher standards of infection control and zero carbon emissions. “The government is only going to deliver its ambitious building programme if companies like Merit enter the fold and show how it can be done. This will also be a critical element towards achieving the NHS’s net zero carbon commitment which was announced last week. Our individual hospital bay ventilation and extraction technology also means no cross contamination, which is critical as the NHS continues to deal with Covid-19 as well as future potential pandemics.”

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Medical technology

Sensyne Health and Milton Keynes University Hospital sign research agreement Clinical AI company Sensyne Health has signed a five-year non-exclusive Strategic Research Agreement (SRA) with Milton Keynes University Hospital NHS Foundation Trust (MKUH) to enable the ethical application of clinical AI research to improve patient care and accelerate research into new medicines. Milton Keynes NHS Foundation Trust has around 550 beds, including day, acute and neonatal beds and employs around 3,500 staff, providing a full range of acute hospital services and specialist services to the population of Milton Keynes and surrounding areas. All in-patient services and most outpatient services are provided on the main hospital site. The trust is organised into four clinical divisions (medicine, surgery, women and children. and core clinical) and a number of corporate directorates.

The dataset covers 650,000 unique patient records, with 55,000 annual hospital admissions from a patient population of approximately 350,000 people. The new SRA with MKUH brings the combined total of anonymised data available for analysis by Sensyne to 4.5 million patients. Oxford-headquartered Sensyne Health stated that the research will be undertaken to high standards of information governance and data security in accordance with NHS principles, the UK government code of practice and data protection legislation. All data supplied to Sensyne will be anonymised by MKUH beforehand and the provision of the data will operate under an agreed Data Processing Protocol (DPP) under MKUH ethical oversight. MKUH patient data sits securely in a data warehouse which will facilitate efficient data processing with Sensyne and

enable immediate implementation. MKUH will receive 1.4 million ordinary shares in Sensyne Health representing 1.1% of the existing issued share capital of the company. This brings the total share ownership held by NHS trusts in Sensyne to 10.86%. MKUH will also receive from Sensyne an investment of up to £250,000 a year over the five-year term of the contract for specific investments in information technology to enable the curation and analysis of data under the SRA. MKUH will also receive a royalty on revenue generated by Sensyne from the research undertaken under the SRA. The financial return MKUH receives from Sensyne will be reinvested back into the NHS to fund patient care. MKUH has entered into a lock-up agreement whereby it has agreed not to dispose of any shares for a period of two years from the date the shares are issued.

MKUH joins existing SRAs the company has in place with Oxford University Hospitals NHS Foundation Trust, Chelsea & Westminster Hospitals NHS Foundation Trust, South Warwickshire NHS Foundation Trust, Wye Valley and George Eliot NHS Trusts. Lord Drayson, chief executive of Sensyne Health, said: “We are delighted to be working with Milton Keynes in using anonymised patient data to improve patient care and accelerate the development of new medicines. SRAs are a fundamental part of Sensyne’s unique model – giving NHS trusts equity, funding and the ability to share in revenues. Growing our access to anonymised patient data is key to our strategy. This new non-exclusive SRA moves us closer to our target of over five million unique patient records in the current financial year.”

Software, hardware and services company Tunstall Healthcare has called on health and social care leaders to invest in technological solutions to protect vulnerable people as winter approaches. The Yorkshire-based company has developed a remote patient monitoring (RPM) platform which can support vulnerable people in their community, enabling early interventions to avoid the need for more complex care. Zillah Moore, director at Tunstall Healthcare, said: “As identified by The Academy of Medical Sciences, this winter could see health and social care services facing four acute pressures: rising cases of Covid-19, disruption of the NHS, a backlog of routine care, and flu season coinciding with the current pandemic. With forecasts

of unprecedented pressure on the NHS this winter, the role of robust remote patient monitoring solutions has never been better recognised, nor the need for them more acute.” Tunstall Healthcare’s RPM platform comprises three technological solutions which enable sophisticated remote health monitoring. The ICP triagemanager portal enables remote monitoring, risk stratification and management of patients by clinical and service teams through customised or preapproved questionnaire templates, a traffic light-prioritisation system that triages patients to identify those most in need of intervention, videoconferencing which allows communication without the need for face-to-face contact, and a library of educational content that can be made available to

Tunstall Healthcare

Tunstall Healthcare calls for technology investment

patients to improve their awareness and responsibility for health management. Moore added: “We’ve also introduced two unique apps, the single-user myMobile, and multiuse myKiosk. The applications have been specifically designed to support

both individuals in their community, and residents in group living environments. The apps are easy to use and intuitive and enable patient engagement in the management of long-term conditions, alongside the effective transmission of data between patients and clinicians.”

HealthInvestor UK • November 2020

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Medical technology

Psyomics secures £1.5m funding for mental health diagnosis tool Psyomics, a healthtech and University of Cambridge spinout, has closed a £1.5 million funding round from existing and new investors to bring its Censeo mental health assessment and diagnosis platform to market in the UK. University spinout specialists Parkwalk led the round, joined by fellow existing investors Jonathan Milner, Martlet Capital, and Cambridge Enterprise. Censeo mirrors the process of a face-to-face psychiatric assessment, guiding a user through a series of adaptive questions. Smart algorithms perform a detailed and bespoke analysis, creating a ‘map’ of an individual’s mental health, providing diagnosis where appropriate and enabling a clear treatment pathway. Censeo says it supports GPs and clinicians in getting patients to the right level of support at the outset and

provides patients with a stigmafree way to start addressing their mental health concerns. Professor Sabine Bahn, Psyomics’ co-founder and chief medical officer, said: “Diagnosing mental health issues correctly in primary care can be difficult, due to time constraints and the fact that mental health conditions can be masked by physical symptoms. Delays in diagnosing – or misdiagnosis – mean that it can take several years for an individual with depression to be correctly diagnosed. For bipolar disorder the average delay is six to eight years. The consequence of this is that many people suffer unnecessarily from debilitating symptoms that could be successfully treated. It is clear that faster and earlier diagnosis followed by the most appropriate treatment will improve the quality of life of affected individuals, while at the same time relieving pressure

on the healthcare system.” Psyomics’ co-founder and chief executive Dan Cowell added: “This funding will enable Psyomics to support the UK’s plans to improve mental health provisions for the nation. Through giving patients, clinicians, and caregivers an earlier and clearer understanding of individual mental health needs, we believe we can make significant improvements in patient experience and clinical capacity, with positive impacts throughout the entire healthcare system. Our investors share our belief in the opportunity to make a genuine impact with Censeo.” Martin Glen, investment director at Parkwalk, said: “Covid-19 has accelerated adoption of digital tools for a wide range of applications, and Psyomics’ clinical and techled diagnostic tool can transform mental health diagnosis. We have always felt that what sets Psyomics

apart is its deep clinical roots and knowledge. We are pleased to be a part of this next funding round and look forward to seeing Psyomics continue to grow with its marketready product.” Tom Hall, senior investment manager at Martlet Capital, said: “We’re pleased to again be supporting Psyomics as the company now commercialises Censeo, its mental health diagnostics solution, at a time when mental health and wellbeing is one of society’s most prevalent themes and pressing matters. Censeo’s digital triage and assessment tools enable earlier, accurate and actionable diagnosis of mental health disorders and personalised pathways to the right support. Bringing this product to market can bring real benefit to both clinicians and patients through shorter time to diagnosis and better outcomes.”

Prisoners given virtual consultations with NHS doctors Prisons in England are being virtually connected to local hospitals by secure encrypted video, in a move to reduce the need for prisoners to travel to receive specialist care. NHS England and NHS Improvement have signed a new national agreement that is connecting prisons in England with specialists in their local hospital through a video collaboration platform provided by healthtech company Visionable. Instead of coordinating costly physical visits to hospital, prisons can now use Visionable’s technology to allow prisoners to speak securely with consultants remotely whenever possible and appropriate. A secure, encrypted client version of the Visionable system

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was initially rolled out to a prison in March allowing hospital clinicians to provide specialist video consultations to prisoners under the supervision of the prison’s medical team. The initiative is now being scaled nationally and is in the process of being deployed to 114 prisons and young offender institutions, 15 secure children’s homes, and five immigration removal centres. Visionable stated that in the longer term it could potentially be also used to connect patients virtually to other NHS services, including primary care and mental health. Security has been a paramount consideration during the introduction of the system into prisons. Secure laptops can only be activated with a remote key held by the prison’s healthcare team,

who take the laptop to the prisoner’s location. Visionable chief executive Alan Lowe said: “Virtual ways of working in healthcare have quickly become more urgent since Covid-19. But they are also a key means for transforming how people interact with their healthcare professionals in the longer term. This particular project, envisioned before the coronavirus pandemic, is an important expansion of how the NHS has been using remote video technology to transform pathways, and will result in significant efficiency and security gains for organisations involved. But it also demonstrates how clinicians can be brought to the individual, regardless of their location. If used in the right way, remote technologies provide significant

Alan Lowe, Visionable

opportunities to bring services to individuals in a more convenient way and in ways that can improve access and equity in healthcare.”

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Medical technology

Doctor Care Anywhere bags big bank, expands into Ireland and announces Australian IPO Digital healthcare company Doctor Care Anywhere has signed an agreement to provide services to employees of one of the UK’s Big Four banks and is also entering Ireland’s healthcare market. Patients in the Republic will be offered a range of virtual GP services, including consultations with doctors registered with the Irish Medical Council, booking 20-minute phone and video GP appointments, requesting specialist referral letters and certified fit notes which can be sent by patients directly to their employer, and being able to pick up prescribed medication from local pharmacies. Dr Bayju Thakar (pictured), chief executive of Doctor Care Anywhere, said: “We are delighted to have entered a partnership to support one of the UK’s leading retail financial services player, to ensure their employees are able to access the excellent medical care and support that they need from our highlyskilled clinicians, especially during

this difficult time of the coronavirus pandemic. “Our entry into the Republic of Ireland is an integral part of the business’s future growth plans. We are excited to bring innovative new services to this healthcare market through one of our valued channel partners, transforming employees’ health and wellbeing, and are pleased that there has already been a high activation rate among individuals who have access to our service.”

