Presentation - Convertible Loan Notes
Doctor Care Anywhere
Transforming lives through
better healthcare
Convertible Loan Note Private Placement
Investment Opportunity
Q4 2023
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© 2023 Doctor Care Anywhere
Important Notice and Disclaimer
This presentation has been prepared by Doctor Care Anywhere Group Plc, an
entity incorporated in England and Wales with English Company Number
08915336 and Australian Registered Body Number 645 163 873 (Doctor Care
Anywhere or Company) and is dated 23 November 2023. This presentation is
for information purposes only and it is not financial product or investment
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References to Doctor Care Anywhere or the Company in this presentation are
to the Doctor Care Anywhere group including all subsidiaries, unless stated
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© 2023 Doctor Care Anywhere
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Financial Data
All amounts are in British pounds (£ or GBP) unless otherwise indicated.
a)
A number of figures, amounts, percentages, estimates, calculations of value
and fractions in this presentation are subject to the effect of rounding.
Accordingly, the actual calculation of these figures may differ from the figures
set out in this presentation.
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Investors should also be aware that certain financial data included in this
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meaning prescribed by Australian International Financial Reporting Standards
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c)
if you are located in Australia, you are a wholesale client for the purposes
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Acceptance
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Executive Summary
Offer highlights*
1. DCA is one of the UK’s leading private providers of telehealth services
A. We deliver over 60,000 consultations per month, with +75 Net Promoter Score
B. Our long-standing, exclusive partnership with AXA offers access to their 2.8 million UK
health insurance members
C. H1 FY23 Revenue £19m; grown at CAGR >40% since IPO
2. Opportunity in the UK today
A. Shortfalls in NHS primary care workforce highlight acute need for UK telehealth
B. Private care providers instrumental in filling the NHS gap
C. Recent sector developments underscore strategic opportunity
3. Capital structure repositioned for the future
A. Purpose of the £10.5m convertible note offer is to repay existing £10m loan with AXA
B. AXA supports this raise and will participate in the convertible note offer
* Certain information in this slide is based on the Company’s full year and half year audited and reviewed financial statements released on the ASX and certain numbers previously released
© 2023 Doctor Care Anywhere in the Company’s ASX announcements which have been extracted from the Company’s management reports.
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Who we are
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© 2023 Doctor Care Anywhere
Our Service
Doctor Care Anywhere (DCA) Group PLC is one of the UK’s largest private
providers of telehealth services. We offer private virtual General
Practitioner (GP) and Advanced Nurse Practitioner (ANP) appointments,
24 hours a day, 365 days a year via video and phone.
DCA is a UK-based digital health company that is committed to delivering
high-quality, effective and efficient care to its patients, whilst reducing the
overall cost of providing clinical services. DCA utilises its relationships with
health insurers, healthcare providers and corporate customers to connect
with patients and deliver a range of telehealth services.
DCA was founded in 2013 in London, UK. In 2015, DCA entered a strategic
relationship with AXA Health to offer virtual GP services to AXA’s customers
under the AXA Doctor at Hand with Diagnostics brand.
We manage the specialist referral pathway for AXA patients, to enhance their
patient journey and reduce costs for AXA by avoiding unnecessary tests and
interventions.
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£19.2M
> 40%
70%
Revenue in
1H 2023
Revenue CAGR
since IPO
Returning
patient share
© 2023 Doctor Care Anywhere
Multi-channel Distribution of Our Services
We use a successful B2B2C delivery model and partnerships through
multiple channels to deliver services to corporate clients and members
Insurers
Health providers
Serving 1,500+ organisations
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© 2023 Doctor Care Anywhere
Employee engagement platforms
Direct relationships
The DCA Service
We currently offer access to the following features...
Appointments with GPs and ANPs by
video call or phone, available 24/7, 365
days a year via web & app
Referrals – diagnostic, open
specialist and therapy referrals
Up to 20 minute appointment with
ANPs and GPs for a variety of health
concerns
My Health, which provides a
range of resources to support
our patient's mental wellbeing
and the promotion of self-care
and patient empowerment
Prescriptions are sent electronically to
a local pharmacy of the patient's choice
or to delivery partner enabling the
patient to have medication to be
delivered to a chosen address.
