29Engineering riskWe are now in year three of our five-year engineering plant replacement programme. It is designed to ensure that important facilities, such as ventilation equipment and boilers, are upgraded on a rolling basis and functioning well. Over £4 million was invested in 2010. The Engineering Governance component of the Spire Healthcare Engineering Strategy won the Laing & Buisson 'Excellence in Risk Management' award in September 2010. An overview of this strategy, 'Managing Engineering Risk - Strategy, Implementation and Benefits', was published in the IHEEM Health Estate Journal and presented at the Institute of Healthcare Engineering and Estates Management conference in October 2010. Regulatory riskSpire Healthcare enjoys good relationships with our key operational regulators, including the Care Quality Commission and the Health and Safety Executive. Standards are internally monitored by a programme of on-site clinical reviews involving peer audit and, for health and safety, external audit by our contracted health and safety advisors. Where regulators make suggestions or recommendations we work quickly to respond to these. In 2010 we received no formal improvement notices. Our clinical education and development programmes assist those staff subject to professional regulation to meet the requirements of continuing professional development. We operate robust systems to detect, prioritise, manage, analyse and learn should outcomes fall short of our high standards. A single incident reporting system and central incident review process aims to ensure serious events are dealt with in a timely and thorough manner. Our clinical governance system uses a wide range of patient-related data though the clinical scorecard, which allows us to benchmark performance and share best practice across our 37 hospitals and London Fertility Centre.Health and safety Our policy for the health, safety and welfare of employees, patients, visitors and all other persons affected by our activities promotes compliance with statutory duties and requirements of health and safety legislation. We set specific objectives and targets, promote good practice and, by monitoring performance, continually improve our high standards. Local health and safety plans promote safe systems at work and exist for hazards associated with specific activities and processes. A positive health and safety culture is fostered by active, visible leadership.We continually monitor adverse events, audits and risk assessments. External assurance was provided by Jacobs Consultancy who, in their 2010 annual audit report, commented on our continual improvement giving many examples of best practice. The mean hospital audit score in 2009/10 was 84%, improving from 77% in 2006/07*.* Figure relates to the hospitals audited in each of the years stated.

30Spire Healthcare Annual Review 2010Board of DirectorsThe Board of Spire Healthcare Group UK Limited hosts Spire's principal corporate governance functions.010407030609020508