An Industry Perspective 6 th January 2011 John Ivers, Chief Executive, Nestor Healthcare Group plc Treasurer UKHCA

Nestor Overview Nestor currently comprises two major business elements: Social Care – High quality home care to adults and children In excess of 9 million of home based care hours pa across approx 104 locations UK wide In excess of 9 million of home based care hours pa across approx 104 locations UK wide Partnerships with over 70% of Local Authorities across the UK Partnerships with over 70% of Local Authorities across the UK Major provider UK wide to privately funded clients Major provider UK wide to privately funded clients Primecare - Primary Healthcare Division Operates 5 new NHS GP walk in centres, delivers Urgent Care services, Care in Secure settings, NHS Dentistry, forensic medical, occupational health and Locums Operates 5 new NHS GP walk in centres, delivers Urgent Care services, Care in Secure settings, NHS Dentistry, forensic medical, occupational health and LocumsOverall Well placed with our ‘unique’ focus on health and social care across UK Well placed with our ‘unique’ focus on health and social care across UK

Challenges and Opportunities Challenges LA Fiscal Constraints LA Fiscal Constraints NHS 4% Cost saving efficiencies required NHS 4% Cost saving efficiencies required PCT pressured to reduce admissions PCT pressured to reduce admissions Regulatory pressures Regulatory pressures Radical Health reforms Radical Health reforms Provider margin squeeze jeopardises quality Provider margin squeeze jeopardises quality Opportunities 3% increase in numbers of people receiving Fragmented market offers diverse range of services- plurality Value proposition ‘broadly based’ across NHS/LA boundaries/Community Looking to offer ‘more bang for your buck’ but retaining quality Providers welcoming chance to work in partnership

The way forward ‘Seizing the Opportunity’ ‘ Half the failures in life arise from pulling in one’s horse as it is leaping’ Julian Hare

‘Innovation out of Austerity’ Need to view Providers as a key part Need to view Providers as a key part of the ‘solution’ rather than the ‘problem’ Embrace joint ‘smarter’ commissioning Embrace joint ‘smarter’ commissioning across health and social care across health and social care Focus on early interventions and Focus on early interventions andprevention Give citizens greater home based Give citizens greater home based choice and independence, outcome focused, ensure plurality of services

Priorities for 2011 Economic climate demands new ways of operating in health and social care Need ‘smarter’ more radical and creative approaches across traditional boundaries, learning each others language, playing to each others strengths Need ‘smarter’ more radical and creative approaches across traditional boundaries, learning each others language, playing to each others strengths Focus on re-ablement plus early intervention and prevention Focus on re-ablement plus early intervention and prevention Supported early discharge from hospital Supported early discharge from hospital Admission avoidance Admission avoidance Pooling budgets and sensible joint management focused on ‘whole’ system not separate services with ‘Holistic’ approach Pooling budgets and sensible joint management focused on ‘whole’ system not separate services with ‘Holistic’ approach Signposting/single point of access Signposting/single point of access

Positives Outcomes Positive impact on patient/citizen’s experience and personalised outcomes Positive impact on patient/citizen’s experience and personalised outcomes Citizens receive care and support in most appropriate and cost effective way Citizens receive care and support in most appropriate and cost effective way Commissioners ensure cost saving efficiencies Commissioners ensure cost saving efficiencies Providers support commissioners by offering innovative solutions to meet fiscal and demographic challenges. Providers support commissioners by offering innovative solutions to meet fiscal and demographic challenges. Locally based providers in a good position to support Big Society agenda Locally based providers in a good position to support Big Society agenda

“Standing still is the fastest way of moving backwards in a rapidly changing world” Anon Any Questions?