Overview of our international portfolio

Our international portfolio comprises our investment in Alliance Medical Group Limited (Alliance Medical), Europe's leading independent provider of diagnostic imaging services, and Scanmed S.A. (Scanmed), which offers a wide range of healthcare services to patients across Poland.

Alliance Medical

Alliance Medical provides complex diagnostic imaging services and integrated molecular imaging services to public health authorities and independent organisations across the United Kingdom (UK) and Europe. Our main markets are in the UK where we partner with the National Health Service (NHS), Italy, where we supply Azienda Sanitaria Locale (ASL), Ireland and northern Europe.

The majority of our revenue is sourced from diagnostic imaging services, including magnetic resonance imaging (MRI), computerised tomography (CT) and molecular imaging via positron emission tomography-computerised tomography (PET-CT). We also manufacture and distribute radiopharmaceuticals.

	What we offer			How these services create value
	MRI, which uses spatially varying magnetic fields and radio waves to produce cross-sectional, two and three-dimensional images of organs and internal body structures.			Unlike x-rays and CT scans, an MRI does not use ionising radiation and is therefore the preferred technique for children and patients requiring multiple imaging examinations. An MRI is also appropriate for investigating soft tissue, such as ligament and tendon injuries, brain tumours and spinal cord injuries.
	CT scans, which emit several simultaneous x-ray beams from varying angles to produce two or three-dimensional images of body structures. Tomography is the process of generating a two-dimensional representation of a slice or section through a three-dimensional object. Multiple two-dimensional parts can be combined using tomography to produce three-dimensional images of body structures.			A key advantage of CT technology is that it has a smaller installed base and a shorter scanning time than MRI scanning equipment, which makes it ideal as an emergency assessment tool. CT is best matched for diagnosing bone injuries, identifying lung and chest difficulties, as well as diagnosing cancers and is often used in accident and emergency departments to assess injuries and acute medical conditions.
	During PET-CT procedures, a radiopharmaceutical (a pharmaceutical drug with radioactivity) is injected into a patient and localises in a specific organ or system within the body. Radiopharmaceuticals emit minuscule amounts of measurable positron radiation. These are captured by a PET camera which generates an image of the specific organ or system for the clinician to assess. Doctors use the image results to identify small changes in body tissues at a cellular level by highlighting physiological processes rather than anatomical structures.			PET-CT combines the high-quality resolution of the patient's anatomy using CT with the ability to measure the metabolic activity of cells. The metabolic activity helps clinicians better understand changes at the cellular level, which could be early indications of cancer. This has proven invaluable in helping oncologists make more accurate diagnosis and staging assessments, choosing the most appropriate therapies and determining which therapy is an effective treatment for cancer. PET-CT is also used to identify other degenerative conditions, such as cardiac and neurological diseases.
	Within radiopharmacy, we manufacture the radiopharmaceuticals used in molecular imaging procedures. Radiopharmaceuticals are usually manufactured in a cyclotron – a type of particle accelerator.			Radiopharmacy supports the high demand for molecular imaging services we perform. Alliance Medical also sells radioisotopes commercially to other PET-CT operators and for use in clinical trials.
	LMI is a research and development company dedicated to the development and global commercialisation of innovative molecular imaging agents for use in PET-CT diagnostics. Operating out of its laboratories and offices in Berlin, Germany, LMI has developed a pipeline of novel imaging agents addressing major unmet clinical needs in neurological, oncological, and cardiovascular diseases. LMI's first registered molecular imaging tracer, Neuraceq (florbetaben F18) is a globally approved and commercialised product for assisting in the diagnosis of Alzheimer's disease.			LMI forms part of the Alliance Medical Group – adding to the fully integrated Molecular Imaging business which now includes research and development laboratories, a network of cyclotrons, radiopharmacies and imaging facilities. This significantly adds to AMG's PET-CT service offering to the NHS and other healthcare commissioning organisations around the world and in addition efficiently serves the international research community and pharma industry by providing novel biomarkers integrated with production and imaging facilities for their clinical trials.

Over the past 30 years, Alliance Medical has integrated patient care, technical excellence and efficient service with a flexible business model that delivers value. This has led to the consistent growth of the Group, with a focus on delivery, mobilisation, quality and sustainability, allowing the business to become an integral part of the UK and European public and private health sectors.

In the UK, MRI, CT and PET-CT scans are conducted through contracts with local NHS trusts, and our services are facilitated by 49 diagnostic imaging scanners at 33 diagnostic imaging sites, 44 mobile scanners, 36 PET-CT scanners at 36 different sites and four cyclotrons. In Italy, we provide services in 34 clinics, eight static sites and one cyclotron. In Ireland, we provide services in 27 sites, while in northern Europe we operate 15 mobile scanners, three relocatable buildings and four cyclotrons, as well as operating from 11 sites in Spain.

Our PET-CT collaborative network with the NHS and other partners was secured four years ago under a 10-year PET wave 1 contract, which offers price certainty until December 2025. Since securing this contract, we have invested approximately £80 million into creating a network throughout the UK to ensure that no patient will be more than an hour's drive away from a diagnostic centre. Our footprint, therefore, has expanded significantly and we provide PET-CT scans at 36 cancer centres across England that operate under a national governance framework. Our partner, and the largest cancer centre in Europe, the Christie NHS Foundation Trust (the Christie) provides clinical leadership for this framework.

Pleasingly, this year we were awarded four PET wave 2 fixed-price contracts, across five locations, with a seven-year term and an option to extend for another three years.

In Italy, Alliance Medical has the largest network of community-based diagnostic imaging clinics. These provide MRI, CT and PET-CT services, as well as more basic diagnostic services, to local communities. In contrast to the UK, the market in Ireland is characterised by a self-pay model, with patients electing to consult general practitioners (GPs), who refer them to scanning services.

Our northern Europe business is a mix between mobile fleets and PET-CT in the Nordics, which is a significant growth area for Alliance Medical.

Scanmed

Scanmed provides comprehensive medical services – from consultations to diagnostics, analytical tests, medical transports and home visits, as well as in-hospital treatments. For more than a decade, Scanmed has offered its patients access to comprehensive treatment methods, technologically advanced and high-quality medical equipment and experienced specialists to facilitate their recovery.

We operate in 41 locations across Poland, comprising:

• a total of 12 cardiology centres offering comprehensive diagnostics and cardiological treatment through conservative, interventional and electrophysiological cardiology treatments;
• two multi-specialist hospitals – St Raphael's Hospital in Kraków and a hospital in Blachownia;
• a gastroenterology clinic in Lublin;
• a sports clinic in Zory, which offers comprehensive treatment of musculoskeletal disorders and injuries;
• a medical centre in Pabianice; and
• an ophthalmology clinic in Chórzow.

We also provide outpatient care services, diagnostic imaging and medical transport in major Polish cities, including Warsaw, Kraków, Poznan, Wroclaw, Gdansk, and Pabianice.