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Growth – InternationalCOVID-19 impacted our growth strategy in our international markets, but we are well-positioned to capture future opportunities and increase our market share. We remain committed to growing our revenue and earnings from non-acute sources.
Our 2020 priorities |
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ACHIEVED
PARTIALLY ACHIEVED
ONGOING OR NOT ACHIEVED
DELAYED DUE TO COVID-19
Alliance Medical proved to be robust in the face of significant headwinds during the year. With a strong performance up to February 2020, the business saw a steady increase in demand since restrictions eased in the countries we operate.
| Geographical segment | Year-on-year trend (%) |
2020 | 2019 | ||||
| UK | |||||||
| Diagnostic imaging | |||||||
| Statics (scans) |  |
(18.5%) | 262 016 | 321 576 | |||
| Mobile (days) | |
(5.5%) | 10 466 | 11 070 | |||
| Mobile utilisation (%) | |
(5.7%) | 77% | 82% | |||
| Molecular imaging | |||||||
| PET-CT (scans) |  |
1.8% | 85 604 | 84 057 | |||
| Radiopharmacy (doses)1 | |
(2.0%) | 104 783 | 106 690 | |||
| ITALY | |||||||
| Diagnostic imaging | |||||||
| MRI and CT (scans)4 | |
(6.9%) | 250 289 | 268 820 | |||
| Other diagnostic imaging (scans)2,4 | |
(17.7%) | 567 941 | 689 700 | |||
| IRELAND | |||||||
| Diagnostic imaging | |||||||
| MRI and CT (scans) | |
0.7% | 202 384 | 201 029 | |||
| Other3 | |
20.4% | 59 884 | 49 734 | |||
| Molecular imaging | |||||||
| PET-CT (scans) | |
(2.8%) | 1 698 | 1 747 | |||
| NORTHERN EUROPE | |||||||
| Diagnostic imaging | |||||||
| MRI and CT (scans) | |
(35.3%) | 15 020 | 23 202 | |||
| Molecular imaging | |||||||
| PET-CT (scans) | |
(17.2%) | 3 841 | 4 641 | |||
| Radiopharmacy (doses) | |
6.4% | 73 162 | 68 776 | |||
| SPAIN | |||||||
| Diagnostic imaging | |||||||
| MRI and CT (scans) | |
5.0% | 68 546 | 65 313 | |||
| Molecular imaging | |||||||
| PET-CT (scans) | |
45.3% | 1 123 | 783 |
| 1 | We requested that some third-party customers source their fluorodeoxyglucose (FDG) elsewhere as part of our PET wave 2 contract. |
| 2 | Includes, among others, X-rays, mammograms, ultrasounds and mammo-tomosynthesis. |
| 3 | Includes X-ray, ultrasound and other diagnostic imaging scans. |
| 4 | Prior year adjusted for Italian acquisitions. |
| UK |
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We continued with our refurbishment programme this year and completed vital upgrades to cyclotrons at two of our sites. Four cyclotrons are operational and serving the market's growing demand. We started refurbishing our third site in September 2020. Production reliability reached about 99%, which is higher than the industry norm. Substantial additional production capacity has been introduced as a result of a fifth site, Dinnington, opening in September, with commercial supply due to commence imminently to cater for the continued growth in PET-CT. While our PET-CT centres were operational during the government-imposed lockdown, scan volumes reduced by up to 40%. However, we saw a significant recovery as restrictions eased, with pre-COVID-19 volumes reached in June 2020. Our diagnostic imaging business achieved strong organic growth up to February 2020, supported by effective cost management and increased volumes. The business was significantly impacted by COVID-19, as the NHS stopped all effective work and clinics. Volumes increased steadily week-on-week from July, with diagnostic imaging now at about 90% of pre‑COVID-19 levels reached at year-end, with PET-CT now exceeding pre‑COVID-19 levels. We continued to execute our strategy in the UK mobile MRI business, transitioning to longer-term customer relationships with lower pricing. This business was impacted much the same as our diagnostic imaging business. We concluded an agreement with the NHS, where we provided 16 CT scanners – available 24/7 for six months - to support the UK government's response to COVID-19. Furthermore, we provided training for eight weeks in CT imaging procedures for approximately 60 clinical employees to support the UK government's field hospital. We believe this partnership further reinforces our commitment to value creation. |