7
consults
per month
Access to Fit notes
Secure medical records including all GP and ANP written notes
550+ GPs and ANPs
2.8m+
30+ specialists
eligible lives
reached
viaAnywhere
AXA on contract with DCA
© 2023
Doctor Care
60,000+
1500+
corporate customers
+75
net promoter
score
Key Metric Overview*
Track record of growth
376
965
869
559
1H 2022
2H 2022
180
433
2H 2020
313
260
756
675
303
137
1H 2021
2H 2021
1H 2022
2H 2022
1H 2023
2H 2020
19.2
1.3
13.7
1.0
11.2
2H 2021
2H 2020
1H 2021
2H 2021
1H 2022
2H 2022
5.8
2H 2020
-3.5
17.9
0.9
14.2
12.7
13.4
-5.6
8.3
-7.5
1H 2021
2H 2021
Utilisation
1H 2022
Subscription
Other
2H 2022
1H 2023
-9.1
Total
-11.5
Revenue by half year (£m’s)
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1H 2023
14.5
1.1
2.0
6.9
1.0
1H 2023
Consultations by half year (000’s)
Activated Lives by half year (000’s)
15.3
1.1
1H 2021
-10.7
EBITDA loss by half year (£m’s)
* Based on the Company’s full year and half year audited and reviewed financial statements released on the ASX and certain numbers previously released in the Company’s ASX
© 2023 Doctor Care Anywhere
announcements which have been extracted from the Company’s management reports.
Clear Disconnect
Share price versus business value
Market valuation
A$ 0.31
A$ 0.12
Share price
EV (£m)
A$ 0.05
37.7
20.6
16.5
2021
2022
Today
Financial performance 12m
12m
6m
30
19
43%
44%
22%
25%
Revenue (£m)
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Gross Profit Margin
42%
Contribution
Margin
EBIT Margin
20%
-24%
-82%
-66%
2021
2022
H1 2023
Comments from Bell Potter,
Analyst Report July 2023
• “We upgrade from Hold to Buy (Speculative)
with valuation raised to $0.08. The rate
negotiation with AXA is completed, the roll out
of the MCW is imminent, patient numbers
continue to grow and guidance has been
maintained.
Commentary
• “The company continues to make good progress
towards profitability. The sale of GP2U and
conclusion of rate negotiations with AXA
represent significant milestones.
• “Our valuation is limited to 100% upside from
the current market value, hence remains well
below the EV/Revenue multiple applied to
peers”
1H23 Business update
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© 2023 Doctor Care Anywhere
1H23 Results Overview*
375,000
265,000
20,000
consultations delivered
returning patient consultations
secondary care journeys
(+24% on 1H22)
(70% recurring)
(+46% on 1H’22)
Driven by acquisition of 210,000 new patients
Demonstrating quality and retention value of service
£19.2 M
43.6%
(£3.5) M
revenue
1H23 gross profit margin
ebitda
(+26% revenue growth on 1H’22)
(+170bps on 1H’22)
(+60% loss reduction on 1H’22)
Demonstrating improving base economics of DCA
* Based on the Company’s full year and half year audited and reviewed financial statements released on the ASX and certain numbers previously released in the Company’s ASX
announcements which have been extracted from the Company’s management reports.
© 2023 Doctor Care Anywhere
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1H23 Highlights
Continued growth in consultations
375,000 consultations delivered in 1H23
+32% year-on-year
• May 23 monthly high of 65,000 consultations (excludes Australian
subsidiary GP2U sold in July 2023)
• Volume growth drives increased revenue to £19.2m – up 26% compared
to 1H22 which supports margin expansion
Sale of GP2U
• Sale of Australian subsidiary GP2U (completed in early July 2023) for
$3m to My Emergency Doctor (“MED”).
• Consideration comprising A$2.5m worth of unlisted ordinary shares in
MED and $0.5m of cash, adjusted for normalised working capital
• This will reduce ongoing losses by $0.8m AUD p.a. (£0.5m) and allow
to Care
focus
on our core UK market
© 2023 Doctor
Anywhere
12management
Successful launch of Mixed Clinical Workforce
proposition
• Advanced Nurse Practitioners (ANPs) are now live on the DCA platform;
ANPs are able to diagnose, prescribe and refer patients
• ANPs provide DCA with additional capacity to support our growth and
reduce cost to serve
• Over 8,000 appointments performed in June 2023, with share of
appointments expected to grow
• Significant margin improvements forecast in 2H 23 following launch of
Mixed Clinical workforce proposition
Working towards EBITDA breakeven
• EBITDA loss reduced to £3.5m in 1H 23 vs high of £11.5m in 2H 21,
through combination of revenue growth, margin growth and close
management of fixed costs
• Market guidance, as released Feb-23 : EBITDA breakeven in 1H 24
• Further efficiencies to come through automation projects and sublet
of corporate headquarters
2H 2023 Key Initiatives
Realign capital structure
• AXA facility in December 22 was a bridge into a long-term, stable and pro-growth capital structure
• Operating performance supports proposed debt and accelerating cash build-up next 18 months
• Repurposing balance sheet and internally generated cash positions DCA to win in the UK
Change in operating
model driving margins
• Successful launch of Mixed Clinical workforce in Q2 expected to support increased margins in H2
• Enhanced patient experience as we use health information to guide patients through the care journey
• Management continues to drive efficiencies in operating model and enhance platform service capacity
Significant strategic
opportunities in the UK
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© 2023 Doctor Care Anywhere
• Our platform capabilities deemed core for full-service client propositions – private AND public
• Executive leadership team focused on capitalising on changing competitive landscape
• Pathway to significant new partnerships via channels parallel to private health insurance
Opportunity in the UK today
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© 2023 Doctor Care Anywhere
Our proposition in demand more than ever
Private market participants could be well positioned to capitalise and address
unmet needs caused by the NHS facing unprecedented pressure.
