THE NHS & INDIAN HEALTHCARE PROVIDERS - SYNERGY Commissioning Live - Birmingham June, 16

THE NHS & INDIAN HEALTHCARE

PROVIDERS - SYNERGY

Agenda

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Private Healthcare in India – An Overview

Synergies – 5 Key Drivers

Max Healthcare Institute Ltd. – Brief Introduction

Agenda

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Indian healthcare industry is expected to reach ~$400

billion fuelled by multiple demand drivers

4 Sources: India Brand Equity Foundation – Healthcare report, 2012; BofA Merrill Lynch Global Research Sept’15, IBEF report Mar'15

60 79 102

280

2010 2012 2015 2020 2025

Indian healthcare sector* Estimated size, Bn USD

Demand drivers for growth

* Healthcare sector includes hospitals, pharmaceuticals, and medical technology sub-sectors

~500 mn additional middle class by 2025 ~45% Insurance penetration by 2020 ~134 mn population > 60 years by 2020 ~$8 bn medical tourism market size by 2020 from 3 bn in 2016 ~320 mn

at risk of dying due to NCDs by 2020 ~2 mn beds required by 2025 CAGR 11.2% CAGR 14.6% ^ 350 - 450

Hospitals constitute ~70% of Indian healthcare market

with increasingly dominant role of private sector

5 Sources: BofA Merrill Lynch Global Research Sept’15, Indian Brand Equity Foundation report Mar'15

Private players have established a dominating presence in tertiary / quaternary care

70% _{63% 60%} 78% 80%

30% _{37% 40%} 22% 20%

Market Share Beds Inpatients Outpatients Doctors

Private sector Public sector

70% 20%

10%

Hospitals

Pharmaceuticals

Medical technology / Others Indian healthcare sector * Market share %

Market size of private hospitals is expected to reach ~$ 120 bn by 2020

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36

50

120

2009 2012 2015 2020

Private sector hospitals

Estimated size, Bn USD

CAGR ~14.7%

CAGR ~19.2%

Private Sector Share Compared to Other Countries

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New Delhi alone accounts for over 50,000 beds available at private hospitals.

Source: McKinsey & Company

Treatment Costs Nearly a 10

_{of Developed Countries}

7 Sources: AMA report published in the BofA Merrill Lynch Global Research Sept’15

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Developing countries benchmark (INICC)

MHC Rate

MHC Target to be achieved by Mar 2016

Developed Countries Benchmark(NHSN)

Patient Safety (1/5)

Catheter Related Blood Stream Infection Rate

1.83 _1.75 1.25 1.10 1.68 4.9 0.9 0 1 2 3 4 5 6

Apr-Jun'15 Jul-Sep'15 Oct-Dec'15 Jan-Mar'16

CLABSI Rate per 1000 Central Line Days

9 Developing countries benchmark (INICC) MHC Rate MHC Target to be achieved by Mar 2016 Developed Countries Benchmark(NHSN)

Patient Safety (2/5)

Catheter Associated Urinary Tract Infection Rate

1.71 1.36 _1.17 0.90 1.54 1.2 5.3 0 1 2 3 4 5 6

Apr-Jun'15 Jul-Sep'15 Oct-Dec'15 Jan-Mar'16

CAUTI Rate per 1000 Catheter Days

10 Developing countries benchmark (INICC) MHC Target to be achieved by Mar 2016 MHC Rate Developed Countries Benchmark(NHSN)

Patient Safety (3/5)

Ventilator Associated Pneumonia Infection Rate

2.57 1.92 2.31 1.80 2.31 1.1 16.5 0 2 4 6 8 10 12 14 16 18

Apr-Jun'15 Jul-Sep'15 Oct-Dec'15 Jan-Mar'16

VAP Rate per 1000 Ventilator Days

Patient Safety (4/5)

Gross Surgical Mortality Rate per 100 surgeries

Surgical Mortality - Comparison cumulative rate 0.43% 0.64% 0.73% 0.54% 0.42% 0.68% 0.85% 0.70% 0.77% 0.50% 0.65% 0.61% 0.62% 0.60% 0.60% Gross Surgical Mortality Rate - Pan Max/ 100 Surgeries -

Trends

Monthly Rate Cumulative Rate

Patient Safety (5/5)

Compliance to Medical Documentation

12 100% 99% 100% 100% 100% 100% 100% 100% 100% A pr-15 M ay -15 Ju n-1 5 Ju l-1 5 A ug -15 S ep-1 5 O ct-15 N ov -15 D ec-1 5 J a n -16 F eb -1 6 M ar-1 6 Y TD

Mortality - Peer Review Rate

Peer Reviewed Rate Target

91.0% 90.5% 90.8% 91.4% 93.7% 92.1% 94.4% 94.8% 94.8% _94.6% 94.3% 94.7% 93.1% 95% Ap r-1 5 Ma y-15 Jun -15 Jul-1 5 Au g -15 S ep-15 O ct-15 No v-1 5 De c-15 Ja n -1 6 F eb-16 Ma r-16 Y T D

Compliance to Medical Documentation

Compliance to Medical Documentation Target

Agenda

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1. Pricing

• Unbelievable pricing with world class outcomes

• Host of amenities and services for International patients

• Latest up to date technology offered

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2. Waiting Time

• None absolutely !

