10Spire Healthcare Annual Review 2010of the talking therapies, such as cognitive behavioural therapy. We aim for the service, rebranded as The Insight Network, to grow into a national network that is recognised by all major private medical insurers, offering a cost-effective out-patient mental health service. During 2010, we successfully pursued our cancer strategy through further development of services in collaboration with CancerPartnersUK. A dedicated chemotherapy suite, run by Spire Bushey Hospital, was opened within the new Elstree Cancer Centre in Hertfordshire. It provides expanded capacity and a range of services for private chemotherapy treatment, alongside CancerPartnersUK's state-of-the-art image-guided radiotherapy service. This collaboration drives growth of cancer-related surgery, diagnostics and chemotherapy through our hospitals. This was our third site with CancerPartnersUK, with the fourth opened at Spire Little Aston Hospital (Birmingham) in March 2011.PeopleOne of our proudest achievements of 2010 was Spire's employee engagement scores, which showed that 70% of our staff judged Spire to be a 'great place to work'. This compares with 62% one year ago. In addition, the number of staff feeling an increased sense of ownership and accountability for Spire Healthcare's business performance (64%, up from 35% in 2009) is highly gratifying and I am certain this underpins our financial results. We believe we have achieved this high level of engagement by focusing on developing the right culture, driven by sound management capability. We have invested more than £500,000 over the past three years in developing Spire Healthcare's managers and continue to work on transforming the culture to one of strong leadership and high performance. Our focus is on creating the right Our strategy to become the major national private provider of fertility services in the UK is developing well. Following the 2010 launch of IVF Scotland at the new Spire Shawfair Park Hospital in Edinburgh and the acquisition of Harley Street's London Fertility Centre, we are successfully establishing a referring network of Spire hospitals that are able to provide services to a growing number of patients and drive growth in this area of the business. Our entry into this market has been planned to capture the anticipated increasing demand from consumers and coincides with pressure on funding for access to publicly provided fertility services.In late 2010, Spire Healthcare invested in The London Cognitive Behaviour Therapy Centres - an established London-based network of mental health professionals who practise in growth areas Chief Executive's statement continued Employee engagementOur employee engagement is measured across four areas using a ten-point scale. Results are compared to other companies in a benchmark group. More than 5,200 Spire employees completed the survey in September 2010, and the overall result demonstrates we have achieved significant improvements since 2008.Measure2008 result2009 result2010 result2010 benchmark comparisonAutonomy and control6810Significantly above average scoreNature of work7810Significantly above average scoreMy manager6710Significantly above average scoreEngagement5610Significantly above average score

11consultant survey produced record results for 2010, with 71% of consultants rating Spire Healthcare as 'excellent' or 'very good'. This represents an excellent improvement from the 51% score measured in 2008 and validates our strong locally-driven, relationship-based approach of working with consultants.It was equally pleasing that 90% of Spire Healthcare's patients rated our overall service 'excellent' or 'very good'. Within that result, 51% of patients rated us as 'excellent', compared with 44% on the same measures back in 2008. ConclusionIn summary, I am proud of what Spire Healthcare has achieved in 2010 and over the past three years. I believe the strong platform we have built over this time and the growth opportunities that have been created will be fully exploited by the incoming CEO, Rob Roger, as he drives this business forward. Rob moves into the CEO role from that of CFO and as such ensures continuity, having been a key part of the team that has produced three years of outstanding results at Spire Healthcare. Before joining Spire Healthcare in 2007, Rob was CFO at The Tussauds Group Ltd where he gained significant experience of leading mergers and acquisitions, including the sale of the company to Dubai International Capital and the merger of the company with Merlin Entertainment in 2007.Spire is a strong business with a great leadership team and I'm pleased we've been able to demonstrate strong growth during my tenure. I am returning to Australia to rejoin my family and I leave the company in very strong and capable hands.Rob Wise, Chief Executive Officerteam and devolving authority to hospitals, allowing them to run the business in a way that maximises local market opportunities and delivers increased value to the business.Service qualityWe take our responsibilities as a healthcare provider very seriously, putting staff wellbeing, patient safety and patient care at the forefront of all we do. Our business is about optimising outcomes for patients, which involves creating a framework for excellence and systems that deliver the best possible clinical results. We are continually striving for, and achieving, improvements in our clinical performance. For example, in 2010 the number of surgical site infections following hip and knee replacements fell by 20%. Over our full three years of operation as Spire our clinical performance indicators, including returns to theatre, unplanned transfers and readmissions, have remained exceptionally low.Our three-year trend of improvement in non-clinical health and safety bears testimony to the rigour we apply to meet regulatory requirements. We monitor the effectiveness of our health and safety policy by reviewing adverse events and carrying out risk assessments and audits. External audits of our results show the mean scores from 36 Spire hospitals have risen from 77% in 2006/07 to 84% in 2010*.ReputationConsultant and patient satisfaction with our services is fundamental to our success and we monitor their views closely. Again, I am delighted to report a three-year trend of steady improvement in these relationships. Our * Figure relates to the hospitals audited in each of the years stated. Measured on a scoring system used by H&S auditors, Jacobs Consultancy.