There are 3 main drivers of the pressure faced by the UK
healthcare market:
A massive growth in demand
Significant supply-side pressures (e.g., capacity,
staffing)
Which are only likely to be unlocked through:
Increased spending from
- the government to ameliorate NHS challenges
- employers and individuals to increase private
insurance coverage
- self-pay for others to access additional capacity
Significant reform is needed to address
structural challenges in the NHS (e.g., limited
diagnostics capacity)…and will take time
A renewed focus on enhancing efficacy and
productivity to maximise capacity of existing
resources
Slow and challenging post-COVID recovery,
which is amplified by strikes, inflation, and labour
pressures
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© 2023 Doctor Care Anywhere
Changing patterns of demand and supply side
responses (e.g., increasing outsourcing, private
sector, and private pay)
Patients are noticing the shortfall in GP care
Ease of access to GP services
%, 2017 – 2023
Timely availability of GP services
%, 2017 – 2023
% of people who spoke to someone at a time they wanted to or sooner
% of people that found it easy to get through to their practice by phone
70
68
71
68
68
65
62
-18%p
57
59
53
50
2017
16
2018
2019
2020
2021
2022
2023
2017
2018
2019
© 2023 Doctor Care Anywhere
Source: GP Patient Survey 2017-2023, Strategy & Analysis
-21%p
56
2020
2021
51
50
2022
2023
Shortfalls in primary care workforce highlight acute need
for UK telehealth
Estimated FTE shortfalls based on current policies
2021/22-2030/31
Number of appointments cancelled due to industrial action across the NHS
000s, Jan 2023 – Aug 2023
Forecast
Total strike cancellations
Junior doctor strike cancellations
8.6%
839.3
8,800
6,700
GPs
4,200
195.0
175.0
2021/22
2023/24
All strikes
Jan-Aug 2023
-4.2%
Nurses
50,600
30,300
2021/22
2023/24
102.0
June
July
61.2
2030/31
Forecast
44,500
106.1
March
April
August
# strike
days
n/a
3
4
3
5
5
# doctors
on strike
n/a
28,708
27,631
23,158
20,432
23,682
As % of
total appt.
n/a
1.7%
2.3%
1.1%
n/a
n/a
2030/31
Notes: (1) Assumes workforce numbers increase in line with current trends and policies already being implemented to promote staff recruitment and retention;
(2) Includes both weekend days; (3) Reflects the number of doctors on strike at peak of strike; (4) Total inpatient admissions and attendant outpatient appointments;
(5) NHS has not yet released July and August 2023 attendance as of preparation date of these materials.
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© 2023 Doctor Care Anywhere
Source: The Health Foundation, NHS England, Strategy & Analysis.