Doctor Care Anywhere is also undertaking an initial public offering on the Australian Stock Exchange, offering new shares at A$0.80 per share to raise approximately A$102 million (£55.5 million). The company stated it will use most of the funds raised to follow its growth strategy, which is focused on marketing and engagement capabilities; new services to drive growth in existing markets, including mental health and virtual specialist services; and building international business development capabilities to pursue growth in new markets. The company will have a market capitalisation of approximately A$254.8 million on listing. Jonathan Baines, chairman of Doctor Care Anywhere, said: “DOC has grown rapidly since its inception in 2014, providing services to more than 1,500 corporate and SME clients through its major channel relationships. The impact of Covid-19 on all our lives has demonstrated the vital role that technology can and

must play in the future of healthcare. We see DOC at the forefront of this revolution and we have a clear and ambitious growth strategy that aims to create real value for investors in the rapidly growing digital health market.” Thakar added: “The business was set up because we are determined to improve healthcare systems for patients everywhere. Our ability to bring together experienced clinicians and a proprietary digital platform is a unique and highly scalable proposition, and will meet growing demand worldwide. We are therefore thrilled to be launching in Australia, and believe that this is an important next step in our company’s story as we continue to focus on innovation in order to strengthen our service offering for patients.” Doctor Care Anywhere was founded in 2013 and provides services to more than 1,500 corporate and SME clients covering two million eligible lives. The company says its GPs conduct more than 20,000 appointments with patients every month.

Induction Healthcare and Cerner to collaborate Healthcare technology companies Induction Healthcare and Cerner Corporation have entered into a strategic collaboration. Induction, which provides the Zesty patient portal for hospitals, and Cerner will develop a joint patient engagement solution for the NHS. The collaboration will align existing patient-facing technology in the UK and Ireland, joining up Zesty with Cerner’s patient portal solution Healthelife and Cerner’s electronic health record (EHR), Cerner Millennium. NHS trusts are expected to help patients manage outpatient appointments, complete care questionnaires, and view hospital correspondence on their mobile phones – helping to reduce delays and

costs associated with posting letters, reducing demands on administrative, medical and nursing staff, and improving patient experience and access to care options. As part of the value added reseller agreement, NHS trusts that are already Cerner clients will have access to Zesty’s patient portal under their existing contractual arrangements. James Balmain, joint chief executive of Induction Healthcare, said: “It is a landmark moment for Zesty to be selected by Cerner in the UK and Ireland to jointly develop patient engagement solutions for NHS hospitals. Together, our organisations can provide staff and patients with world-class digital tools to manage their care and operate

more efficiently in the current environment of rapidly changing and unfamiliar conditions. The prospect of a patient-facing platform that represents the best of Zesty and the best of Cerner will be game-changing for both existing and new Cerner customers.” Distie Profit, managing director of Cerner UK, added: “We will all be patients at some stage in our life, which is why Cerner is committed to providing our clients with scalable and interoperable solutions that help them create the best possible experience for their patients. Helping patients become more engaged and empowered through access to their health information allows them to receive care remotely and better manage

their health. This new collaboration with Zesty is expected to provide a more streamlined experience for both patients and healthcare professionals and reaffirms our commitment to improving the outcomes for all individuals by creating innovative solutions and collaborations to benefit our clients.” In the UK, Cerner’s EHR is used by more than144,000 health and care professionals across 24 NHS trusts to manage 1.5 million patients every month. Its Health Information Exchange shares more than 19 million health records, and its population health intelligence platform, HealtheIntent, is contracted to help clients manage and improve the health of more than 9.5 million individuals.

HealthInvestor UK • November 2020

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Medical technology

Gresham House Ventures invests £5m into NHS digital triage provider Growth equity investor Gresham House Ventures has invested £5 million in eConsult Health, an online consultation provider for primary care. eConsult stated it will use the investment to continue providing digital triage services in GP surgeries and for the continued roll-out of its secondary care digital triage platform. Gresham House Ventures’ investment director, Henry Alty, said: “At such a crucial moment for healthcare provision, funding

the right businesses in this space is more important than ever. Founded by four innovative GP partners in South London, the eConsult platform has already proven the power of its technology, as the most widely used digital consultation solution and the first choice for NHS GP surgeries. “By expanding its services to cover secondary as well as primary care, eConsult Health has the potential to go even further and completely revolutionise healthcare provision in the UK, improving

outcomes while at the same time driving effectiveness. We are very excited to work alongside an extremely knowledgeable management team and further improve their current platform.” Dr Murray Ellender, chief executive of eConsult Health, added: “This funding will help us keep pace with the product development we need to support cutting-edge health technology across both primary and secondary care. NHS patients deserve an excellent digital experience when interacting with

the health service and we now look forward to delivering the transformation needed at pace.” Diligence providers were Candesic (commercial DD), Azets (financial DD), Rich Kershaw (tech DD), Sales Forensics (sales DD), DSG-B2B (marketing DD) and Confidas People (management and organisational referencing). Investor legal advice was provided by Shoosmiths. eConsult Health was advised by Anthem Corporate Finance and Ashfords.

Your.MD closes $30m Series A round

Doctorlink launches urgent care triage platform

Global consumer health, hygiene and nutrition company Reckitt Benckiser has invested additional funds into pre-primary care hub, Your.MD. The investment follows an initial funding round led by Reckitt Benckiser and existing shareholders last year. Your.MD stated that its Series A funding round is now completed – and that this latest investment will enable the brand to expand its reach across markets, including the UK, India and the US, as the first stop for personalised, clinical-grade information that individuals can use to manage their health and before contacting a doctor. Founded in 2015, Your.MD combines augmented intelligence with medically validated information, giving individuals personalised and relevant health tools and support to enable them to self-care when appropriate. The company said it has seen exponential user growth of 350% over the past 12 months. Arjun Purkayastha, senior vicepresident-eRB at Reckitt Benckiser, said: “After an incredible year

Doctorlink, the online triage provider to NHS general practice, has launched an urgent care triage platform for Accident & Emergency departments, which it claims will reduce waiting times by helping patients more quickly access the correct form of clinical care for their symptoms. Research has shown that four million A&E appointments each year are not clinically urgent. These non-urgent attendances – where symptoms and medical history indicate patients should receive care from a GP, pharmacist or other community service – represent a sixth of annual A&E visits. To use the platform, patients will answer a set of questions about their condition on a touchscreen, which will help hospital staff to prioritise visitors. Patients whose symptoms do not indicate a need for A&E consultation will be offered other forms of care tailored to their symptoms and medical history, including face-toface GP appointments, pharmacy consultations or safe self-care. Doctorlink’s general practice online triage currently operates in more than 1,500 GP practices, covering 12.5 million NHS patients.

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of growth, RB is delighted to strengthen our partnership with Your.MD to deliver better self-care access and tools for consumers all over the world. We are excited to see the global expansion of the Healthily app, which will create immersive, digital-first experiences for consumers.” Your.MD chief executive Matteo Berlucchi added: “We’re delighted that our platform is growing from strength to strength and continues to attract best-in-class international partners that share our vision. Our relentless work toward democratising access to personalised healthcare information is progressing at pace and thanks to our strategic partnership with RB we are one step closer to reaching this ambitious, yet achievable, goal.”

Rupert Spiegelberg, chief executive of Doctorlink said: “We’ve already seen impressive results from the use of our online triage tool in general practice. Doctorlink’s new urgent care platform will help people who need A&E attention be seen by clinicians faster than they do now. Other patients will be directed to other local services best suited to their medical history and symptoms. This can include GP appointments, pharmacy consultation, mental health services and other community health organisations. “It is a great example of how technology can help and assist healthcare professionals for better outcomes. This is exactly what NHS emergency departments need, especially in the run up to winter and with the potential for another wave of Covid-19 demand. By directing patients to the correct form of care, practices save valuable time and money and patients get the care they need in a fraction of the time. Our platform will help emergency departments to manage demand, reduce costs and improve performance over this challenging period.”

WOMEN IN MANAGEMENT

HealthInvestor UK â&#x20AC;¢ November 2020

WOMEN IN MANAGEMENT

Atop the glass ceiling Kindness is at the core of the culture being built by the all-women management trio driving specialist healthcare business Active Care Group. Kathy Oxtoby talks to the trio about their plans for the business, and overcoming challenges for women in healthcare management

hen you’ve been put in the driving seat of an organisation that’s rated as a leader in its field, you could decide on a business strategy that places profit margins before people to keep your competitive edge. Not Ruth Smith. Since her appointment as chief executive of specialist healthcare business Active Care Group (ACG) this February, Smith has looked to ensure values of kindness and compassion are at the heart of everything the organisation does and plans to do. This strategy has helped the group grow significantly as a provider of rehabilitation and complex care services for children, young people and adults, and it’s set to double in size over the next five years. Smith, together with chief financial officer Katy Lineker, and Claire Leake, group people director, are a formidable trio, leading an organisation established in 2019 that brings together more than 40 care providers to form a progressive, integrated, specialist healthcare business. It employs over 4,000 staff who support more than 2,000 clients across 60-plus locations in England, Scotland and Wales. And these are not the only standout statistics associated with the group. According to the World Economic Forum, just 35% of the leadership roles in the global health care industry are held by women, making ACG’s all-female senior management team relatively unusual.

Born wanting to care For 27 years Smith has been involved in the care sector. “Some people are born with a sense of wanting to take care of people. I wanted to work in healthcare because I genuinely care about people,” she says. Even before she left school, “I always volunteered to help out at the Friday night discos for people with learning disabilities, and would

HealthInvestor UK • November 2020

spend my Saturday mornings cleaning out older people’s commodes.” Ruth began her career in a purely clinical setting as a specialist brain injury rehabilitation nurse, an area “where my passion is”, and progressed into quality assurance, health and social care management positions. In 2016 Smith joined Christchurch Group, a provider of clinically-led neurorehabilitation services for patients with acquired brain injury, spinal injury and other neurological conditions, as chief operations officer and then chief executive. At Christchurch Ruth spearheaded improvements across the company’s 10 centres – 100% of which are now rated Good or Outstanding by the Care Quality Commission – and improved outcomes for patients – 86% of whom returned home after a period of rehabilitation. Following ACG’s acquisition of Christchurch in 2019, Smith served as the group’s COO. During that time, she led a restructure of the six group divisions spanning residential and supported living, care in the home, Christchurch rehabilitation services, Remeo respiratory services, case management and Jane Lewis Healthcare Recruitment Solutions. This June, The Montreux Healthcare Fund – which acquired ACG in 2018 – promoted Smith to chief executive. As with all her senior leadership roles, she finds her clinical background and firsthand experience of being in the front line of care, “helps to support the clinical strategies of the company”. “I understand from the grass roots up what people are going through in terms of their work on the wards and the services they provide,” she says, adding, “I don’t understand how some leaders in healthcare function without having some clinical background, and I can’t imagine someone being able to lead this company without it.”

