20Spire Healthcare Annual Review 2010Business review continuedday-case and wide-awake neurosurgery, pain management and minimal access spinal surgery.Taken together, our three years of acquisition and investment in new and upgraded facilities has firmly established Spire as one of the UK's leading private healthcare providers and extended our reach into new and innovative services. We have invested in two new hospitals - Spire Shawfair Park Hospital (Edinburgh), opened in February 2010, and Montefiore Hospital (Brighton), due to open in 2012. In addition, since 2008 we have built or completely revised seven theatres, with another due to open in 2011. We have improved our critical care capability in six of our critical care units, introduced seven new satellite out-patient clinics and opened two Spire Eye Centres - centres of excellence for ophthalmic services. We are also continuing to install MRI and CT scanners, have upgraded three cardiac catheter labs and all our hospitals now have the ability to store and move diagnostic scans electronically, speeding up diagnosis.Through this programme of continuous investment we are able to offer high-quality facilities and capability in healthcare areas where demand is highest and the potential for growth is greatest.Patient careSpire's journey over the last three years has been fuelled by the desire to provide a better experience for our patients and to work more closely with our consultant colleagues to be their provider of choice.Last year's opening of the Portsmouth cancer centre was followed early in 2010 by a centre in Southampton, and another in Hertfordshire in July. Built by CancerPartnersUK in collaboration with Spire Bushey Hospital, the Elstree Cancer Centre aims to support cancer patients both emotionally and physically. It is one of the country's few stand-alone, dedicated private chemotherapy and radiotherapy cancer centres and is designed to provide leading-edge technology and a comfortable, out-of-hospital environment. A fourth centre in our Little Aston hospital, near Birmingham, opened in March 2011.The Insight Network, a Spire Healthcare business, represents another step into new growth markets. This is an established London-based network of mental health professionals who offer cognitive behaviour therapy, cognitive analytical therapy and other treatments to help resolve a range of common issues in daily life, including stress, anxiety, depression, eating disorders, addictions and phobias. As we continue to move further into complex surgery, we have invested heavily in advanced equipment for investigations of neurological disorders. In the past three years neurosurgeons operating at Spire have contributed to a 26% increase in revenue in this area. With the needs of an ageing UK population in view, we are laying a base for growth, for example, through the creation of a centre of excellence for neurosurgery in Bristol - a consultant-led, state-of-the-art facility. We are also increasingly performing innovative procedures such as

21When asked if they would recommend their Spire hospital, either to their friends and family or to a new consultant, 77% said they would. Looking back to 2008, this is an increase of over 15 percentage points.In terms of how we work with consultants, 86% believe we are working in partnership with them to support their practice. 94% of consultants feel that staff go out of their way to help them and believe that relationships with hospital staff have improved. The way we work with consultants is a fundamental part of Spire's goal to be the provider of choice for their private practice. These results show that our strategy for building strong local relationships with consultants and helping them to grow their practice is valued and appreciated.Employee engagementSince Spire Healthcare started in August 2007, we have been working to create a culture of high performance. In 2010 the effectiveness of our approach was demonstrated by a third successive year of significant improvements in the independent Spire Healthcare Employee Engagement Survey, which was completed in September 2010 by more than 5,200 employees. It showed that over 70% of our staff judge Spire to be a 'great place to work' compared with 62% one year ago. Employees also feel they have greater ownership and accountability for Spire Healthcare's business performance, an uplift of 29 percentage points (from 35% to 64%).Patients and consultants are surveyed on an annual basis at hospital level and, in addition, local hospitals collect feedback on a continuous basis through questionnaires, focus groups and personal visits.The satisfaction survey results for 2010 show that we have made excellent progress, with all-time high scores in both our patient and consultant satisfaction surveys. In 2010 over 11,000 patients shared their views of their experience with us. 90% of patients rated our overall service 'excellent' or 'very good' - an increase of three percentage points over last year's survey - and 85% of our patients said they would recommend their local Spire hospital - an increase of five percentage points from 2009. In addition, 96% of our patients agree that staff go out of their way to make a difference to their stay and 93% rate the cleanliness of the hospital as 'excellent' or 'very good'.Patients who value the service they receive in a Spire hospital are more likely to come to us again for treatment, to recommend us to their friends and family and to feed back positively to their referring GP. Consultant relationshipsOur consultant satisfaction survey, completed by over 3,000 consultants, also had strong results with 71% of consultants rating us 'excellent' or 'very good'. This is an uplift of six percentage points from last year and a significant increase from 51% in 2008.