Private care providers instrumental in filling the NHS gap
Private healthcare admissions by funding source
000s, 2019 – 2022
Healthcare activity by provider and funder
% activity, 2019-22
Privately funded, NHS provided
Privately funded, Privately provided
NHS funded, Privately provided
NHS funded, NHS provided
1%
6%
6%
1%
5%
6%
1%
6%
Private insurance
admissions
Private self-pay
admissions
Total
7%
819
779
88%
89%
CAGR 19-22
86%
758
199
(26%)
525
262
(35%)
272
(33%)
145
(28%)
2019/20
2020/21
2021/22
Total
private
provision
11.2%
10.8%
13.0%
Total
private
spending
6.4%
6.3%
7.5%
18
580
(74%)
2019
© 2023 Doctor Care Anywhere
Source: PHIN, BHI, Strategy & Analysis
380
(72%)
2020
496
(66%)
547
(67%)
2021
2022
(1.9%)
11.0%
Recent sector developments underscore strategic opportunity
Several players have either vertically integrated or been carved-up
• The UK health sector is experiencing an exciting pace of
change
• Private equity firms have clinched 150 deals with UK
healthcare companies in the past 2 years (LaingBuisson)
• Healthcare providers are combining in-person and digital
services, either through partnerships or acquisition
• DCA’s capabilities in digital health, clinical workforce
management and patient navigation are highly relevant
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© 2023 Doctor Care Anywhere
Ascenti acquires My
Online Therapy
(August 2023)
Babylon UK goes into
administration…business
sold for £0.5m (August 23)
“Circle’s new virtual GP
service offers you
access…”
“Kry launches digital
care pathways for
chronic respiratory
“IK Fund acquires
condtions” (May 23)
Medica Group,
international provider of
high quality telemedicine
services” (July 23)
PureHealth acquires
Circle Health for $1.2
billion (Aug 23)
Proposed Transaction
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© 2023 Doctor Care Anywhere
Illustrative Term Sheet:
£10.5 M Convertible Loan Note (Private Placement)
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© 2023 Doctor Care Anywhere
Key Terms
Range
Maturity
4 year, bullet
Non-callable
Cannot be prepaid for 2 years
Coupon
0%
Conversion
A$0.0875 per CDI
Issue size
£10.5 m
Covenants
Market standard ; unsecured
Use of Proceeds
Convertible loan note issue is a refinancing of existing senior debt
Sources of Capital from Raise
• £10.5 M new issue CLN
• Stable capital structure to maturity
• AXA and market investors participate
Uses of Capital from Raise
• £10.5 M retire accrued AXA senior loan
• Avoid repayments £0.8 M/qtr from Nov’23
• Amendment of liquidity covenants
Net impact
A. AXA becomes strategic investor in DCA’s growth, but without blocking stake if converts
B. DCA balance sheet resources free to focus on operations and growth
C. Underscores current market valuation gap to business performance
D. Shows DCA access to new capital, after period of stabilisation in 2023
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© 2023 Doctor Care Anywhere
AXA supports this raise
AXA is swapping their loan for convertible notes: reflects a re-alignment
to DCA’s significantly improved position today, versus a year ago.
1. Repayment of principal: accelerated
2. Continuity of service: de-risked
3. Repriced yield to market rate: coupon reset
4. Transparent, arms-length validation: market terms
5. Participation in value created: equity upside
6. Reduced administration and reporting: streamlined
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© 2023 Doctor Care Anywhere
Indicative deal timeline – subject to change
Executing in Q4 2023
1.Q3 Results and Market announcement: 18 October
2.Binding commitments: week of 23 October
3.Board meeting: 24 October
4.Closing and funding: Nov. / Dec., based on ASX / UK shareholder approval rules
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© 2023 Doctor Care Anywhere
GLOSSARY
1.Eligible Lives: the total number of people who have an entitlement to use DOC’s services,
generally through a subscription funded by an insurer or employer.
2.Activated Lives: The total number of people who “sign up” for DOC’s service and enter
their personal details via the DOC app or website.
3.Consultations: The number of GP and ANP consultations delivered to patients over the
period.
4.Secondary Care Journeys: The number of secondary care journeys completed by patients
over the period following a referral from an initial GP or ANP consultation on the DCA
platform; the journey involves a diagnostic test, a Virtual Specialist Review of the test
results, and a GP/ANP follow-up consultation with the patient.
5.Repeat Patients: The number of consultations completed by patients who had previously
completed an appointment.
6.Advanced Nurse Practitioners (ANP): ANPs are educated to Masters level in clinical
practice and have been assessed as competent in practice. They have the authority to
make autonomous decisions in the assessment, diagnosis and treatment of patients.
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© 2023 Doctor Care Anywhere
Key Risks
Concentration of revenue
A significant portion of DOC’s revenue is derived under several
agreements it has with AXA PPP Healthcare Group Limited (AXA). In
FY2022, the relationship with AXA accounted for approximately 90% of
the Company’s total revenue. A decrease in revenue received from AXA
for any reason could have a material adverse effect on DOC’s revenue
and profitability.