• Straight from the airport to the hospital

• Surgery within 24 hours of arrival (depending on reports)

• Appointments and rooms RESERVED well in advance

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3. Talent Pool

• World renowned doctors

• Trained at the best facilities in the world

• Awarded and recognised globally

• Best in class treatment and care

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4. Exchange of Ideas

• Continuous skill enhancement of doctors

• Indian doctors training in the UK

• UK doctors training in India

• Mutual benefits and professional enhancement

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5. Support Infrastructure in India

• Over 6 direct daily flights between UK and India apart from countless 1 stop flights

• English is the most commonly spoken language in India – 100% staff at the hospital speak in English.

• Globally present 5 star hotel chains

operating out of India apart from many 3 & 4 star options.

• World famous sights & sounds located

minutes from our facilities, excursions a few hours drive away.

• Ayurveda, spa treatments available for post-op recuperation.

Agenda

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MHC has a strong presence in North India

70

402

535

46

64

215

186

168

260

224

275

countries treated

Greater Noida

100

MHC has invested in state of the art equipment to

achieve clinical excellence

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Advanced robotics provides high precision, minimum invasive surgery across multiple specialities

High dose radiation with extreme precision (~ 0.5 mm accuracy)

Advanced image guided surgery -provides real-time views and automated image processing - Third in the World and

First in Asia

Robotic radio-surgery (non-invasive) system for both cancerous & non-cancerous systems

Rob ot ics Brain suit e Nov alis LINA C Cy berKnif e * * planned

We have a proven record of building an institution

MHC is one of the top 3 healthcare chains

in India

Strengthened capabilities to provide comprehensive tertiary & quaternary care

Network of highly qualified doctors, nurses and medical personnel

Organic growth through expansion of hospital network

JV with Life Healthcare, South Africa, extending expertise and global reach

Centres of Excellence

Max Heart & Vascular Institute

Max Cancer Centre

Max Institute of Renal Sciences

Max Institute of Neurosciences

Max Institute of Obstetrics & Gynaecology

Max Institute of Pediatrics

Max Institute of

Musculoskeletal Sciences Max Institute of Minimal Access & Bariatric Surgery Max Institute of Aesthetic & Reconstructive Surgery

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Allied Specialities

• Medical & Surgical Gastroenterology

• GI Endoscopy & Bronchoscopy

• Dermatology

• Pulmonology

• Anesthesiology

• Endocrinology/Diabetics

• Mental Health & Behavioral Sciences

• Emergency & Trauma Care

• 24 X 7 Max Chemist • Internal Medicine • Podiatry • General Surgery • IVF • Dental • Ophthalmology • ENT • Dietetics • Rheumatology

• Physiotherapy & Rehabilitation

Agenda

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Overview

• Over 20,000 international patients treated in a year

• Max Hospital is the healthcare destination of choice for patients coming from:

• SAARC

• Middle East

• Africa

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International Patients

Popular procedures for overseas medical travel -

• Orthopaedics & Joint Replacement

• Cardiac diseases & conditions

• Cancer treatment

• Spinal surgeries

• Cosmetic Surgery

• Bariatric & Weight loss surgery

• Dental treatment

International patient at an advantage:

• Affordable quality healthcare

• 40-60 % cost savings compared to the west

• Internationally trained doctors & surgeons

• State of the art technology being used

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International Patient Services

• Dedicated International patient services team with relationship managers being the single point of contact

• Online query resolution along with tele-consultation services

• Complimentary airport pick up and transfers

• Interpreters available for language support

• Accommodation arrangements for the attendants

• Visa arrangements

• Currency exchange support

• Choice of international cuisine

• Regular update on patient’s progress

Pre-Admission Services

• Airport Pick-up from the International Airport in New Delhi.

• Patient is handed over to the IPS team & a dedicated relationship manager is assigned to the patient.

• International Patient Lounge

• Patient’s room and OT are already booked before the patient arrives at the hospital.

• The relationship manager helps the patient in the admission procedure and also in the registration formalities.

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Post-Admission Services

• Centrally air-conditioned hospitals

• Choice of international cuisines

• Interpreters in select languages

• Wi-Fi enabled rooms

• Book shop/Coffee Shop

• Prayer rooms

• Money Exchange Services

• Arrangement of local Sim card for easy access and communication.

• Easy Payment Options

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Post-Discharge Services

• Patient is discharged and shifted to Guest House/ Hotel/ Airport

• Arrange for sight seeing in New Delhi

• Travel back home facilitated

• Post procedure follow up via email/ phone/ video conferencing

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SKS Marya

MS DNB MCh (L’Pool) FRCS (Eng) FICS

Chairman Institute of Musculoskeletal Sciences

Max Healthcare