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FALCK GROUP EMERGENCY MEDICAL SERVICES February 2011. GEORGIAN HEALTH CARE 2020: MEDEA 2011 WASHINGTON, DC, UNITED STATES. Overview. 1. Introduction to the Falck Group. 2 . Falck’s worldwide Emergency Medical Services. 3 . Falck entering new markets – Slovakian case study.
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FALCK GROUPEMERGENCY MEDICAL SERVICESFebruary 2011 GEORGIAN HEALTH CARE 2020: MEDEA 2011 WASHINGTON, DC, UNITED STATES
Overview 1. Introduction to the Falck Group 2. Falck’s worldwide Emergency Medical Services 3. Falck entering new markets – Slovakian case study
Falck at a glance – Group overview Key facts Revenue breakdown • Revenue (2009): 1,369m USD • Employees (2009): 16,457 • Falck provides services to a wide range of customers, including.: • Public sector • Private persons • Corporate/Business • Insurance companies • Pension providers • Market position: • #1 Global cross-borderprovider of privatizedambulance services • #1 Global provider of offshore and maritime safety training • #1 Nordic provider of auto, home and healthcare assistance Business Area Geography • Falck is present in 23 countries • Note: Revenue converted from DKK to 5.5 USD. • Segmental breakdown based on FY 2010 financials 3
Reliable Accessible Helpful Fast Competent Efficient Introduction to Falck GroupAll Activities are linked to Mission and Values Mission Values For more than 100 years, it has been Falck’s mission to: • Prevent accidents, diseases and emergency situations • Rescue and assist people in emergencies quickly and competently • Alleviate the after-effects of emergencies • Rehabilitate people after illness and injury • Always be there so that people can live their lives safely 4
Introduction to Falck GroupMore than 100 years of history within emergency, safety and healthcare services Ownership Baltica Falck family Private ownership Listed Standalone Group4Falck Standalone Falck Founded Services Rescue Roadside Assistance PatientTransportation Ambulance Fire Offshore Training Healthcare Alarms Home care 1926 1933 1988 1906 1908 1922 1995 1996 2000 2001 2005 2006 2007 2008 2009 2010 No. of countries Denmark Geographies 1 Nordics 3 Rest of Europe 9 Rest of World 10
Introduction to Falck GroupGeographic diversification – a global company Countries with established activities Countries where Falck currently is establishing new activities
Introduction to Falck GroupSegmental overview Emergency Assistance Healthcare Training • Leading international provider of emergency services • Leading Danish provider of private healthcare services • Leading global provider of offshore and maritime safety training • Leading Nordic provider of auto and home assistance services • 12% of revenues • 51% of revenues • 27% of revenues • 10% of revenues B2C 2% B2C 5% B2G 4% Customers B2B 10% B2C 51% B2B 49% B2B 49% B2G 49% B2B 91% B2G 90% • Subscription model, highly resilient • Long-term contracts, high visibility • Partly subscription based • Framework agreements Geography • 12 countries • 5 countries • 7 countries • 15 countries • Note: Segmental breakdown based on 2010F financials
Introduction to Falck GroupEmergency Core services • Emergency Medical Services • Ambulance services • Pre-hospital service/rapid response units • Critical transfers (CCT) • Transport of stretcher patients (ATS) • Dispatch centers • Helicopter Emergency Medical Services (‘HEMS’) • Passengers with Reduced Mobility (‘PRM’) • Fire fighting • Petrochemical/nuclear plants • Other industrial fire fighting • Airports
Introduction to Falck Group Assistance Core services • Auto • Roadside assistance • Roadside repair services • First-aid courses and materials / Fire extinguishers • Home assistance • Storms, flooding and other house damage • Home alarms • Transportation for treatment • Travel assistance
Introduction to Falck Group Healthcare Core services • Employee health • Preventive cross-disciplinary • Physical healthcare • Health checks and counselling • Psychological crisis aid and counselling • Primary health clinics • Primary care, specialist care, day surgery, dental and rehabilitation • Medical professionals staffing • Doctors • Nurses • Health assistants • Home care services • Jobservice and absence management • Fast diagnoses • Workability analysis • Case management and counselling
Introduction to Falck Group Training Core services • Offshore and maritime training • Helicopter underwater escape training • Fire fighting • Confined space evacuation • Working in heights • Specialized hazardous chemical/safe handling • Consultancy, Hot work enclosures, Health checks and Manning • Major Emergency Management Training • Provide personnel with knowledge, experience and techniques • Enable Emergency Command Teams to react effectively to maintain protection to all personnel, environment and assets.
