FALCK GROUP
EMERGENCY MEDICAL SERVICES
February 2011
GEORGIAN HEALTH CARE 2020: MEDEA 2011
WASHINGTON, DC, UNITED STATES
Overview
1.
2.
3.
2
Introduction to the Falck Group
Falck’s worldwide Emergency Medical Services
Falck entering new markets – Slovakian case study
Falck at a glance – Group overview
Key facts
Revenue (2009):
Employees (2009):
Revenue breakdown
1,369m USD
16,457
Falck provides services to a wide range
of customers, including.:
Business Area
Training
10%
Healthcare
12%
 Public sector
Emergency
51%
 Private persons
 Corporate/Business
Assistance
27%
 Insurance companies
 Pension providers
Market position:
Geography
 Falck is present in 23 countries
 #1 Global cross-border provider of privatized
RoW
16%
ambulance services
 #1 Global provider of offshore and maritime
safety training
 #1 Nordic provider of auto, home and
Europe
11%
healthcare assistance
Nordic
17%
Note: Revenue converted from DKK to 5.5 USD.
Segmental breakdown based on FY 2010 financials
3
Denmark
56%
Introduction to Falck Group
All 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
Reliable
Accessible
Helpful
 Alleviate the after-effects of
emergencies
 Rehabilitate people after
illness and injury
 Always be there so that people
can live their lives safely
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Fast
Competent
Efficient
Introduction to Falck Group
Ownership
More than 100 years of history within emergency, safety and healthcare services
Falck family
Baltica
Private ownership
Listed
Standalone
Group4Falck Standalone
Services
Falck
Founded
Rescue
Ambulance
1906
1908
Roadside
Assistance
Patient
Transportation
Fire
1922 1926 1933 1988
Offshore
Training
1995 1996
Healthcare
2000 2001
Alarms
2005
2006
2007
Home care
2008
2009
2010
No. of countries
Geographies
Denmark
1
Nordics
3
Rest of Europe
9
Rest of World
5
10
Introduction to Falck Group
Geographic diversification – a global company
Countries with established activities
Countries where Falck currently is establishing new activities
6
Introduction to Falck Group
Segmental overview
Emergency
Assistance
Healthcare
Training
Leading international
provider of
emergency services
51% of revenues
Leading Nordic provider
of auto and home
assistance services
27% of revenues
Leading Danish provider
of private
healthcare services
12% of revenues
Leading global provider
of offshore and maritime
safety training
10% of revenues
B2C
2%
Customers
B2B
10%
B2C
51%
Geography
B2B
49%
B2G
4%
B2G
49%
B2B
91%
B2G
90%
● Long-term contracts,
high visibility
Europe
19%
Nordic
14%
● Subscription model,
highly resilient
Denmark
67%
Note: Segmental breakdown based on 2010F financials
● Partly subscription
based
Denmark
5%
RoW
39%
Denmark
72%
● 5 countries
● Framework agreements
RoW
Europe
2%
Nordic 5%
5%
Nordic
28%
● 12 countries
7
B2B
49%
B2C
5%
Denmark
88%
● 7 countries
Nordic
25%
Europe
31%
● 15 countries
Introduction to Falck Group
Emergency
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
8
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
9
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
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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.
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Introduction to Falck Group
Unique ability to build and execute the business
Strong fundamentals
Ability to execute
1
•
•
•
•
•
Competencies
2
Infrastructure
Competencies:
Brand
3
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 centers network
Global knowledge base
Brand:
•
•
Trustful, reliable, credible, efficient and
accessible
Publicity of operations, and quick to
establish strong reputation
Uniqueness of Falck
• More than 100 years of experience
• Flexible execution model
• Convert single service offering to multi service offering
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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
• Roadside assistance with maximum
response time requirements
• Cost efficient dimensioning with
retainers for peak service demands
● Stringent performance requirements
─ E.g: high performance response times
• Simulate life-and-death situations in
a secure environment
● Dimensioning and managing network to provide
services efficiently
─ Utilize full time employees and mutual aid
agreements
• Train and maintain highly skilled
instructors
• Dimensioning of healthcare networks
with guaranteed treatment time
• Handling peaks and valleys in
demand analysis
─ Station network and rolling stock
Exceptional ability
More than 100 years of training to adapt to any accident scene
13
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
train more than 5,000 people in Houma, Louisiana.