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WOMEN IN MANAGEMENT

▶ Culture of being kind Since joining ACG, Smith has sought to create a “caring culture” across the whole organisation. “We work in a caring business so we should treat each other and our service users with kindness.” To embed a culture of kindness into the group, Smith employs role model values-based leadership. “As CEO you are the biggest role model and should be influencing the group’s culture,” she says. Smith says recent group acquisitions have resulted in a need to integrate different businesses under one group umbrella, and to win the hearts and minds of employees. For her, this has involved being “visible and approachable”, and developing close working relationships. To carry out the role of CEO in the healthcare sector effectively, she says individuals need to be “passionate, manage stress well and keep a level head at all times, have good clinical knowledge and sector knowledge, and be able to have open communication”. Smith says she hasn’t found gender an issue working for “open minded” Montreaux Capital, but says she has come across organisations where attitudes were less open, recalling how she was once told not to wear red before attending a meeting “because it’s distracting”. Smith says there are now “more opportunities” for women to take on senior level jobs in the sector and that having more females in these roles can help inspire others. “Recently a friend said they had been following my career and that I had motivated them to try for something different – and that I was an inspiration to my twin daughters,” she says. However, managing work-life balance, particularly for those with families, remains a challenge for women in healthcare management, she believes, “so you definitely need to have a supportive partner or family member”. But with seniority comes rewards, and working in the healthcare sector has meant Smith has experienced “many career highlights”.

Good news stories “Every single day I hear good news stories about, say, someone who has got through rehabilitation and can walk again, or someone who has been weaned off a ventilator. I’m privileged to work in a company with amazing people who have dedicated their lives to making other people’s lives better,” she says. As chief executive she would like to continue to help ACG to grow and develop. And to other women looking to take on a healthcare

Ruth Smith, Active Care Group

We work in a caring business so we should treat each other and our service users with kindness

management role she advises: “Don’t put limitations on yourself – that’s what holds people back. The opportunities are out there, not just for women, but for all of us. And I say ‘go for them’.” But she cautions: “Anyone going into a senior leadership role in healthcare should be doing this for the right reasons – for the patients. Otherwise the quality, reputation and financial performance falls by the wayside.” And she says that while the healthcare market “is very fragmented and difficult to navigate at times and not for the faint-hearted, it offers the most rewarding jobs.”

HealthInvestor UK • November 2020

WOMEN IN MANAGEMENT

management accountant, Lineker has been CFO of ACG since January, and is responsible for protecting its financial performance, while driving strategic growth and ensuring group liquidity. “Ultimately I’m responsible for the financial aspects of the organisation’s strategic plan, ensuring that we continue to grow and are sustainable. “Within that role I enjoy working with our leadership team, looking at giving our employees that secure employment, whilst also growing the business for our stakeholders,” she says.

Hard work, determination and confidence

Katy Lineker, Active Care Group

Ensuring financial performance Katy Lineker, chief financial officer at ACG, has 19 years’ experience working in finance, and was new to the care sector when she joined the group in October 2018 as financial controller. But with a decade of working in financial roles within the pharmaceutical industry and having family members working in healthcare, the care sector was not unfamiliar territory. For Lineker, the appeal of ACG was its growth strategy of mergers, acquisitions and organic growth, and that it’s a care organisation supporting vulnerable populations. A chartered

HealthInvestor UK • November 2020

Leadership qualities are key in terms of leading, coaching, mentoring and developing my team, as well as being a role model for the organisation

To carry out the role effectively requires the ability to give a broad review across the organisation, and “not just purely look at numbers, but understand the implications across the whole organisation of decisions being made. “Leadership qualities are key in terms of leading, coaching, mentoring and developing my team, as well as being a role model for the organisation. And you need to present a confident attitude so people feel they can trust and respect your leadership,” she says. While her role as a CFO within healthcare may traditionally be quite male dominated, she says it’s even more so in the pharma industry, and recalls “the amount of conferences where I was one of a few, if not the only woman there”. However, she believes “hard work, determination and confidence” can overcome obstacles to people achieving their career goals, and for her personal career progression she feels she has been “judged on my own merits”. And she says the career opportunities for women in healthcare management are “endless – whether it’s in finance, clinical or leading a company”. Her current post is the highlight of her career so far, she says. “I’m learning every day. And being part of a group that’s providing care to members of a vulnerable population feels really worthwhile.” In the two years since she joined ACG it has doubled in size. Looking ahead, her plans include the delivery of the group’s strategic plan, incorporating a five-year growth plan, as well as the embedding of core systems and processes across ACG, and building on the group’s estates and procurement strategies. To women considering healthcare management positions, she says: “Have confidence in yourself. And seek help and advice when you feel it’s necessary.

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WOMEN IN MANAGEMENT

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“It’s very rewarding being in healthcare. When we see our clients and the services in place for them, and what we as an organisation are doing on a daily basis to help them, it’s incredible.”

People at the centre of everything Group people director Claire Leake was recruited by ACG last December, bringing with her more than 21 years of human resources experience, including in the care sector. She saw the move as “an amazing opportunity to join a group that provided such a breadth of services in terms of care, and to move back into a sector that puts people at the centre of everything; making a difference to service user’s lives, but also progressing people within our business to help them achieve their full potential,” she says. Leake’s role, she says, is to “look after all things people”. She manages 92 staff and is responsible for the group’s people team, internal recruitment team, and it’s staffing solutions division, which operates under the brand names Jane Lewis, an organisation at the forefront of nursing jobs and healthcare recruitment and MedBank, a specialist nursing agency. Leake is also responsible for ensuring that the group’s people policies comply with current regulations and has authored ACG’s ‘People Strategy’ – a plan closely aligned to the organisation’s objectives, vision and mission for its employees within its six divisions – Residential, Rehabilitation, Respiratory, Case Management, Staffing Solutions, and Care in the Home. Counsel for all employees and managers is provided by her people team who help to maintain effective working relationships with everyone. Online toolkits and resources housed within her newly launched intranet-based People Hub provide managers with pertinent material to support people management processes and provide employees with information on benefits and employment processes. A Wellbeing Hub linked to the group’s Employee Assistance Programme features additional online resources to support the physical, mental, emotional and financial wellbeing of the group’s employees. Business acumen is essential to carrying out her role effectively, she believes. “You have to understand what the business is about, what its goals and objectives are, and to put a people strategy in place that supports those goals and those objectives.

“So, it’s very much a partnership of the HR people function with the business to enable it to grow and perform,” she says.

Making compromises As is the situation for many women, she says balancing a career with family life continues to be a challenge and compromises have to be made, such as working long hours and missing sports days. “But you also have the luxury of enjoying your work – and work is a large part of my identity,” she says. Leake says there are “huge opportunities for women at every level of management within the healthcare sector from a residential setting, operational perspective, or a support function such as HR.” Her current management position is “the high point of my career so far”, she says, adding that she will “continue to improve my operational understanding and how the business operates on the ground to help me to support and partner

If I understand what the group needs to achieve, I can support that by putting in people-based solutions

with the business in a productive way. If I understand what the group needs to achieve, I can support that by putting in people-based solutions,” she says. Leake’s goal is to create an employee brand that is built around employee wellbeing, fairness, inclusion and diversity. “We have the opportunity to offer employees an employee pathway, which means they can join as an apprentice and ultimately progress to becoming a future leader of a division or fulfil a group function,” she says. “Jump feet first” is her advice to women considering healthcare management positions, adding, “if you want to make a difference there isn’t a better sector to try and do that than the care sector.”

Integrated pathway of support Together, the dynamic trio of Smith, Lineker and Leake lead an organisation whose ethos is that by caring for their own people, they will

improve the care they provide to service users. ACG’s mission is to provide progressive, personalised care pathways that combine clinical expertise, personal support and a wide range of therapeutic services, in a variety of different residential environments, for children, young people and adults with complex care needs. “We deliver a better quality of care for a better quality of life,” says Smith. “And we achieve our mission by our progressive innovative approach growing on the highquality high-value business we have, with service users at the centre of what we do.” All staff employ “an innovative, holistic, usercentred approach designed to help individuals to progress towards a more independent future and to lead their best life”, says Smith. ACG’s portfolio of healthcare services across the UK includes: residential and supported living, care in the home, Christchurch Rehabilitation Services, Remeo Respiratory Services, case management, and Jane Lewis Healthcare Recruitment Solutions. Collectively the group has more than 30 years of specialist knowledge and experience in managing complex conditions including ventilation and respiratory, spinal injury, brain injury, epilepsy, neurological conditions and learning disabilities. Strategically, Smith says ACG is “wellpositioned to acquire additional high-quality assets due to its reputation, brand, and proven deliverability compared to its competition”. She says this is demonstrated through the group’s historical success and it will continue to maintain and develop speciality areas, expand its areas of expertise, and add to future research and developments to improve service users’ lives.

Helping service users There are numerous examples of how the group’s integrated pathway approach benefits service users and their families. Smith cites the story of a young child with complex needs who progressed through the pathway supported by highly trained specialist care teams. “They transitioned the young child to the adult side of care and supported her to go to university where she now lives with one of our carers,” says Smith. She also recalls the recent case of a patient who became dependent on a ventilator after initially having the flu and some following infections and suffering from a peri-arrest. “The patient was deemed to have little weaning potential, but was not an end of life care patient.

