Our stakeholders

The sustainability of our business depends on positive relationships with stakeholders. We pursue stakeholder engagement systematically, which allows us to understand those risks that could impact our business. We believe that open exchange with and between diverse stakeholder groups has the potential for value creation. We are therefore committed to understanding the needs of our stakeholders at each point of our value chain, and responding appropriately so we can consistently create value in the short, medium and long term.

STAKEHOLDER	WHAT THESE STAKEHOLDERS CARE ABOUT	OUR STRATEGIC RESPONSES	THE VALUE WE CREATE

Patients	Cost and quality of care Reputation of doctors, specialists, healthcare and other service providers Caring nursing staff Clinical pathway experience	Providing quality, patient-centered healthcare and related medical services to our patients Living our core value of quality to the power of e (ethics, excellence, empowerment, empathy, energy) Transparent measuring and monitoring of patients' experience Using independent service providers to obtain feedback on patient experience Promote positive patient and client interaction through our CARE programme	We create value for our patients by delivering a standard of healthcare that improves the quality of their lives. We do this by holistically addressing the needs of patients and their families, and by operating with a level of outcomes efficiency that sets us apart from our competitors. In southern Africa, our patient experience measure (PXM) remained at 8.4. In Alliance Medical, our patient experience improved in territories and exceeded internal targets. In Scanmed, our healthcare associated infections (HAIs) improved to 0.67 from 0.84 in the prior year. Our outpatient clinics received a score of 88.1% (very satisfied), consistent with the prior year. For more information, refer to Overview of our international portfolio and quality.

Doctors and specialists	Clinical efficiency Insurance Quality of facilities Technology Clinical governance	Striving for and developing long-term relationships with doctors and other healthcare professionals to sustain our operations Working collaboratively with clinicians, healthcare organisations and academic institutes Monitor activities and trends among doctors and specialists Identify and respond to recruitment needs Cultivate a pipeline of future doctors, specialists and healthcare professionals Identify opportunities to improve efficiencies	We provide our doctors and specialists with quality facilities and advanced medical equipment. This, along with our partnership model, creates value by enabling doctors and specialists to provide quality services to patients. We also facilitate the education of doctors and specialists by providing bursaries and training to the value of R6.5 million. For more information, refer to sustainability and Sustainability international.

Healthcare funders	Clinical efficiency Quality of care Cost of healthcare	Developing and sustaining collaborative relationships with public and private funders Engaging with healthcare funders on their concerns Differentiating our service offering by providing value-based healthcare services Implementing an appropriate pricing strategy	With certain healthcare funders, we have a model in place that minimises costs and improves tariffs. Our differentiated service offering sets us apart and makes us a service provider of choice, both in southern Africa and internationally. In southern Africa, we continue to secure DSP network deals.

Industry and regulatory bodies	Compliance with regulatory obligations and environmental laws Involvement in industry discussions	Monitor and respond to changes to our regulatory landscapes, stay up to date with changes in codes, regulations and compliance frameworks Adapt to an increasingly complex environment, while remaining cost efficient and providing effective care Ensure compliance with all applicable legislation Engage with regulatory bodies to provide input for any new proposed legislation	We consistently engage with regulatory authorities on critical issues relevant to our business to ensure the best outcomes for all stakeholders. During the year, critical engagement continued around the HMI and NHI reports in our southern Africa business. For more information, refer to external environment.

Shareholders, investors and financiers	Increasing regulation Dividends paid Effective corporate governance Experienced leaders Sustainable growth Decreasing operating margins	Focusing on delivering operational efficiencies, growth and international diversification Providing a diversified product and service offering, with a growing share of revenue and earnings derived from non-acute sources Appropriately investing in cost-effective, environmentally friendly and innovative technologies Engaging with shareholders on remuneration matters Promoting an ethical culture and responsible corporate citizenship	We expose our shareholders, investors and financiers to the healthcare sector by offering a diversified and integrated portfolio of investments in southern Africa and Europe. During 2019, we distributed R1 365 million (2018: R1 290 million) in dividends to our shareholders.


Government	Employment opportunities Creating a stronger healthcare system Cost of healthcare Regulatory compliance	Striving to be a responsible corporate citizen Addressing skills shortages through our Life College of Learning Participated in government tenders in the provision of healthcare and diagnostic services	We create value for the government by cultivating a pipeline of skilled nurses through various training and development initiatives. We also invest in community health projects, thereby uplifting the societies in which we operate. 562 nurses graduated from the Life College of Learning.

Government as a customer	Efficiency Quality Cost of care	Partnering with government through public-private partnerships (PPPs) in southern Africa and internationally	We partner with government – such as the NHS in the UK and Azienda Sanitaria Locale in Italy – to deliver integrated care, technical excellence and efficient service, thereby becoming an integral part of the UK and European public health sectors. In the UK, through our partnership with the NHS, our services are facilitated by 49 diagnostic imaging scanners at 33 diagnostic imaging sites, 44 mobile scanners, 36 PET-CT scanners and four cyclotrons. In Italy, we operate from 34 clinics, eight static sites and one cyclotron. In Ireland we operate from 27 sites and in Spain we operate from 11 sites. In northern Europe we operate 18 mobile and relocatable buildings.

Employees	Health and safety in the workplace Transformation Remuneration Performance evaluation Career advancement Opportunities for learning and development	Focusing on employee wellness and development, as well as fair and transparent remuneration Recruiting and developing talent Enhancing our employee value proposition Investing in robust leadership development Implementing strategies to ensure a highly engaged workforce Encouraging a culture of safety within the workplace Maintaining healthy relationships with organised labour Succession management Developing a pipeline of future leaders, with a particular focus on African, Coloured and Indian (ACI) individuals	We create value for our employees by offering them opportunities and benefits beyond remuneration. Invested R201 million on training and development in southern Africa, with 1 083 learners enrolled in nursing, pharmacy and technical and vocational education training learnerships. Granted bursaries to 463 employees to encourage studies in scarce skills in southern Africa. Internationally, we have partnerships in place with 11 universities in the UK to provide elective and structured placements while, in Poland, we facilitate the education of specialist doctors. For more information, refer to sustainability. and Sustainability international.

Suppliers	B-BBEE ratings Timely payments Beneficial relationships The brand of Life Healthcare, Alliance Medical and Scanmed	Prioritising fair and transparent procurement activities Investing in enterprise and supplier development (ESD) initiatives Monitoring relationships with our suppliers Conducting reviews to ensure we obtain the best available pricing Ensuring adequate diversification of suppliers Selecting suppliers who provide quality, affordable supplies that meet our requirements Supporting local entrants to the market Seeking to balance transformation goals with cost management drives	We continually support enterprise development initiatives from an ESD perspective. During the year, we granted a total of R18 million to the B-BBEE Life Healthcare Nursing Education Trust.

Society	Community upliftment A healthy society Opportunities to improve education Protection of rights	Support the community through investment in community upliftment, health and education Through a steering committee, recommended projects to the Life Healthcare Foundation Trust for approval Allocated funds to approved corporate social investment (CSI) programmes Manage the use of renewable and non-renewable natural resources which impact the societies in which we operate	We believe that we can make people's lives better by investing in projects that facilitate brighter futures for the societies in which we operate. Through our CSI programmes, we create both financial and non-financial value for these communities. In South Africa, our CSI programmes complement shortfalls in public healthcare services and training. During the year, we invested a total of R106 million. For more information on our CSI programmes, refer to our corporate social investment.