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A long-term track record and strong relationships with the NHS and GPs. Assura is well positioned to alleviate the pressures on primary care.

Market outlook – key statistics

90%

In 2039, the number of people aged 75 or over is expected to be 90% higher at 9.9 million people

2.9m

On average, people aged 85 and over see their GPs 13 times a year - significantly more than those under 85.

£21

A visit to a primary care centre costs, on average, £21 compared to £124 for a visit to A&E

NHS

The NHS publication of the “General Practice Forward View”, in April 2016, further emphasised the need for appropriate primary care infrastructure and premises.

Market Outlook

The primary care sector is characterised by strong real estate fundamentals: secure occupier covenants, minimal development risk, restricted supply with no speculative development and long leases without breaks. In addition, the underlying open market rent review mechanism most common in the sector has provided inflation tracking returns over the medium term. A secure and predictable income stream, with an underpinning of inflation linkage, is a highly attractive proposition for an investor who is looking for an alternative investment in real estate, with different characteristics to mainstream sectors, such as residential, retail or office.

The relative stability and quality of the underlying income stream are particularly relevant at a time of macro-economic uncertainties in the global economy and in the UK’s relationship with Europe. In addition, the sector is experiencing increasing demand at a time when supply has been heavily restricted by the approval processes of the NHS. There are increasing signs that this latter situation is improving and the unblocking of the significant investment required in primary care property will become more likely.

  • The relative attractiveness of our asset class is shown in the chart [below] from IPD that shows the overall return and the level of volatility of that return since its inception to 2016. Primary healthcare provides both the second highest level of return and the lowest level of volatility over that period. If you put those two factors together, then primary healthcare provides the best risk adjusted return over a ten-year time horizon.

  • “A secure and predictable income stream, with an underpinning of inflation linkage, is a highly attractive proposition”

Risk reward spectrum, nine-year total return vs standard deviation 2007-2015 (since the inception of the IPD healthcare index)

Increasing demand

Assura as a developer and investor in primary care property provides bespoke, purpose built premises that meet the evolving needs of GPs as they look to meet the increasing health requirements of the UK population.

GPs are the cornerstone of the UK health model and provide consultations with over 1.3 million patients every day. Many of these consultations take place in outdated and unsuitable premises that are not able to provide the broad range of additional services that are available in our modern purpose built premises. In the 2014 BMA Survey of GP practices 40% of GPs stated that their premises were not fit for purpose.

Net yield initial movement

Market overview

The continuing attractiveness of our sector for its security and longevity of income has seen yields tightened with a movement of 27 basis points on a net initial basis and 25 basis points on our net equivalent yield.