Assura Plc · OTC:ARSSF
Assura — Investor Day (February 2024)
43 slides from Assura's investor day presentation, Feb 8, 2024
Slide 1: Assura plc Capital markets event
Assura plc Capital markets event 8 February 2024 Image: CGI of GenesisCare, Guildford 1
Slide 2: Assura team
Capital markets event February 2024 Assura team Speakers Jonathan Murphy Jayne Cottam Jon Webb CEO CFO Development Director Other team members present Sian Taylor Alastair Barlow David Purcell Operations Director Senior Development Manager Investor Relations Director 2
Slide 3: Today's agenda
Capital markets event February 2024 Today’s agenda Introduction & market update Jonathan Murphy Private market overview Will Thompson (Barclays) Assura’s position in the private market Jon Webb Financing approach Jayne Cottam Summary Jonathan Murphy Q&A Tour of GenesisCare Cancer Centr
Slide 4: Introduction & market update
Capital markets event February 2024 Introduction & market update Jonathan Murphy CEO Image: CGI of GenesisCare, Guildford 4
Slide 5: Pressure on NHS is growing
Capital markets event February 2024 Pressure on NHS is growing Large number of recent reports Supportive political backdrop Which all highlight the need for substantial Both major political parties placing emphasis on investment in community infrastructure improving NHS services and efficiency State
Slide 6: Assura's buildings are part of the solution
Capital markets event February 2024 Assura’s buildings are part of the solution Our buildings increase capacity in the community that they serves This allows a greater number and range of health practitioners to deliver services All of which eases pressure on the local hospital and health system Del
Slide 7: Significant market opportunity
Capital markets event February 2024 Significant market opportunity Existing GP market Significantly underinvested estate with Material demand from NHS (and huge opportunity for improvement patients) for these buildings One third of current UK GP estate Bureaucracy means process is needs repl
Slide 8: Growing focus on emerging opportunities
Capital markets event February 2024 Growing focus on emerging opportunities Current portfolio Topic covered today Topic covered today Private health NHS Trusts Mental health Ireland 14, £144m 12, £127m 9, £56m 3, €31m Pipelines 1 scheme on site, 3 schemes on site, Currently direct with 2 schemes on
Slide 9: Sector comparison
Capital markets event February 2024 Sector comparison GP NHS Trusts Private Mental health Ireland Initial lease 21+ years 25-30 years 25-30 years 20-30 years 25 years length Typical rent OMR, 3 yearly Indexed, 1-5 yearly Indexed, 5 yearly Indexed, 5 yearly Irish CPI, 5 yearly review basis Establishe
Slide 10: Growing demand for private providers
Capital markets event February 2024 Growing demand for private providers Three main strands of private (PMI, self-pay, NHS referred) all experiencing growing demand Top procedures include cataract surgery, chemotherapy, diagnostics (endoscopy, colonoscopy) or orthopaedics (hip/knee replacement)
Slide 11: Assura's skills & USPs
Capital markets event February 2024 Assura’s skills & USPs Ability to capture these opportunities Long term Development & Social impact & relationships in asset enhancement sustainability healthcare capabilities 11
Slide 12: Private market overview
Capital markets event February 2024 Private market overview Will Thompson Barclays Image: Stourside Hospital, Stourbridge 12
Slide 13: Overview of the independent hospital market
Capital markets event February 2024 Overview of the independent hospital market Summary of points covered by Will Thompson, Barclays Favourable socio- Increasing and ageing population, rising long-term conditions and high level of multi-morbidity demographic drivers NHS entering a period of hype
Slide 14: Assura's position in the private market
Capital markets event February 2024 Assura’s position in the private market Jon Webb Development Director Image: Glendon Wood Hospital, Kettering 14
Slide 15: Significant market opportunity
Capital markets event February 2024 Significant market opportunity Private market NHS accounts for significant majority of NHS and private markets are treatments currently interdependent 31m primary care patient contacts Benefit from long-term in November 2023 underlying healthcare demand