HealthInvestor UK • November 2020

WOMEN IN MANAGEMENT

Preparing for the next growth cycle

Claire Leake, Active Care Group

“They also acquired Covid whilst in hospital, which further delayed and complicated her rehab. From being completely bed bound on admission, after several months, Remeo was able to discharge them, weaned from the ventilator, able to eat independently, and able to move with only a walking stick,” says Smith.

Standing up to the Covid challenge When the pandemic hit, ACG has “stood up to the challenge, putting a robust plan in place to keep Covid-19 out of services, which included dynamic risk assessments and

HealthInvestor UK • November 2020

infection prevention and control procedures,” says Smith. Leake says the group has taken a “proactive approach to supporting staff” during the pandemic. “This has been focused on strong communications, providing our employees with tools and resources through our employee assistance programme and Wellbeing Hub. “We’ve been very much focused on people’s physical, mental and emotional wellbeing, providing employees with access to counsellors and psychologists, and ensuring access to PPE to make sure they are working in a Covid secure environment,” she says.

Discussing future plans, Smith says that having been through a period of considerable growth, ACG is now “getting ready for the next growth cycle”. “In terms of strategy we are planning different acquisitions and organic growth. In the next five years we might be double the size we are now,” she says. ACG currently has eight developments in planning and construction, which is expected to add 61 beds, two new builds in York and Surrey, as well as the expansion of current services. “We are currently looking for further acquisitions. There are numerous opportunities available of various sizes given the highly fragmented nature of the market, and a number of potential acquisitions currently under review,” says Smith. Future plans also feature the development of ACG’s culture and people operations to reflect a focus on employee wellbeing, inclusive people practices, and employee retention, with a specific focus on creating an environment of inclusion for women, ethnic or racial minorities and LGBTQIA employees and candidates. Leake’s plans to address this include creating a diverse and inclusive leadership team, building a culture of meritocracy through initiatives and governance to ensure fairness, and creating a sponsorship environment whereby senior leaders who are LBGTQIA or from ethnic or racial minorities, are accessible to employees requiring support and mentoring. As ACG plans for a ‘second wave’, and flu pressures, Smith says the organisation has “really come together and supported each other, clients, and families”. Work meetings have been conducted via Zoom, but outside working hours there have been organised remote events such as quiz nights “to try and keep people’s morale up”, says Smith. And there’s still been room for charity activities, including a 10k charity bike ride by the management team in aid of spinal cord injury charity Back Up. “We were all in separate places – I was in York, Claire in Caterham, Katy in her spare bedroom in Tunbridge Wells, and the rest of the teams were across the UK, but all riding our bikes together for charity,” says Smith. Which is typical of the trio’s united attitude towards their roles and the business they are responsible for developing – there’s kindness at its core. n

Advisory & Finance

Clinical services

Bank or lender of the year Barclays

Diagnostics provider of the year Alliance Medical

Consultants of the year – strategic PLMR Consultants of the year – transactional Candesic Corporate financier of the year Deloitte

Investment

Technology

Private equity investor of the year Downing

Technology provider of the year Person Centred Software IT innovator of the year Healthcode

Primary care provider of the year The Dermatology Partnership Private hospital group of the year HCA Healthcare UK Recruiter of the year Nurseplus

Legal advisors of the year – private Browne Jacobson Legal advisors of the year – public Mills & Reeve Legal advisors of the year – transactional Bevan Brittan

15 October 2020 | VIRTUAL EXPERIENCE

The HealthInvestor Awards 2020 took place on 15 October, with the awards ceremony hosted online as a fully immersive and interactive digital experience, complete with live-streamed content from the ‘main stage’, virtual bar, one-to-one networking opportunities and more. With more than 250 submissions entered, successful entries were shortlisted before being sent to an independent panel of high-profile judges. This year, the judges were looking for organisations and individuals that have made an outstanding contribution to healthcare in 2019, and represent the leading players in this diverse and burgeoning market.

ipevents.net/healthinvestorawards

Winners

Property

Social care

Property consultants of the year – capital markets Cushman & Wakefield

Community support provider of the year Venture People

Property consultants of the year – property services AECOM

Complex care provider of the year Cornerstone Healthcare Group

Property developer of the year Prime Property investor of the year Inspired Villages

Publicprivate partnership of the year

Outstanding contribution This Award is dedicated to all front-line health and social care workers

Regent’s Park Healthcare

Domiciliary care provider of the year The Good Care Group Residential care provider of the year Avery Healthcare Group Specialist care provider of the year Voyage Care

Event partners

Award sponsors Silver partner

15 October 2020 | VIRTUAL EXPERIENCE

FRONTIER

VITAS

IN V ES

ENT

Gold partner

ENT

MAN

ipevents.net/healthinvestorawards

EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

Specialist care accelerates

The latest Alantra Specialist Care Fast 50, published annually by global mid-market investment bank Alantra, reveals a robust sector, with operators proving resilient during the Covid-19 pandemic. Justin Crowther, an Alantra partner and its UK head of healthcare, unveils this year’s report

pecialist care businesses have found themselves on the front line of the Covid-19 crisis, battling to continue providing essential support and services to the most vulnerable members of society. The pandemic has presented significant challenges, but the sector has proved resilient, with industry leaders able to rely on robust operating processes, innovative technology and committed staff. This resolute performance reflects the strength of leading specialist care businesses coming into the crisis. The average business in this year’s Alantra Specialist Care Fast 50 ranking has posted a compound annualised growth rate (CAGR) of 23.1% over its two most recent financial years (data as at 31 March 2020). That represents a significant acceleration from 2019, when the equivalent figure was 18.2%. This year’s ranking includes businesses in four subsectors of the market: learning disabilities, specialist educational needs, mental health, and advanced neurobehavioural services. In each of these sub sectors, the fastest-growing business posted growth of at least 36%. Chesterfield-based Heathcotes Group, the number one business in this year’s ranking, has grown even more rapidly, reporting a CAGR of 93.6%. Managing director Brendan Kelly, who has overseen an expansion of the business’s facilities from five to 72 since joining in 2009, says the key has been to build a scalable business model that is agile enough to respond to changing market needs. “It’s about identifying where the need is emerging and then moving quickly to meet that need,” says Kelly, who employs someone with a specific role to work with local authorities across the UK to understand their requirements and pinpoint opportunities to meet new needs at the earliest possible stage.

Regional split of companies in the Alantra Specialist Care Fast 50 Scotland 2%

Wales 2%

Midlands 38% South 36%

North 22%

HealthInvestor UK • November 2020

EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

The impact of Covid-19

Ownership split of companies in the Alantra Specialist Care Fast 50 35 30 25 20 15 10 5 0

Privately owned

Infra/PE owned

HealthInvestor UK • November 2020

Kelly expects this year’s crisis to accelerate consolidation in a sector where the most successful operators increasingly see the advantages of building scale – and regard M&A activity as well as organic growth as a means of achieving it. “It has been a hugely difficult time for smaller operators in our sector, so there may well be opportunities, though it’s important to be very careful about what you buy,” he says. Indeed, Heathcotes has just announced its own transaction – Civitas Investment Management has acquired its healthcare real estate assets, while Envivo Group has bought the operational care business. The problems posed by Covid-19 have varied from business to business, depending on their individual circumstances, but challenges have been both operational and strategic. Day-to-day problems have ranged from the difficulty of securing supplies of personal protective equipment and accessing testing, to working with service users struggling to understand why facilities are in lockdown. The fact that many operators were effectively forced to accept patients discharged from hospital with Covid-19 only compounded these issues. “It has been unbelievably stressful,” says Roy Bernard, chief executive of Select Healthcare, which works Covid-19 has with adults with complex needs and slowed us down learning and physical disabilities. “Staff on the frontline have done an in terms of adding amazing job but understandably felt to our facilities: very vulnerable.” it’s made it more More positively, many specialist difficult to get care operators report impressive levels builders in to finish of collaboration between providers during the crisis. And staffing was new builds, and not as difficult as many operators the regulators have feared. In many cases, dedicated not been coming staff moved into facilities to ensure out to inspect they would be able to keep working; and approve meanwhile, recruitment has been boosted by people losing their jobs new facilities in other sectors – and the increased profile of carers. Still, at a strategic level, there is no doubt that Covid-19 has been a brake on growth, with commissioners and local authorities struggling to place service users and approve new facilities because of restrictions on their staff’s ability to get out into the community. At Pebbles Care, chief executive Michael Walsh adds: “Covid-19 has slowed us down in terms of adding to our facilities; it’s made it more difficult to get builders in to finish new builds, and the regulators have not been coming out to inspect and approve new facilities.”

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EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

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Assessing future growth prospects

healthcare now going to look like and will the government Nevertheless, businesses in the sector believe they can get deliver what it has promised?” he asks. “Is there going to growth back on track. At The Aurora Group, for example, be money to pay our fees given what the government has Mark Costello, chief executive of the specialist educational spent on Covid?” and care needs provider, says the shortage of provision Certainly, specialist care is a sector in which the normal in many parts of the country means the industry is badly laws of supply and demand do not apply – while there are needed. shortages of provision in many areas, both geographical and by specialty, hard-pressed Aurora, the second-placed business in this year’s Alantra Specialist Care commissioners and local authorities Fast 50 ranking, with CAGR of 57.4%, are often simply unable to pay more. has delivered this acceleration through “Rates are squeezed,” warns Mitesh a combination of organic growth and Dhanak, the founder and chairman of It’s harder to Precious Homes. “The national minimum acquisitions. “Our long-term vision is increase or adjust sustainable growth with no compromise wage has consistently run ahead of the an older fee level on quality and we don’t see any cap on fee increases that local authorities offer; than to agree a new our potential,” Costello says. so we have to work with our service Further challenges lie ahead. One users, to get them to a stage where one, very often concern widely shared by many they’re ready to move on, and then to providers is that the care sector will bring in new users where there is an suffer as the government tries to opportunity to refresh the rate.” repair the public finances in the wake This is also leading to many providers of the pandemic. While successive governments have investing in competencies that enable them to deliver higher promised reforms of the care sector, along with additional acuity services. “It’s harder to increase or adjust an older investment, the pressure to reduce debt will require some fee level than to agree a new one, very often,” says John Farragher, executive chairman of Potens, which works with tough decisions. Johann van Zyl, the group chief executive of Cornerstone children and adults with a range of learning disabilities, Healthcare, the top-performing business in the advanced autism, mental health and complex needs. “This is why neurobehavioural services category with CAGR of 36.1%, we are now focusing on services with higher acuities and is one leader who is worried. “What is integrated social and on supported living.”