Introduction to Falck Group Unique ability to build and execute the business Strong fundamentals Ability to execute Competencies 1 Competencies: • Ability to manage complexity • Expertise across the value chain • Operational excellence • Medicine focus • Strong track-record partnering with local entrepreneurs Infrastructure: • IT and communication platform • Control centersnetwork • Global knowledge base Brand: • Trustful, reliable, credible, efficient and accessible • Publicity of operations, and quick to establish strong reputation 2 Infrastructure Brand 3 • More than 100 years of experience • Flexible execution model • Convert single service offering to multi service offering Uniqueness of Falck 12
Introduction to Falck Group Ability to manage complexity High complexity in Emergency Situations Competencies leveraged in other segments • Leading and managing people in life-and-death situations • Stringent performance requirements • E.g: high performance response times • Dimensioning and managing network to provide services efficiently • Utilize full time employees and mutual aid agreements • Station network and rolling stock • Roadside assistance with maximum response time requirements • Cost efficient dimensioning with retainers for peak service demands • Dimensioning of healthcare networks with guaranteed treatment time • Handling peaks and valleys in demand analysis • Simulate life-and-death situations in a secure environment • Train and maintain highly skilled instructors More than 100 years of training to adapt to any accident scene Exceptional ability
Introduction to Falck Group Unique adaptation competencies in handling major accidents Falck was a key player in the disastrous Deep Water Horizon oil spill in the Gulf of Mexico • Deep Water Horizon exploded in April 2010; 11 people died and 17 were injured. Subsequently, the spill developed into one of the worst environmental disasters of all time. • Falck provided disaster training prior to the incident which played a key role in minimizing injuries and death. • To help facilitate the clean up, Falck developed a training program in close cooperation with BP to trainmore than 5,000 people in Houma, Louisiana. • Falck provided training on the clean up animal habitats on the beach and in the ocean. • The operations and tasks at hand were enormous and Falck quickly hired 200 additional people to further help with the clean-up. • This is the largest single personnel assignment Falck has had so far in the US. • “In the past, we’ve sent everything from paramedics to firefighters to jobs in the Gulf of Mexico; however, we’ve never had an assignment of this magnitude. It has given us invaluable experience in handling disasters – experience that we can put to good use in the future.” Morten Halager VP Falck Alford. 14
Introduction to Falck Group Disaster management capabilities and experience Falck’s Emergency Response Team • 365 days per year, 24 hours per day, the Emergency Response Team (ERT) is on stand-by to be deployed in the event of fires on board ships, incidents with hazardous substances, and/or refinery fires. • The team consists of specialists, who in addition to their daily activities, immediately deploy to the scene of an emergency with their own equipment - anywhere in the world. • The ERT is employed by government authorities, shipping companies, salvage companies, and insurance companies. • The commitment of the ERT makes the difference between limited damages and total loss, as well as the difference between life and death. • In 2010 the team had 6 deployments, mainly to extreme fire disasters on board large ships. Falck takes pride in participating in disaster management activities and has decades of experience. • Tsunami in December 2004 • Co-working with The Danish National Emergency Agency • Large explosion incident in November 2004, damaging approximately 250 homes and evacuating 5,000 residents. 15
Overview 1. Introduction to Falck Group 2. Falck’s worldwide Emergency Medical Services 3. Falck entering new markets – Slovakian case study
Emergency Medical ServicesOverview of services Ambulance Services Patient Transport Fire Fighting Control Centers Emergency ambulance servicesRapid response units with paramedics, nurses and doctorsOther pre-hospital modalities Air ambulance services RPM-services for Airports Non-emergency patient transportCritical care transportPatient transport services (PTS)Transport of disabled persons (ATS) Fire Fighting Fire Training Fire and Safety Consultancy Airport Fire Fighting Risk Management Dispatch of fire resources, emergency ambulances, non- emergency ambulances, assistance vehicles and patient transport Monitoring of different alarm systems Logistics management Services are provided and developed according to local requirementsin close co-operation with the public authorities – state, regions, and municipalities; and/or clients in high-risk industries – nuclear, petrochemical, airports, ports, etc. 17