Slide 16: Private providers
Capital markets event February 2024 Private providers A market with huge growth potential Current portfolio of 14 buildings (£144m) % of rent roll plus recent completion at Guildford Ramsay 3% GenesisCare 2% Main tenants currently Ramsay and GenesisCare Others 2% 7%1 1 Proforma following complet
Slide 17: Private sector has attractive investment characteristics
Capital markets event February 2024 Private sector has attractive investment characteristics National relationships give Growing patient demand Attractive lease structure opportunity for repeat for private services business Sustainable growth prospects Opportunities for portfolio across all three re
Slide 18: Assura's existing skills translate well
Capital markets event February 2024 Assura’s existing skills translate well…. Long term relationships Social impact & Development & asset in healthcare sustainability enhancement capabilities 18
Slide 19: ...and the private market offers a significant opportunity
Capital markets event February 2024 …and the private market offers a significant opportunity Private providers seeking specialist landlord-developer Opportunities for both developments and acquisitions Our advanced ESG offering can unlock lower running costs Faster adoption of PropTech withi
Slide 20: Example assets
Capital markets event February 2024 Example assets Relationship with Ramsay has led to additional opportunities over recent years Tees Valley Hospital, Stourside Hospital, Glendon Wood Hospital, Middlesbrough Stourbridge Kettering 2018 2020 2020 2021 2023 Potential future opportunities Beacon Park H
Slide 21: Glendon Wood Hospital, Kettering
Capital markets event February 2024 Glendon Wood Hospital, Kettering Link to video on website 21
Slide 22: Example assets
Capital markets event February 2024 Example assets Recent completion at Guildford builds on existing assets owned in Windsor and Bristol Guildford asset offers cutting edge technology for cancer treatment Close to existing NHS hospital site Capacity for both NHS referred work and private pay
Slide 23: Mental health
Capital markets event February 2024 Mental health Opportunities with both NHS and private operators Mental health estate in need of significant investment Assura Community Fund has funded health and wellbeing projects supporting 190,000 people Current portfolio of 9 buildings (£56m) plus on-si
Slide 24: Mental health assets example
Capital markets event February 2024 Mental health assets example Attractive asset enhancement opportunities enhance returns Asset enhancement at Eccles, Norfolk – private tenant with government income Building provides much need mental health capacity in the area, being SEN (Specialist Education
Slide 25: Sector comparison
Capital markets event February 2024 Sector comparison GP NHS Trusts Private Mental health Ireland Initial lease 21+ years 25-30 years 25-30 years 20-30 years 25 years length Typical rent OMR, 3 yearly Indexed, 1-5 yearly Indexed, 5 yearly Indexed, 5 yearly Irish CPI, 5 yearly review basis Establishe
Slide 26: Financing approach
Capital markets event February 2024 Financing approach Jayne Cottam CFO Image: Station Medical Centre, Hereford 26
Slide 27: Strong balance sheet
Capital markets event February 2024 Strong balance sheet Robust financial metrics Fixed for the long-term Interest cover 4.8 Debt maturity profile 4.5 £m 4.1 350 Private placements Unsecured bond 3.9 3.6 300 250 200 150 100 2020 2021 2022 2023 Sep-23 50 0 Net debt to EBITDA Mar-24 Mar-25 Mar-26 Mar-
Slide 28: Diversity of funding sources
Capital markets event February 2024 Diversity of funding sources Broad range of debt Capital recycling Equity sources Public bonds Portfolio disposals Extensive track record of Revolving credit facility Exploring both outright sale successfully deploying proceeds of equity raises Private placements
Slide 29: Summary
Capital markets event February 2024 Summary Jonathan Murphy CEO Image: GenesisCare, Bristol 29
Slide 30: Summary
Capital markets event February 2024 Summary Chronic need for investment in health assets in a community setting – significant opportunity Need for investment and new developments will be beneficial to existing portfolio Emerging opportunities offer exciting growth prospects Assura is best placed to