AXA may terminate its arrangements with DOC
DOC is party to several agreements with AXA which govern most
material aspects of the relationship, including the terms on which clinical
services are provided to AXA, and the terms on which technology
development, hosting and maintenance services are provided to AXA. In
particular, certain documents set out the joint venture arrangements
between AXA and DOC including the Joint Venture Agreement. These
arrangements contain various rights for AXA to trigger a call option to
acquire DOC’s shares in the joint venture entity and to terminate the joint
venture arrangements, including a right to terminate these arrangements
due to a material breach of the Joint Venture Agreement or for
convenience between 1 February 2025 and 27 April 2025. Termination
of the arrangements with AXA would have a materially adverse effect on
the Company’s ability to generate revenue and would materially
adversely impact the Company’s operations and business.
In October 2023, DOC and AXA agreed non-binding Heads of Terms,
subject to a formal binding agreement, for certain changes to be made to
the contractual relationship between the parties. These changes include
the termination of the joint venture arrangements between DOC and
AXA and the winding-up of the joint venture entity, while continuing the
commercial arrangements between the parties in relation to sharing the
economic benefits of the diagnostic referral pathway management
services provided by DOC to AXA. However, there is a risk that the
parties do not enter into formally binding arrangements to effect these
intended changes to their contractual relationship, and there is a risk that
even if these intended changes are made, the expected benefits do not
materialise or are not as significant as initially thought.
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© 2023 Doctor Care Anywhere
Restrictions on the expansion of DOC’s business
The agreements with AXA include various exclusivity restrictions that
may prevent the Company from developing or making available products
that include both online GP services and the facilitation of diagnostics to
any direct competitor of AXA (this includes healthcare providers,
administrators and distributors) or other large providers in the UK or
Republic of Ireland. In addition, if DOC intends to provide similar
services in Italy, France, Spain, Germany, Switzerland, Belgium, Japan
or Mexico, the opportunity to provide those services must first be
provided to the Joint Venture Entity.
These restrictions may make it more difficult for DOC to achieve its
objectives by growing its business in new products or markets. There is
also a risk that if DOC fails to comply with such restrictions, it will give
rise to an immediate termination right by AXA. This could adversely
impact DOC’s reputation and its financial performance and position.
Under the Heads of Terms, among other changes, DOC and AXA
agreed that the exclusivity restrictions imposed on both DOC and
AXA under the existing contractual arrangements would be terminated.
This change enables DOC to sell its services to other health insurers and
providers, while also enabling AXA (subject to a specified notice period)
to procure services from DOC’s competitors. There is a risk that, despite
the longstanding relationship and established operational processes in
place between the parties, AXA chooses to procure services from DOC’s
competitors, which could lead to a reduction in DOC’s revenues from
AXA and a deterioration in its financial performance and position. There
is also a risk that the intended changes to the contractual relationship as
described in the Heads of Terms (including termination of these
exclusivity restrictions) are not concluded in a binding contract.
Early-stage business risk
DOC is an early-stage business that does not generate profits. DOC’s
ability to achieve its anticipated growth is dependent on the successful
implementation of its growth strategy, including DOC’s ability to expand
into new markets and increase revenue under channel relationships.
DOC does not have a significant history of operations and there can be
no assurance that it would be able to generate or increase revenues
from its existing and proposed products or avoid losses in any future
period.
Activation of existing eligible lives and utilisation of the service
Whilst DOC understands that there is a large potential market for its
services, and it already has approximately 3 million people who have an
entitlement to use its services (Eligible Lives), there is no guarantee
that DOC will be successful in converting the market for its services into
Eligible Lives or that DOC’s existing Eligible Lives will subscribe and
utilise DOC’s services.
Acquisitions, expansion or growth initiatives by DOC may not be
successful
As part of its growth strategy, DOC may investigate and undertake
expansion, acquisition and other growth initiatives from time to time. It is
possible that despite analysis and assumptions made by the Company,
there will be a failure to realise the anticipated synergies and any
anticipated increases in the revenue, margins and net profit from any
acquired businesses or growth initiatives. There is also a risk that the
integration of the acquired business may result in more time and cost
than originally anticipated. There is also a risk that DOC’s due diligence
fails to identify all material risks and liabilities relating to the acquired
business. Any of these matters could materially adversely impact DOC’s
financial performance and position.
Requirements for additional funding
Additional funding may be required to meet the objectives of DOC in the
event that costs exceed the expectations of the Company or further
opportunities arise for capital expenditure, investment in new projects,
acquisitions or joint ventures. Should such event occur, the Company
could look to raise additional funds via equity financing or debt financing.
There can be no assurance that additional financing will be available
when needed, on terms appropriate to DOC or that do not involve
substantial dilution to securityholders.
Key Risks
Inability to attract new customers
DOC distributes services to patients through various sales channels,
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