● Falck provided training on the clean up animal
habitats on the beach and in the ocean.
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● 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.
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.
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Overview
1.
2.
3.
16
Introduction to Falck Group
Falck’s worldwide Emergency Medical Services
Falck entering new markets – Slovakian case study
Emergency Medical Services
Overview of services
Ambulance Services
Patient Transport
Fire Fighting
Emergency
ambulance services
Non-emergency
patient transport
Fire Fighting
Rapid response units
with paramedics,
nurses and doctors
Critical care transport
Fire and Safety
Consultancy
Other pre-hospital
modalities
Air ambulance
services
RPM-services for
Airports
Patient transport
services (PTS)
Transport of disabled
persons (ATS)
Fire Training
Airport Fire Fighting
Risk Management
Control Centers
Dispatch of fire
resources,
emergency
ambulances, nonemergency
ambulances,
assistance vehicles
and patient transport
Monitoring of
different alarm
systems
Logistics
management
Services are provided and developed according to local requirements in
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 Services
Overview of European markets
Norway
• Emergency vehicles: 34
Denmark
• Ambulance stations: 19
• Emergency vehicles: 476
• Ambulance staff FTE: 78
• Ambulance stations: 134
• Rescuers FTE: 4,549
• Fire stations: 148
Sweden
• Municipality fire contracts: 66
• Control centres: 5
Slovakia
• Emergency vehicles: 104
• Emergency vehicles: 121
• Ambulance stations: 39
• Ambulance staff FTE: 574
Belgium
• Ambulance stations: 91
• Emergency vehicles: 103
• Ambulance staff FTE: 851
• Ambulance stations: 15
• Fire stations: 1
• Ambulance staff FTE: 803
• Fire fighters FTE: 48
• Control centres: 2
• Fire stations: 4
The Netherlands
• Consultants, trainers FTE: 109
• Training centres: 2
Poland
Spain
• Emergency vehicles: 79
• Fire stations: 20
• Fire fighters FTE: 281
• Training centres: 3
Romania
Denmark
• Fire stations: 6
Nordic
• Fire fighters FTE: 212
Europe
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• Ambulance stations: 23
• Ambulance staff FTE: 826
• Control centres: 7
Emergency Medical Services
Overview of American markets
USA - East Coast
• Emergency vehicles: 440
• Ambulance stations: 26
USA - West Coast
• Ambulance staff FTE: 1,224
• Emergency vehicles: 135
• Ambulance stations: 33
• Ambulance staff FTE: 626
Brazil
• Emergency vehicles: 194
Falck Worldwide
• Emergency vehicles: 1,690
• Ambulance stations: 383
• Ambulance staff FTE: 9,830
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• Ambulance staff FTE: 885
Emergency Medical Services
Operational services and competencies
Falck: Advisor
Falck: Operator
Alarm
Center
operations
The proper
resource to the
actual need
Dispatch
Center
operations
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
Ambulance
operations
Characteristics
Falck operations:
• All types of
emergency vehicles
• Equipment
• Training
• Communication
• Telemedicine
• Electronic patient
care record
Emergency
rooms
R&D on pre-hospital medical
services through non-profit
Falck Foundation
• Board of internationally
recognized medical
professionals from different
countries
Falck’s vast experience and knowledge in the EMS industry is second to none.
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Emergency Medical Services
World class radio and data network solutions
Alarm Call
GIS work station
Dispatch system
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Emergency Medical Services
Operational services and competencies
Operational excellence
●
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
Equates to improved outcomes
●
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
Operational experience and competencies
Business model
23
• BtG
• Ambulance and other pre-hospital services in 8 countries
• BtItC
• Ambulance and pre-hospital in Slovakia
• BtC
• Ambulance and pre-hospital in USA
• BtB and BtC
• Road assistance, courses in first aid and fire fighting
• PPP
• Assistive aids company
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
Country
EMT
Paramedic
Nurse (CCT)
Doctors
HEMS
Denmark
None
Level 1+2+3
(British type)
Re-educate to
paramedic level
2 or 3
Medical support teams
(intervention cars)
SAR+HEMS
Poland
One in every
ambulance
One basic in
every ambulance
One in every
”R” ambulance
One in every ambulance ”R” and
”W”
Government operated
Slovakia
One in every
ambulance
3 different levels
one in every
ambulance
None
One in part of the ambulances by
region / demography / distances
determined by the government
Private HEMS regulated by
government used
intensively for the military
Holland
One in every
ambulance
None
One in every
ambulance
Special trauma teams / HEMS
(anaesthesiology)
Private. Scaled and
financed by government
Belgium
At least one in
every
ambulance
None
In some
ambulances
(departing from
hospital)
Medical support teams
(intervention cars)
Private and limited SAR.