Slide 31: Additional information
Capital markets event February 2024 Additional information Image: Assura Head Office 31
Slide 32: Additional information
Capital markets event February 2024 Additional information 1.1 Operating in a market in critical need of investment 1.2 More appointments delivered in primary care 1 1.3 Market drivers increasing 1.4 Growing calls for investment 1.5 Assura already does what these reports call for 2 2.1 Healthcare ma
Slide 33: Operating in a market in critical need of investment
Results for the six months ended 30 September 2023 1.1 Operating in a market in critical need of investment Delivery of health services in a primary care setting is cost effective for the NHS 1. Primary healthcare sector – £42 x2 c. 9,000 primary care medical centres 350m – c. 30% of centres not fit
Slide 34: More appointments delivered in primary care
Capital markets event February 2024 1.2 More appointments delivered in primary care …the number of appointments delivered in hospitals has Despite there being more hospital staff and decreased, whilst the number of GP appointments has fewer GPs than in 2019… increased. Source: Institute for Fiscal S
Slide 35: Market drivers increasing
Capital markets event February 2024 1.3 Market drivers increasing Health challenge Solution Cheaper to deliver services in Budgetary pressure primary care compared with hospital Investment in primary care capacity Growing waiting lists can increase health services delivered in a community setting Ma
Slide 36: Growing calls for investment
Capital markets event February 2024 1.4 Growing calls for investment State of health care and adult social care in England Economic cost of health inequalities in England Care Quality Commission, October 2023 Oxera for Times Health “Oxera estimates that the economic cost of lost output in England “T
Slide 37: Assura already does what these reports call for
Capital markets event February 2024 1.5 Assura already does what these reports call for State of health care and adult social care in England Care Quality Commission, October 2023 Assura standard practice State of Care report “Innovative practice to address health inequalities: All buildings designe
Slide 38: Healthcare markets
Capital markets event February 2024 2.1 Healthcare markets Current / emerging opportunity Not currently of interest Public healthcare Private healthcare Diagnostics Private Private research GP surgeries Acute hospitals treatment treatment Private hospitals labs centres centres Non-clinical (key work
Slide 39: Private – Kettering
Capital markets event February 2024 3.1 Private – Kettering Opportunity from strength of relationship with Ramsay as existing tenant in building – led to separate development opportunity 5th development completed for Ramsay building, with several more for other operators Despite contractor adm
Slide 40: Mental health asset example
Capital markets event February 2024 3.2 Mental health asset example Attractive asset enhancement opportunities enhance returns Asset enhancement at Eccles, Norfolk Acquired in 2021 Relationship developed with occupier Aurora Building provides much need mental health capacity in the area, bei
Slide 41: High quality portfolio positioned for long term returns
Capital markets event February 2024 4.1 High quality portfolio positioned for long term returns % of Lease expiry profile Tenant covenant rent roll 35 GMS/NHS GPs & NHS 81% £2.7bn 225 Pharmacy/other leases Current value 30 Pharmacy 8% 283 leases Independent providers 6% 5.03% 25 164 Other 5% Rental
Slide 42: Security of tenant and lease length
Capital markets event February 2024 4.2 Security of tenant and lease length Rent roll Property value by WAULT (£m) Value (%) £m GPs 87.4 60 1,200 83% NHS Body 31.1 21 1,000 Of rent Pharmacy 11.4 8 roll still contracted Private providers 8.7 6 800 In 2028 Other 8.3 5 600 146.9 100 >90% Remaining leas
Slide 43: Disclaimer
Capital markets event February 2024 Disclaimer This presentation contains certain statements that are neither financial results nor other historical Image list: information. These statements are forward-looking in nature and are subject to risks and uncertainties. Cover: CGI of GenesisCare, Guildfor