| ITALY |
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Italy was the first region to experience the full impact of COVID-19, with scan volumes during March and April the most affected. However, volumes steadily increased as lockdown restrictions eased. Our priorities in this region included:
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| IRELAND |
| Following the strong performance of the previous financial year, Ireland was tracking double-digit growth during the first half. The business could not avoid the impacts of COVID-19. However, we saw a strong recovery over recent months. Our performance during quarter four brought the business in line with our original expectations - a significant achievement given the year's circumstances. |
| NORTHERN EUROPE |
| Our business in northern Europe proved to be resilient, with robust performance from our radiopharmacy business. While demand for MRIs slowed down due to COVID-19, our CT business continued to perform well. |
| SPAIN |
| Our business in Spain experienced a significant decrease in activity during lockdown. Our largest contract is with government hospitals, and recovery was in line with hospital activity. We introduced a second mobile PET-CT solution during the year, and PET-CT remains a growth area. |
We aim to deliver high-quality medical services and will continue exploring ways to grow our business and improve how we care for our patients. We focused specifically on organic growth and operational excellence in 2020, with promising results during the first half of the year.
| Revenue source (PLN million) | Year-on-year trend % |
2020 | 2019 | 2018 | |||
| NFZ | 9.3 | 313.5 | 286.8 | 274.8 | |||
|---|---|---|---|---|---|---|---|
| Private | 0.1 | 75.5 | 75.4 | 69.3 | |||
| Total revenue | 7.4 | 389.0 | 362.2 | 344.1 |
Contracts with Poland's NFZ constitute approximately 81% of Scanmed's overall revenue, up from 79% in 2019, mainly due to increases in lump sum and limited contracts, growth in the number of unlimited procedures and new contracts.
Beds, units and facilities
| Category | 2020 | 2019 | 2018 | ||
| Beds | 582 | 579 | 624 | ||
|---|---|---|---|---|---|
| Cardiac units | 13 | 12 | 12 | ||
| Medical facilities | 42 | 41 | 40 |
Bed occupancy decreased slightly due to the pandemic's impact. We opened our 13th cathlab in Bielsk Pdlaski in December 2019, which started operating under contract with the NFZ in March 2020. We designed our cathlab in Racibórz as an infectious disease hospital for cardiac patients diagnosed with COVID-19. We also use our ambulances to transport infected patients.
Operational information
| Number of procedures ('000) | Year-on-year trend % |
2020 | 2019 | 2018 | ||
| Blachownia Hospital | 0.4 | 5 743 | 5 721 | 6 334 | ||
|---|---|---|---|---|---|---|
| St Raphael Hospital | (20.7) | 11 985 | 15 116 | 13 180 | ||
| Weiss | 0.4 | 25 052 | 24 942 | 26 453 | ||
| Gastromed | (15.8) | 13 194 | 15 671 | 14 496 | ||
| Sport Klinika | 19.4 | 11 478 | 9 612 | 10 411 | ||
| Cardiology1 | (17.6) | 16 023 | 19 441 | 18 865 |
| 1 | Includes procedures performed in Scanmed Kardiologia, Polska Grupa Medyczne (PGM) and Carint. |
The number of procedures in our facilities decreased compared to 2019 as a result of COVID-19. However, we have seen a steady increase in procedures since May 2020 and expect to reach our average achieved over the first half of the year by the end of the 2020 calendar year. We opened a neonatology ward at Blachownia Hospital and concluded a contract with the NFZ in this regard. This addition further supports the reputable team of doctors and the facility's modern infrastructure. We expanded the orthopaedic and spinal surgery services of St Raphael Hospital during the year to meet the strong demand for private services in the local market.
| OUR 2021 PRIORITIES | ||
| ALLIANCE MEDICAL | SCANMED | |
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