Emergency Medical ServicesOverview of European markets Norway Denmark • Emergency vehicles: 34 • Ambulance stations: 19 • Ambulance staff FTE: 78 • Emergency vehicles: 476 • Ambulance stations: 134 • Rescuers FTE: 4,549 • Fire stations: 148 • Municipality fire contracts: 66 • Control centres: 5 The Netherlands Slovakia Belgium Sweden • Consultants, trainers FTE: 109 • Training centres: 2 • Emergency vehicles: 104 • Ambulance stations: 91 • Ambulance staff FTE: 851 • Fire stations: 1 • Fire fighters FTE: 48 • Emergency vehicles: 103 • Ambulance stations: 15 • Ambulance staff FTE: 803 • Control centres: 2 • Emergency vehicles: 121 • Ambulance stations: 39 • Ambulance staff FTE: 574 • Fire stations: 4 Spain • Fire stations: 20 • Fire fighters FTE: 281 • Training centres: 3 Poland Romania • Emergency vehicles: 79 • Ambulance stations: 23 • Ambulance staff FTE: 826 • Control centres: 7 • Fire stations: 6 • Fire fighters FTE: 212 Denmark Nordic Europe
Emergency Medical ServicesOverview of American markets USA - East Coast • Emergencyvehicles: 440 • Ambulance stations: 26 • Ambulance staff FTE: 1,224 USA - West Coast • Emergencyvehicles: 135 • Ambulance stations: 33 • Ambulance staff FTE: 626 Brazil • Emergencyvehicles: 194 • Ambulance staff FTE: 885 Falck Worldwide • Emergencyvehicles: 1,690 • Ambulance stations: 383 • Ambulance staff FTE: 9,830
Emergency Medical Services Operational services and competencies Falck: Advisor Falck: Operator Alarm Center operations Dispatch Center operations Ambulance operations Emergency rooms Characteristics Falck operations: • All types of emergency vehicles • Equipment • Training • Communication • Telemedicine • Electronic patient care record Characteristics Falck operations: • GPS/GIS(for more than 10 years) • Securing effective and available resources by planning and simulation systems • Systematic reporting internally and to the customer R&D on pre-hospital medical services through non-profit Falck Foundation • Board of internationally recognized medical professionals from different countries The proper resource to the actual need Falck’s vast experience and knowledge in the EMS industry is second to none. 20
Emergency Medical Services World class radio and data network solutions Alarm Call Dispatch system GIS work station Data radio Data radio Radio system 21
Emergency Medical Services Operational services and competencies Operational excellence Equates to improved outcomes • Ability to adapt to different environments/different concepts and maintain the same operating efficiency • Key Performance Indicator (KPI) - reporting system to support effective resource management • Quality certified(ISO) or accredited services • Economies of scale due to size • Pre-hospital systems with doctors, nurses, paramedics • Ambulances, critical care transport units, neonatal and pediatric transport units, and other adaptable – specialized units • Training of resources in collaboration with the public schools for pre-hospital education Size and international experience, as well as the global reach capabilities of Falck, provide credibility for safe, reliable, and adaptable service models in different environments 22
Emergency Medical Services Operationalexperience and competencies Business model • Ambulance and other pre-hospital services in 8 countries • BtG • Ambulance and pre-hospital in Slovakia • BtItC • Ambulance and pre-hospital in USA • BtC • Road assistance, courses in first aid and fire fighting • BtB and BtC • Assistive aids company • PPP
Emergency Medical Services Falck operates numerous pre-hospital and care models at incident scenes • Several principles around the level of healthcare are currently in operation around the world 24
Emergency Medical Services Greenfieldstrategy and experience Greenfield strategy PriceDiscipline Costdiscipline • Our size and international reach makes Falck a reliable and adaptable partner • Disciplined and selective approach • Identification of local partner with competencies and market knowledge, i.e. local contacts and network • Local knowledge and adaptation • Match with Falck brand and values • Attractive partnerships • 8 out of 10 local founders are still part of Falck Partner ship Focus onValue-Add Brand International Greenfields Very successful track record Countries • Slovakia (2006) • Nigeria (2009) • United Arab Emirates (2009) • ~ 10 Greenfields since 2005 25
Overview 1. Introduction to Falck Group 2. Flack's worldwide Emergency Medical Services 3. Falck entering new markets – Slovakian case study
Market Entry Case Study: SlovakiaOverview Key facts Achieved results (revenues, DKKm) • Competitive RFP entry in September 2006 • Successful greenfield start-up • Local equity participation • Cross-pollination between industrial fire fighting and healthcare clinics • New RFP round in 2009 expanded emergency coverage from 28% to 33%