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HealthInvestor UK • November 2020

EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

ALANTRA SPECIALIST CARE FAST 50 Rank

Company

2 Year CAGR (%) Region

Activity

Heathcotes Group*

93.6

East Midlands

Experienced provider of residential care for adults with learning disabilities and associated complex needs

Aurora Care & Education

57.4

West Midlands

Innovative provider of specialist education and care for children, young people and adults with special needs

Bradbury House

50.5

South West

Specialist care provider for individuals with forensic backgrounds, learning difficulties and mental health needs

Glenholme Healthcare

49.2

Central

Supporting young adults with learning disabilities, complex needs, mental health conditions and problems with addiction

Eagle House Group

39.0

Greater London

Specialist schools for children with autism

Cornerstone Healthcare

South West

Specialist nursing homes focused on caring for people with complex neurological, physical and mental health needs

Horizon Care & Education

33.0

West Midlands

Market-leading provider of specialist care for children and adolescents

Dolphin Homes

32.0

South West

Specialist care provider for adults with learning difficulties, challenging behaviours and complex health needs

Orbis Education & Care

Wales

Provider of schools, residential homes and facilities for children and adults with a diagnosis of autism

The Esland Group

30.4

East Midlands

Behavioural management specialists who deliver bespoke, individualised packages of care to young people

Cuerden Care

27.9

North West

Specialist care for complex dementia and mental health needs

Harbour Healthcare

26.9

North West

Specialist residential services, including mental health care and young person's disability care

Compass Community

26.2

East Midlands

Leading provider of fostering services, children’s residential care and schooling

Krinvest Care

24.3

Greater London

Independent rehabilitation service for people with complex mental health needs including acquired brain injury

Thomas Owen House

23.3

North East

Specialist nursing care home providing high quality, continuing care for people who have long term mental health problems

Select Health Care

22.8

West Midlands

Diverse range of specialist care centres providing 24-hour care for mental health, learning disabilities or brain injury needs

Witherslack Group

21.9

North East

Provider of specialist education and care for young people with social, emotional and mental health needs

Precious Homes

21.6

Greater London

Empowering people with learning disabilities, autism and other complex needs

Midway Care

21.6

West Midlands

Provider of services for people with learning disabilities and associated complex needs

Accomplish Group

21.3

West Midlands

Specialist support for adults with autism, mental health needs and acquired brain injuries

Kisimul Schools Group

20.8

East Midlands

Specialist education and residential care for children or young adults with autism and associated learning disabilities

Hatzfeld Care

20.3

East Midlands

Residential care for adults with varying needs such as Asperger's, Schizophrenia or eating disorders to age-related illnesses or dementia

Exemplar Health Care*

20.2

North East

Leading provider of specialist nursing care for adults with complex needs and challenging behaviour

Eleanor Health Care

19.6

Greater London

Provider of a range of care services including residential care homes, supported living facilities and mental health care

New Forest Care

19.1

South West

Residential childcare service to children and young people with complex needs (social, emotional, mental health and behavioural)

Kedleston Schools

19.1

East Midlands

Provider of care, education and support services for children with emotional, behavioural and learning disabilities

Holmleigh Care Homes

18.9

West Midlands

Provider of essential residential care, supported living and domiciliary care services to adults with a varied range of disabilities and challenges

Sonnet Care Homes

18.4

South East

High-end residential nursing care for the elderly and complex dementia patients

Pebbles Care

17.8

North East

Provider of residential care and education for young people

Bramley Health

17.5

Greater London

Specialist health and social care provider supporting individuals with complex and challenging needs

36.1

31.8

Continue to 31-50 ▶

HealthInvestor UK • November 2020

EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

▶

More consolidation ahead Roy Bernard of Select Healthcare argues these issues add to the case for consolidation in the sector, with larger and better diversified groups able to cope better with the shifting policies and attitudes of individual local authorities and commissioning groups. “Our geographical spread has certainly helped us in that regard,” he says. Expect more deal activity, in other words, both from trade buyers and from private equity, which is taking an increasingly active interest in a sector seen as offering defensive qualities as well as strong growth dynamics. Inevitably, there was a pause in M&A in the spring. But while investors and banks chose to hold fire during the pandemic and trade buyers were preoccupied with the impacts of Covid-19, confidence has begun to return to the marketplace in recent months. “M&A pipelines are very strong as paused deals come back to the market and huge amounts of dry capital look for assets; fear of CGT changes is also driving activity. Banks will inevitably continue to focus on supporting existing customers but remain keen to deploy development and investment finance into robust businesses with strong fundamental characteristics,” says Jamie Stuart, deputy head of health and social care at the banking group CYBG. “The market is attractive,” argues Mark Hall, senior partner of Graphite Capital, owner of two businesses in the Alantra Specialist Care Fast 50 in Horizon Care & Education and Compass Community. “The pandemic has shown that specialist care is an essential service and that plurality of supply is crucial.” Competition for the best assets is therefore likely to intensify, with a broad base of potential buyers. This includes bidders from within the sector, including the growing number of platforms effectively operating a buy and build strategy in specialist care. Notable examples include Pebbles Care, Compass Community and Sandcastle Care in the children’s services market, and Cornerstone Healthcare in the neurological sector. Investors, meanwhile, come in different shapes and sizes. Specialists in healthcare are increasingly being joined by generalists attracted to the sector’s resilient income streams, as well as institutional investors for whom the underlying real estate is an important element of deal rationale. Clare Connell, the founder of Connell Consulting, which provides due diligence services to buyers of specialist care

businesses, says that while she had expected to see work slow markedly during the pandemic, this is not how it turned out. “There is a high level of interest in specialist care as most operators have seen demand unaffected by Covid-19. We’ve remained busy with both due diligence work and strategic consultancy for operators,” she says. “For PE houses, specialist care offers some fantastic diversification benefits,” she points out. One question for the sector is the extent to which UK specialist care will attract further international interest, whether from trade buyers, investment capital, or global real estate and infrastructure investors; there are certainly precedents for deals. Christopher Jobst, director of healthcare at Alantra in Germany, says: “There are reasons to be optimistic, with European providers increasingly focused on international expansion and interested in the UK, though it may well be that deals that would have got done this year will now be postponed until 2021.” Franck Noat, head of European care services at Alantra in France, adds: “Having been involved in several complex cross-border care service transactions over the last 12 months, it remains clear that institutional funders and market-leading European players are increasingly likely to scrutinise the UK market for the right opportunities.” This is not to underestimate the significant risks that the specialist care sector carries. Businesses in the sector operate in a highly-regulated space and will fall short unless they are expertly run by experienced management teams, a point Brendan Kelly, Heathcotes Group’s managing director, is keen to emphasise. “We are responsible for providing a better quality of life and enhanced opportunities to often very vulnerable individuals and any investor in the sector must appreciate that providing these services rightly comes with strict regulations and requires significant sums to be invested in high-quality services and compliance,” he cautions. Moreover, standards are rising all the time, says Sam Gray, managing partner of Apposite Capital, an investor in Swanton Care & Community. “The consolidation trend we see is driven by the increased expectations commissioners have of operators, in terms of regulation, reporting and professionalism,” he says. But this requires time and investment. After Apposite invested in Swanton in 2017, it spent a full year investing in central services, technology and the management team, Gray recalls.

HealthInvestor UK • November 2020

EXCLUSIVE: ALANTRA SPECIALIST CARE FAST 50

▶

ALANTRA SPECIALIST CARE FAST 50 Rank

Company

2 Year CAGR Region (%)

Activity

St Matthews Healthcare

17.5

East Midlands

Bespoke intensive mental healthcare and therapy in hospital, residential and step-down settings

Horizon Healthcare Homes

17.2

North East

Residential support for adults with learning difficulties and associated complex needs

Select Lifestyles

16.7

West Midlands

Supportive services for adults with learning disabilities, autism spectrum disorders and mental health needs

Phoenix Learning & Care

16.2

South West

Therapeutically supported children's residential care and education facilities for young people with complex needs

Healthcare Homes

15.0

South East

Residential support for people with physical disabilities, specialising in care for people with multiple sclerosis

Comfort Care Services

14.9

Central

Specialist providers of supported housing for vulnerable adults with mental health needs and for individuals recovering from substance/ alcohol misuse

Progressive Care & GDMA Group

14.6

North East

Provider of care, assessment and support packages for children, young people and adults with complex needs

Salutem Healthcare

14.4

Central

Residential provider of learning disability services , children’s educational services, mental health and autism services

Active Pathways

14.0

North West

Recovery focused mental health services

Gainford Care

13.6

North East

Residential nursing care for the elderly and complex dementia patients

Home From Home Care

13.5

East Midlands

Residential care for adults with learning disabilities including autism and epilepsy

Potens Group

12.7

North West

Specialist residential mental healthcare

TLC Care

12.6

West Midlands

Providers of expert nursing, complex dementia and respite care

Castle Craig Hospital

11.9

Scotland

Private residential drug and alcohol rehabilitation clinic

Midhurst Child Care

11.7

South West

Care services for children, including residential children's homes, therapeutic crisis intervention and education services

Pathfinders Care

11.6

East Midlands

Specialist care for people with complex care needs, from slow-stream rehabilitation through to end-of-life care

NG Healthcare

11.6

West Midlands

Residential care and support to a variety of people with progressive mental health needs

N. Notaro Homes

11.4

South West

Advanced residential dementia care and support

Bryn Melyn Care*

11.0

West Midlands

Provider of therapeutic residential care, independent education, and integrated clinical services for children

Sequence Care

11.0

Greater London

Residential provider of care and support for people with learning disabilities, autism and associated mental health care needs

*In November 2020, Heathcotes announced Civitas Investment Management had acquired its healthcare real estate assets while Envivo Group has bought the operational care business; Ares Management acquired Exemplar Health Care in November 2020; and Outcomes First Group acquired Bryn Melyn Care in October 2020, after the reference period for this year’s award listing.