Financed by sponsors and
government
Sweden
None
One basic in
every ambulance
In 50% of the
ambulances
Telemetry – advise back up
system: severe circumstances
Private. Scaled and
financed by government
Norway
None
Advanced level
(British type) or
equal
None
Medical support teams (mostly
HEMS)
Private. Scaled and
financed by government
USA
One in every
ambulance
One in every
ambulance
Only in critical
care transports
None
SAR+HEMS
Brazil
One in every
ambulance
None
Nurse or doctor
Nurse or doctor
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Emergency Medical Services
Greenfield strategy and experience
Greenfield strategy
Price
Discipline
Cost
discipline
● 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
Partner
ship
Focus on
Value-Add
Brand
● Attractive partnerships
−
8 out of 10 local founders are still part of
Falck
Very successful track record
● ~ 10 Greenfields since 2005
International Greenfields
Countries
● Slovakia (2006)
● Nigeria (2009)
● United Arab Emirates (2009)
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Overview
1.
2.
3.
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Introduction to Falck Group
Flack's worldwide Emergency Medical Services
Falck entering new markets – Slovakian case study
Market Entry Case Study: Slovakia
Overview
Key facts
Achieved results (revenues, DKKm)
• Competitive RFP entry in September 2006
13%
12%
178
159%
• Successful greenfield start-up
157
140
• Local equity participation
• Cross-pollination between industrial fire fighting
and healthcare clinics
54
• New RFP round in 2009 expanded emergency
coverage from 28% to 33%
2006
27
2007
2008
2009
Market Entry Case Study: Slovakia
Status 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
The largest ambulance service provider in
Slovakia
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• ISO certification 07.02.2008
Market Entry Case Study: Slovakia
How it was done.....
Key Facts
• 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
A three phased roll out.....
1
Building Phase
“Initial Ramp-up”
01.01.2006
May 2006; another 37
licences; deadline
08/15/2006
January 2006; first 36
licences; deadline
06/15/2006
• 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
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Building Phase
terminated
Building Phase
2 Consolidation Phase
01.08.2006
07/31/2006
73 stations opened
“Maintenance Phase”
09/15/2006, last station
in Beladice opened
31.12.2006
3 Stabilization Phase
“Fine-tuning”
30.06.2007
Processes setup update
Market Entry Case Study: Slovakia
How it was done.....
From building phase….
● Roll-out done locally according to local laws and
regulations - by local people, managed and guided
by centrally coordinated Falck Group competences.
....to start of operations
● In 7 months the operational platform was in place
and operations started throughout the country.
● Priority was to hire and train personnel and to buildup 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.
● 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.
● August 2006 all stations were connected to internal
data network and voice VPN, both fixed and mobile.
● 84 new ambulances were delivered by Falck within
this time period.
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Market Entry Case Study: Slovakia
How it was done.....
From consolidation phase….
....to stabilization phase
● The priorities for the second phase were to fine
tune operational processes: administration,
procurement, human resources etc.
● The priorities of the last phase were to optimize
cost procedures related to personal, ICT, fuel,
rental costs, and other medical equipment
● Minimizing overtime, optimal planning of shifts,
structuring operational and regional management
● Building medical training center
● 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
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● 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
Market Entry Case Study: Slovakia
Effect on the Slovakian EMS system
Prior system
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.
●
~ 80 different public providers, mostly
hospitals
●
1,500 employees
●
91 stations all around the country
●
100 emergency vehicles
●
Average response time ~30min
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.
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●
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
Falck Group
The “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
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Q & A Session
Questions?
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Contact Information
Boo Heffner
Group Senior Vice President
Falck
President and CEO
Falck USA
Contact details:
E-mail: boo.heffner@falck.com
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