Market Entry Case Study: SlovakiaStatus 2010 Falck Záchranná a.s. Key Facts • Coverage: • Regions: Various across Slovakia • 1.4m inhabitants covered • 14,500 km2 (91 licenses) • Market share: 91 of 264 licences, 34% • Through: • 91 ambulance stations, approx. 40% of the ambulances are physician staffed (3 person crew) with the remainder being paramedics (2 person crew) • 104 ambulance vehicles • More than 1000 staff (paramedics, doctors, nurses, EMTs, administration, and part-time employees) • 87,500 emergency transports per year • 26,000 non-emergency transports per year • Response time average - 15 minutes • Medical training unit in place • Funded by health insurance companies partly owned by the state, based on fixed fees defined by government • ISO certification 07.02.2008 The largest ambulance service provider in Slovakia 28
Market Entry Case Study: SlovakiaHow it was done..... • Based on successful competitive bid process, licenses were awarded by the Slovakian Ministry of Health • 36 licenses in January 2006 • 37 licenses in May 2006 • Slovakia was a completely new country for Falck • Roll out based on Danish model complemented with experience from Poland • Fast track setup with very tight deadlines opening 12 stations on March 1, 2006, and then 12 stations per month, totalling 73 stations in just 9 months Key Facts A three phased roll out..... Building Phase “Initial Ramp-up” January 2006; first 36 licences; deadline 06/15/2006 1 Building Phase May 2006; another 37 licences; deadline 08/15/2006 01.01.2006 Consolidation Phase “Maintenance Phase” 09/15/2006, last station in Beladice opened Processes setup update 2 Building Phase terminated 07/31/2006 73 stations opened 01.08.2006 31.12.2006 Stabilization Phase “Fine-tuning” 3 30.06.2007 29
Market Entry Case Study: SlovakiaHow it was done..... From buildingphase…. ....to start of operations • In 7 months the operational platform was in place and operations started throughout the country. • The project team accomplished everything from the bid process and the contract signing, to ordering and organizing uniforms for 1,000 people, and building and equipping 74 stations with medical equipment, infrastructure, etc. • 84 new ambulances were delivered by Falck within this time period. • Roll-out done locally according to local laws and regulations - by local people, managed and guided by centrally coordinated Falck Group competences. • Priority was to hire and train personnel and to build-up and equip all stations. In 6 months more than 1,000 people were employed and stations built in 30-day periods, with 82% built from scratch. • August 2006 all stations were connected to internal data network and voice VPN, both fixed and mobile. 30
Market Entry Case Study: SlovakiaHow it was done..... From consolidationphase…. ....to stabilization phase • The priorities of the last phase were to optimize cost procedures related to personal, ICT, fuel, rental costs, and other medical equipment • Building medical training center • Focusing on training and development to increase quality in service at all levels • Promotion of Falck by education of the operation to city councils, schools, organizations and other public entities • The priorities for the second phase were to fine tune operational processes: administration, procurement, human resources etc. • Minimizing overtime, optimal planning of shifts, structuring operational and regional management • Completed distribution of all internal policies and procedures • Finalization of the project from the building phase, included installing garages and other reconstruction and equipment management 31
Market Entry Case Study: SlovakiaEffect on the Slovakian EMS system Prior system • ~ 80 different public providers, mostly hospitals • 1,500 employees • 91 stations all around the country • 100 emergency vehicles • Average response time ~30min In 2002 – 2006 Slovakia undertook a long period of reforms aimed at social security, pensions, and healthcare. Reforms included hospital network specializations and reductions, as well as a total reform of the EMS system. Reform process After venture When bids were announced, Falck decided to participate and agreed on a joint venture with the largest Slovakian Private Equity Group Penta. Falck Zachranna a.s. was established as a joint venture operation. • 43 providers, mostly private • 4,500 employees • 264 stations all around the country • 280 emergency vehicles • Average response time ~15min • Falck is the only international provider 32
Falck GroupThe “go to” company for global emergency services • Superior medical quality standards and training • Strong execution capabilities • Flexible business and services models • Operational excellence • Long term partnerships • 100 years of EMS experience • Certified International Emergency Services provider Creates and enhances core competencies in a country’s EMS sector
Q & A Session Questions? 34
Contact Information Boo Heffner Group Senior Vice President Falck President and CEO Falck USA Contact details: E-mail: boo.heffner@falck.com 35