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What the future holds This year’s Alantra Specialist Care Fast 50 reveals this is an industry where growth has been accelerating – and the fundamentals in the sector, of constricted supply versus rising demand, mean this should continue, though Covid-19 may take its toll on 2021 figures. One trend now gathering pace, not least thanks to the funding and expertise provided by investors, is an increasing focus on technological innovation, both to support operational efficiency and better care. For example, specialist care providers are increasingly making use of data dashboards that provide real-time data on every aspect of operational performance. As these providers scale, building out from their central services platforms, this insight boosts effectiveness and efficiency. Elsewhere, the use of data analytics in care delivery are just as exciting. Tools that provide carers with advanced

HealthInvestor UK • November 2020

intelligence on how to work with each of their service users are transforming user-centred care. Innovations such as wearables make it possible for care operators to build ever more detailed pictures of their users. These advances are a natural element of the professionalisation of the care sector, which continues to evolve away from single facility providers towards larger operators applying a platform model, including through consolidation. And that makes sense as attention turns to social care reform – however the government resolves its public finance issues, the care sector will continue to be asked to deliver more for less. Against this backdrop, specialist care offers a range of opportunities. Operators remain committed to delivering the highest standards of care to service users. As the Alantra Specialist Care Fast 50 shows, it is this focus on quality that drives their commercial success. n

TECHNOLOGY

Clean air for social care Technology in the care sector is a growing trend, but as climate awareness intensifies and we learn to live with coronavirus, its use will become increasingly important. Naeem Walji, principal at 4th Wave Technology, distributors of clean air technology, discusses how new technologies can improve the lot of care home residents

HealthInvestor UK â&#x20AC;˘ November 2020

TECHNOLOGY

t is undeniable that technology is changing the way people provide and receive care across the UK. When implemented effectively, innovative uses of technology can provide huge benefits and support in delivering high-quality care with minimal disruption. The adoption of devices such as audio and movement sensors, voice recognition software, and the use of digital records, for example, have improved efficiency in both caregiving and administration across the sector, and can help to make care more person-centred and less disruptive. As we face two major crises – the climate crisis and the coronavirus pandemic – technological advances have the potential not to only improve the efficiency of operations, but also to safeguard residents’ health and improve life expectancy.

Infection control procedures worldwide The coronavirus pandemic has changed the way we view health and safety measures within the social care sector forever, with heightened infection prevention and control standards, and an entirely new perspective on what measures are necessary to keep residents and staff safe. While public health officials had previously warned that a novel disease could eventually cause a global pandemic, only certain Due to the way in which viruses attach to air pollution countries were wholly prepared for the possibility of an particles, heavily polluted spaces also subsequently have a outbreak and had the technology in place to counter it. higher rate of disease infection. Reducing levels of indoor Having experienced the Sars outbreak of 2003, when faced air pollution through increased ventilation and filtration with the initial spread of coronavirus, countries like South therefore not only improves the physical and mental health Korea, Taiwan and Hong Kong were much more experienced of older people, but can also safeguard against airborne in implementing quarantine measures. They were also already disease transmission routes within care homes, reducing utilising technology that improved the the risk of transmission by up to 50%. efficiency of infection control measures. As we move into winter under a For example, over the past 16 years, clean second wave of coronavirus, the use of According to the air technology has been installed in over technologies such as air sterilisers will 80% of the hospitals and universities become one of the many important EPA, the levels in South Korea. By removing viruses, methods that care providers are likely of indoor air bacteria and pollutants from indoor air, to implement in order to slow down the pollutants can be spread of coronavirus. This would support this technology has aided the country in between two to the use of other technologies that are reducing cross-contamination in certain five times higher increasing in popularity across the sector. sectors. Technological applications and As we have already observed, the increased than outdoors initiatives are now multiplying around use of communication technology, such the world in an attempt to stop the spread as telehealth technologies, can help to of coronavirus, among other public health reduce person-to-person contact where issues, and many of these are applicable to the care sector. possible. The installation of thermal imaging cameras is useful in efficiently checking the temperature of care staff Applying lessons learnt to the UK each day, and facial recognition technology is also likely to With air quality in the UK worsening year-on-year, the adverse become more frequently used across the sector, as it helps health effects of pollution are of increasing importance, and to create contactless pathways, reducing pathogen transfer. due to comorbidity, exposure to air pollutants in older people With the current climate changing the way in which is of particular concern. According to the Environmental investment decisions are made across the sector, there is an opportunity to follow in the footsteps of countries such Protection Agency, the levels of indoor air pollutants can as South Korea, in ensuring the rapid incorporation of new be between two to five times higher than outdoors. With older people spending approximately 19-20 hours a day technologies wherever possible. This has the potential to indoors, research from various institutes in Europe shows that enhance the efficiency of infection control measures and to even at low levels, indoor air quality detrimentally affects protect residents, both in the short-term from the ongoing respiratory health in older people living in care homes, with risk posed by coronavirus, and in the long-term in terms of frailty increasing with age. physical and mental health. n

HealthInvestor UK • November 2020

HOSPITAL CONSTRUCTION

Hospitals for the future With the government committing £3.7 billion to building 40 new hospitals by 2030, the infrastructure supporting the overburdened UK health system needs to be adaptable to meet overwhelming demand, says Tony Wells, managing director of offsite construction firm Merit

or the most of this year, hospitals have been in the limelight. Doctors, nurses and other staff have been tirelessly working to provide urgent care for an unprecedented number of patients, day and night. The crisis has already shone a light on some of the lessons which need to be heeded ahead of future similar challenges. For example, it was widely reported that in the early days of the crisis there was a critical need for adequate resources and equipment. Capacity and wards ready to take Covid-19 patients were also an issue, hence the network of Nightingale hospitals. Think about the complexity of the changes required at short notice to isolate Covid units inside hospital buildings at the beginning of the pandemic, or when whole floors were needed to be reorganised to enable efficient work. Adequately designed spaces are essential for our healthcare system, and supportive infrastructure can make care easier, faster and more adaptable to changing circumstances. The government is aware of this, and this may be one of the reasons it has allocated £3.7 billion to build 40 new hospitals by 2030. Hospital construction is a long-term commitment. If we decide to erect new facilities now, we must consider the future needs that ought to be met in one, two or even three decades. We now can design the hospitals of the future, which could and possibly should look very different from existing facilities. This is true for both public and private sector providers. A global pandemic of some description has been anticipated for some time and it’s quite possible that we can expect similar challenges ahead of us. Hospitals in times to come will need to be ready to react rapidly to similar outbreaks to contain them earlier. A focus on infection control will become more important and there will be other major themes such as digital healthcare provision, robotics and increasing use of advanced therapeutic medicines, which the NHS will need to contend with.

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HealthInvestor UK • November 2020

HOSPITAL CONSTRUCTION

Tony Wells, Merit

HealthInvestor UK â&#x20AC;¢ November 2020

HOSPITAL CONSTRUCTION

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All of these factors need to be considered for the facilities This not only means excellence and lasting building quality of the future. Plans need to be made for hospitals with from a construction perspective, but also that hospitals shall wards and even individual rooms, operate sustainably as part of a larger ecosystem. Unlike a previous generation enabling superior infection control while also serving as self-sufficient mini of healthcare facilities, today we have At Merit, we are units with a range of built-in services, access and the knowledge of construction already building independently functioning from other methods that can improve energy parts of the building. efficiency and lower carbon footprints, on our innovative Another aspect when embarking crucial imperatives in the NHS’s new construction on the journey of such a large-scale ‘Net Zero’ plan. Themes connected to techniques to support healthcare facility construction initiative, the environmental, social and corporate the healthcare and is to ensure that these buildings are governance agenda will also be critical life sciences sectors sustainable. “Build back better” has been for private providers needing to address a key reoccurring theme when discussing the impact of their estates more quickly the aftermath of the crisis and how we and under greater public scrutiny. can now pivot systems to a sustainable In addition to that, the pandemic has footing. shown us that new technologies can emerge and accelerate

HealthInvestor UK • November 2020

HOSPITAL CONSTRUCTION

we have accelerated the traditional construction process. We use smart changes that mean no additional costs. The feasibility of our approach has been shown through the numerous cleanroom and high containment laboratories and other healthcare facilities we have built in the last decade. The private sector will have a critical role in bringing expertise and technology to support the NHS to achieve a step change in the performance of hospital buildings. Energy efficiency, infection control, and adaptability are all critical to aspire for and are already feasible to achieve through prevailing technologies – so let’s leverage the assets we have. Today we have the unique opportunity to ensure that future hospitals will be safe, flexible and sustainable for us and the generations that follow. There are many lessons which will emerge from the current crisis, but there are also undeniable opportunities to do things differently and to accelerate change in a meaningful way, unthinkable just a few short months ago. n

faster than anyone imagined. Novel nucleic acid vaccines have never been approved for human use and now they are at the forefront of the vaccine race. We have shown that we can develop vaccines in a fraction of the time previously needed, so why wouldn’t we turn to modern construction techniques that can halve long-established construction time frames and still deliver outstanding results? For instance, offsite construction methods, together with standard designs, are leading the way at changing the traditional approach to construction. At Merit, we are already building on our innovative construction techniques to support the healthcare and life sciences sectors. While a typical acute facility might take three to four years to build, we aim to deliver these in half the time. We manufacture about 75-90% of the building at our 270,000 square foot factory near Newcastle upon Tyne and by having significantly shortened our supply chain,

HealthInvestor UK • November 2020

CYBER SECURITY

Covid is not the only virus While coronavirus has caused the healthcare industry all manner of pain, the viruses spread by cybercriminals also remain a constant threat, warns Keith Glancey, systems engineering manager, Western Europe at Infoblox, an IT automation and security company based in Californiaâ&#x20AC;&#x2122;s Silicon Valley

HealthInvestor UK â&#x20AC;˘ November 2020

CYBER SECURITY

ealthcare organisations globally have faced the With the healthcare industry stretched thin, many immense task of re-equipping their workforce organisations don’t have the manpower to manage the rising for remote working. Traditionally, the healthcare threat levels on their own, yet face disastrous consequences if industry has been slower to digitalise. A 2018 global study security is de-prioritised. by Econsultancy and Adobe found only 7% of healthcare Healthcare organisations’ IT spend and pharmaceutical companies said they had gone digital, Infoblox’s report found the vast majority (77%) of healthcare compared to 15% of companies in other industries. When organisations have already changed their cybersecurity plan the Covid-19 pandemic struck, a recent report by Infoblox for when employees return to work – this was much higher found that 64% of healthcare organisations said they felt than the cross-industry number of 49%. In addition, 73% of they were ‘very prepared’, with another 30% saying they businesses are currently re-evaluating their cloud strategy. So, were ‘somewhat prepared’ when it came to having the right where is the healthcare industry investing? technology or cybersecurity in place for employees to work Well, 75% of organisations invested in endpoint security from home. and secure domain name system, respectively, to help secure Unsurprisingly, cybercriminals exploited industries that their networks and employees as a result of Covid-19. This were ill-prepared for this new way of working. The same report found 70% of healthcare organisations reported seeing was followed by 73% adding artificial intelligence to detect an increase in attempted cyberattacks as a result of Covid-19, anomalous behaviour and 72.5% adding DDI (DNS, DHCP, IP and these threats are only going to get more sophisticated as Address Management) to their security stack. time goes by. Despite this, only 35% are moving resources With all of these options, it can be really difficult for IT teams towards cybersecurity to protect their network, with the to know where to start when considering where to invest their majority (60%), moving resources away. precious dollars. While it might be understandable that How to secure from the the industry under the heaviest strain is not prioritising cybersecurity, this can have network’s core catastrophic consequences. Back in April, Many healthcare organisations operate Unsurprisingly, INTERPOL warned of a significant increase across a large number of sites – whether cybercriminals in cyberattacks against hospitals that are it be a hospital, a medical practice branch exploited industries engaged in the Covid-19 response and that or the thousands of employees’ homes. As that were illattacks could “directly lead to deaths”. The companies increasingly become borderless Guardian reported hackers are also hitting through deploying their IT infrastructure in prepared for this UK research labs amid the vaccine race in the cloud and operating on a decentralised new way of working the hope of stealing extremely valuable network model, it’s getting harder to and confidential information. Even the monitor traffic and devices across all World Health Organization was targeted locations with traditional security solutions. by attackers back in March – part of a As the Infoblox survey found, the vast two-fold increase in attacks levelled against the organisation. majority of healthcare organisations are beginning to invest in So, what kind of attacks should healthcare organisations be DDI solutions to help secure their new remote workforce. This watching out for and how can they best protect themselves is because cloud-managed DDI platforms can extend security policies to the enterprise edge by allowing organisations to while stretched so thin? deploy automatically and centrally manage core network Growing security vulnerabilities across services to all locations. healthcare What’s different about DDI services from, say SD-WANs or According to Infoblox’s survey, 90% of healthcare band-aid solutions like VPNs, is that they sit at the heart of organisations reported seeing phishing and social engineering the network. From there, they can monitor and flag suspicious attacks, 89% said they saw malware exploits targeting activities across hybrid and multi-cloud environments. And organisations, 85% said they had experienced unknown because they’re deployed in the cloud, it helps to alleviate the devices attempting to connect to the network, and 38% strain on IT teams and enable faster roll-out of new solutions, reported domain name system/network traffic hijacking. which is of particular importance given many healthcare All of these threats become exponentially harder to organisations have said they’re shifting resources away from detect and mitigate with a remote workforce connecting cybersecurity. to the corporate network from what could be thousands of The healthcare industry is at an inflexion point. It’s struggling under the strain of a global pandemic, while having a growing insecure personal devices. Almost half (44%) of healthcare target on its back for cybercriminals looking to exploit this for organisations said distributing approved devices was their their own gain. With funds being prioritised for urgent care, biggest challenge when setting up employees to work from IT decision-makers need to consider carefully where they are home. Home networks simply lack the security resources to making investments and consider long-term solutions that fend off these sophisticated attacks. From using Wi-Fi to will help detect threats as their networks continue to expand unapproved devices and applications, the workload for IT to support the growing needs of the borderless enterprise. n and cybersecurity teams is unprecedented.

HealthInvestor UK • November 2020

FINANCE: DEALS

deals Ares acquires specialist nursing firm Exemplar COMPANY: Ares Management Corporation TARGET: Exemplar Health Care TRANSACTION: Acquisition CONSIDERATION: Undisclosed Private equity firm Ares Management Corporation is acquiring Exemplar Health Care from pan-European mid-market private equity firm Agilitas. Exemplar provides person-centred, specialist nursing high-acuity care to individuals living with complex physical and mental health needs in the UK. Advisors to Agilitas included: Macquarie Capital (sell-side corporate finance); Pinsent Masons (sell-side legal, and legal/regulatory due diligence); PwC (sell-side financial due diligence); Connell Consulting (sell-side commercial due diligence); Grant Thornton (sale and purchase agreement accounting support); Ashurst (fund legal); EY (fund tax); Deloitte (sell-side tax).

Ashberry Healthcare completes MBO COMPANY: Ashberry Healthcare TRANSACTION: Management buyout CONSIDERATION: Undisclosed Care home provider Ashberry Healthcare has completed a management buyout from former owners Rosegarth Investments by three members of its existing executive team. Chief executive Nigel Denny alongside chief operating officer Susan Lovelace and chief finance officer, Gary Cottrell, have acquired 100% ownership of the business and property. Tees Law, helped the deal across the line and Joe McDermott from Albright Dene advised on complex property issues. Connell Consulting conducted commercial due diligence on the MBO.

Care at Home buys Westminster Homecare COMPANY: Care at Home TARGET: Westminster Homecare TRANSACTION: Acquisition CONSIDERATION: Undisclosed Home care provider Care at Home has acquired Westminster Homecare. Care at Home Services was advised by Healthpartners Services, MHA MacIntyre Hudson Corporate Finance, CDI Global, GMG Business, and debt financing was provided by ThinCats. Westminster Homecare was advised by Oaklins Smith & Williamson and Hatstone.

CareTech Holdings acquires Smartbox COMPANY: CareTech Holdings TARGET: Smartbox TRANSACTION: Acquisition CONSIDERATION: Up to £10.6 million CareTech Holdings, which provides social care services for adults and children in the UK, has acquired Smartbox Assistive Technology and Sensory Software International (collectively Smartbox). To facilitate the acquisition, CareTech established a new subsidiary, Smartbox Holdings, which is 70% owned by CareTech, with the remaining minority ownership held by the Smartbox management team comprising Dougal Hawes, Jarrod Inott and Hannah Church, as well as previous owners Paul and Alyson Hawes. Smartbox Holdings will pay up to £10.6 million comprising an aggregate initial purchase price of £7.05 million, funded through an equity contribution and loan note from CareTech and equity contribution from the minority holders of Smartbox Holdings. Earn-outs of up to £3.55 million are payable over a two-year period from completion. CareTech’s contribution will be funded from existing cash resources.

HealthInvestor UK • November 2020

FINANCE: DEALS

Start Codon closes new £15m venture for life science innovation COMPANY: Start Codon TRANSACTION: New fund CONSIDERATION: £15 million Start Codon, a life science and healthcare business accelerator based in Cambridge has closed Start Codon Fund I LP at £15 million. The fund will be used to support Start Codon’s offering to start-ups, which includes a minimum of £250,000 seed funding, business support services, expert guidance, and access to office and lab facilities. Limited partner investors in the fund include Novartis International and Cambridge Innovation Capital.

Cera Care acquires Mears Care Scotland COMPANY: Cera Care TARGET: Mears Care Scotland TRANSACTION: Acquisition CONSIDERATION: Undisclosed UK-based home care innovator Cera Care has acquired Mears Care Scotland, which will add more than 1,000 staff and 12 offices in Scotland to Cera Care’s operations. The deal integrated Mears Groups domiciliary care arm in Scotland into Cera Care.

Compass Pathways closes IPO COMPANY: Compass Pathways TRANSACTION: Initial public offering CONSIDERATION: $146.6 million London-based mental health care company Compass Pathways has closed its initial public offering of 8,625,000 American Depositary Shares for $17.00 per ADS, raising $146.6 million. Cowen, Evercore ISI and Berenberg acted as joint book-running managers for the offering. Canaccord Genuity was lead manager and H.C. Wainwright & Co was co-manager for the offering.

Look Ahead acquires Essex specialist care provider COMPANY: Look Ahead TARGET: Kingswood Care Services TRANSACTION: Acquisition CONSIDERATION: Undisclosed The Look Ahead charity has acquired specialist care provider Kingswood Care Services which operates five residential units in Essex. Look Ahead is a provider of specialist care, support and accommodation services to people with a variety of needs across London and the Southeast.

Medica acquires Global Diagnostics Ireland for £15m COMPANY: Medica TARGET: Global Diagnostics Ireland TRANSACTION: Acquisition CONSIDERATION: €16 million UK-based teleradiology firm Medica has acquired Global Diagnostics Ireland from the private Irish healthcare group Centric Health. Medica acquired its Irish counterpart on a cash-free and debt-free basis. Alpha Helix Corporate Finance, the UK healthcare-focused advisors led by Gordon Hamilton, worked on behalf of Medica Group as exclusive buy-side corporate finance advisor on the deal.

Your.MD closes $30 million Series A round COMPANY: Reckitt Benckiser TARGET: Your.MD TRANSACTION: Investment CONSIDERATION: Undisclosed Global consumer health, hygiene and nutrition company Reckitt Benckiser has invested additional funds into pre-primary care hub, Your.MD. The investment follows an initial funding round led by Reckitt Benckiser and existing shareholders last year.

HealthInvestor UK • November 2020

EXECUTIVE MOVES

executive moves Aitchison Raffety Chartered surveyor and town planner Aitchison Raffety has appointed Paula Mace as head of healthcare to lead the company’s primary healthcare team. Mace has worked for Aitchison Raffety since 2003 and was appointed as a director in March last year. She has 15 years’ experience of the healthcare property sector having worked with many surgeries, medical centres, healthcare investors and funds across the country, providing a range of services, including valuations for secured lending, partnerships, portfolios and court purposes, for property owners, investors, and large portfolio holders. Mace has stepped into the shoes of

Philip Waite, who as Aitchison Raffety’s group director, head of operations, oversaw the healthcare, education and valuation teams, before being promoted to managing director of the company.

Audley Group Jon Austen is to retire as chief financial officer at Audley Group at the end of the year, the luxury retirement villages provider has announced. The company stated that a further announcement regarding his replacement will be made in the near future. Austen will continue with his non-executive directorships at McKay Securities and Supermarket Income REIT.

Bevan Brittan Law firm Bevan Brittan has added two experienced lawyers as partners to its growing independent health and social care practice. Sarah Skuse and Siwan Griffiths join the firm’s London office, moving from Capsticks. Skuse is a commercial property lawyer with experience of advising health and social care clients on real estate matters including acquisitions and disposals, development work and various leasing structures with associated funding arrangements and advising national care home operators, funders, investors and developers. Griffiths is a regulatory specialist, advising care home owners, social housing associations,

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HealthInvestor UK • November 2020

EXECUTIVE MOVES

Paula Mace, Aitchison Raffety

Philip Waite, Aitchison Raffety

▶ and independent health and NHS providers Inspired Villages extensively on health and social care regulation. Siwan now rejoins Bevan Brittan, where she previously worked for more than eight years in the 2000s. The two join a team at Bevan Brittan with a significant presence in the independent health and social care market, acting for over 170 care providers, suppliers, funders and investors. The practice has more than doubled its number of clients over the last few years.

Doctor Care Anywhere Digital health services provider Doctor Care Anywhere has appointed Michael Lord as its head of sales and account management, responsible for delivering new customer propositions and managing key client accounts, including AXA Health, HCA UK and Nuffield Health. Lord has experience of sales and business development, having previously worked as the commercial and business development director at King Edward VII’s Hospital, where he had overall responsibility for all commercial activity, and for the development of new and existing relationships with third parties. He was previously commercial contracts director and sales director at Nuffield Health, and head of procurement at Aviva Health UK. Doctor Care Anywhere provided services to more than 1,500 corporate and SME clients and covers two million eligible lives, via its channel relationships.

Inspired Villages Group, the Legal & Generalbacked later living business, has appointed Sharon Badelek as chief financial officer, in a newly created position. Badelek will lead a team of 18 finance and investment professionals, and work closely with group finance manager Tatiana Smith who joined the business in March. Badelek has more than 20 years’ experience of the UK retail, leisure and healthcare sectors. She was previously chief financial officer and chief executive of Novus Leisure, which operates at over 40 venues across the UK, group finance director at Vue Entertainment, as well as group financial controller of Virgin Active and chief financial officer of Westpoint Veterinary Group. Badelek joins the Inspired Villages’ main board along with the company’s chief operating officer, Tom Lord, who joined the business in September 2018 from the InterContinental Group, where he was the head of global operations. Lord has more than 20 years’ experience in the leisure industry. Inspired Villages, which was established by Legal & General in 2017, has grown in the past two years from a team of 25 to around 300 employees, with capital commitments of half a billion pounds across its six later living developments. It states it wants to add a further 2,500 homes over the next six years. Its seventh village, Ledian Gardens in Kent, is set to open next year, with construction under way on an eighth village, Elderswell in Bedfordshire, and

Jon Austen, Audley Group

works due to start on a further four schemes next year. Inspired Villages’ chief executive Jamie Bunce said: “Sharon’s appointment comes at a crucial time for the company. Her business acumen and strong customer-centric approach will be integral to our continued growth. Sharon and Tom’s board appointments will further support the company’s purpose of redefining the later living experience in this country and making a significant contribution to the overall strategic direction of Inspired Villages.” Phil Bayliss, chief executive of Later Living at Legal & General, added: “Covid has shone a light on the clear and pressing need to support our over-65s population, safeguarding them, and reliving the burden on our overwhelmed NHS and social care systems. We all want and deserve to live healthier, better and more independent lives for longer. Sharon’s appointment is a response to Inspired Villages’ fast-paced growth and societal need. Alongside Tom’s, her wealth of experience from growing hospitality and leisure businesses will prove extremely valuable to the company’s strategic direction.”

Kajima Partnerships International property developer and investor Kajima Partnerships has appointed Dwayne McAleer as managing director of Kajima Ireland, based in Dublin. McAleer will lead Kajima’s activity in financing and developing projects across the healthcare sector, including hospitals, community care and

HealthInvestor UK • November 2020

EXECUTIVE MOVES

Sarah Skuse, Bevan Brittan

elderly living, in the Republic and Northern Ireland. He was formerly a senior executive of Ireland’s National Development Finance Agency and more recently the Land Development Agency. With three decades of experience in the Irish market, he has a strong background in unlocking state-owned land for investment, in partnership with both public and private landowners, as well as in the procurement, financing, construction and operation of largescale private finance development. Recent projects he has overseen include the Shanganagh development in Dublin, Ireland’s first large-scale residential development consisting of 100% social and affordable build to rent properties, where he secured investment readiness for the project including planning permission.

Sharon Badelek, Inspired Villages

HealthInvestor UK • November 2020

Siwan Griffiths, Bevan Brittan

McAleer also played a central role in the regulation and delivery of the new third level education and healthcare campus at Grangegorman in Dublin, including large, complex and bespoke public facing buildings. McAleer has developed a significant programme of regional sites in Ireland on a bundled basis and has international experience operating in private consultancy, specialising in feasibility and viability analysis.

Zava European digital healthcare provider Zava has appointed former chief executive of Just Eat David Buttress as its chair and Roy Blanga, former chief operating officer of Deliveroo, as a board member.

Dwayne McAleer, Kajima Partnerships

Michael Lord, Doctor Care Anywhere

Buttress spent 11 years at Just Eat, launching the business in 2006, and was appointed chief executive in January 2013. Blanga oversaw Deliveroo’s rapid scale up and international expansion. Prior to that he led e-commerce marketplace Groupon’s largest international region. He is an active investor and advisor to several start-ups London-based Zava is a large digital healthcare company offering access to healthcare consultations, testing and prescribed treatments from GPs. Operating in France, Germany, Ireland and the UK, and with 4.5 million consultations and treatments completed todate, Zava recently secured $32 million in series A funding. n

David Buttress, Zava

EXECUTIVE CV

Kevin Beirne Head of retirement living at Octopus Real Estate Education I caught the real estate bug while an undergraduate at the University of Salford, being one of the first to study the gentrification of Salford Quays as the dissertation for my geography degree. Once converted to real estate, I decided to kick-start my career in the industry and I studied for a master’s degree in housing at the School of Planning at Oxford Brooks University.

Work history I have more than 25 years’ experience across the real estate sector and have had the opportunity to focus on senior living and healthcare over the past 15 years, while continuing a significant interest in mainstream residential investment. The retirement housing market suffers from a significant supply-demand imbalance, and interest is being driven by an aspirational growing ageing population who increasingly want to downsize and enjoy retirement in highend accommodation. It was an obvious focus for me, and I have worked tirelessly to support development projects of retirement schemes across the country. As a developer/operator and now an investor I have travelled all around the UK and overseas to share learning, define what ‘good’ looks like and bring that into the work we do. The classic City route is often to make your mark in the private sector and later to bring your expertise to the charitable sector. I like to be something of a positive disruptor, so I did it the other way around. I started my career at Cherwell Housing Trust working on the Blackbird Leys extension back in the nineties. I joined One Housing Group in 2002 and at that time became one of the youngest ever executive directors in the sector.

As well as being a group board member, I led the specialist and healthcare business, growing the business more than 20-fold and established it as a leading volume developer and operator of senior living and care. I created both the Season Homes for retirement living and the Baycroft luxury care homes brands, broke new ground through major joint ventures with the NHS, and delivered over 3,000 places for people to live in senior and specialist housing. I have always had a clear aim to create the very best real estate and services that you would choose for yourself, whether in the public or private sphere. I think it’s important in a successful career to give something back to the industry and leave it in a better place than you found it. That said, I am also the founding member and on the steering board of directors for ARCO (Associated Retirement Community Operators) as well as having served as an advisory board member for the Homes and Community Agency (now Homes England) and sat for two terms on the National Housing Federation’s development committee. Strong highlights in my career at One Housing include helping to secure and run the partnership with Argent in developing King’s Cross Central and learning about alternatives by transforming a disused building into the hugely popular and profitable 310-bed Soho backpackers’ hostel; winning the ‘Completed HAPPI Scheme’ at Housing Design Award in 2011 for Trees senior living development in Highgate; introducing Welfare Reform to live TV at the Arlington conference centre, and attending a private audience with the Duke of Edinburgh as a thank you for funding our own DofE Award scheme from our profits. The ultimate highlight to date must be the launch of Arlington in June 2010 alongside

Boris Johnson, Tracy Emin and my inspirational chair at that time – Julia, Baroness Neuberger. Modelled as London’s answer to the famous NYC Times Square project, the scheme was famously challenging to deliver and has transformed the lives of many homeless people by mixing supported housing with equal numbers of key workers, alongside a range of exciting business and arts operations and in so doing creating a pioneering way to tackle homelessness sustainably. I was delighted to have the opportunity to join Octopus Real Estate in 2018 as head of retirement and a member of the management team and investment committee. My team is responsible for both investing and raising institutional funds to facilitate the development of high-quality retirement communities, as well as managing key partnerships such as our institutional investment collaboration with Schroders and investments in retirement operators such as Rangeford. I recently led on our major joint venture with Audley and Schroders and have big ambitions for the retirement team at Octopus Real Estate. The goal for Octopus Real Estate is to be the leading investor in the market, working in partnership with the retirement community sector that delivers new retirement communities for the ageing population over the next decade.

Hobbies I follow a green shirted international rugby team and am a Gunner and like watching Arsenal whenever they play… especially enjoyable if they win! In the winter months I really enjoy getting away for a ski trip to the Italian Alps with my family and friends, but I tend to spend most of my time chasing the kids down the slope! n

Top tip for success Good leadership is the ultimate test of great teamwork. Be sure of your business plan and don’t be afraid to scale up or equally walk away.

HealthInvestor UK • November 2020

EXECUTIVE CV

Kevin Beirne, Octopus Real Estate

HealthInvestor UK â&#x20AC;¢ November 2020

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