Sustainable
corporate governance

The Management Board is responsible for the topic of corporate responsibility. Strategic sustainability management falls within the remit of the ESG Board. The ESG Board was established as a decision-making committee in the fourth quarter of 2021. It is mainly responsible for the orientation and design of the corporate responsibility roadmap (“CR roadmap”). With the CR roadmap, we are picking up on our seven key sustainability topics that we have identified as part of a systematic materiality analysis and have dealt with along with other matters in this report. The roadmap provides information on the goals, timeline, KPIs and scope of a respective issue and is described in more detail on p. 13.

Another of the ESG Board’s tasks is to monitor and support project management. The ESG Board is led by the Chief Executive Officer (CEO) and the Chief Financial Officer (CFO) of the Asklepios Group. The managing director of an operational healthcare facility as well as a regional managing director are also represented on the Board. The implementation of the CR roadmap along with the realisation of sustainability projects at individual clinics falls within the responsibility of the individual healthcare facilities. Responsibility for implementing the adopted resolutions lies with the relevant specialist departments for the Group’s ESG topics, the regional managing directors and with managing directors and those in charge of ESG topics at the individual hospitals.

The heads of the Group departments and the specialist departments along with the Group ESG & Sustainability department act as a link between the ESG Board and those responsible for the operational implementation. The Group ESG & Sustainability department is in close contact with the working group on sustainability. The working group is tasked with coordinating the systematic review for the Corporate Responsibility Report, formulating recommendations for the ESG Board and developing sustainability goals and actions. The working group consists of representatives from central organisational units of the Asklepios Group, including Architecture & Construction, Purchasing & Supplies, ESG & Sustainability, Infrastructure & Data Protection, Investor Relations, IT, Medical Law, Insurance & Compliance, Human Resources, Quality Management, Legal, Risk Management, Service & Technology and Corporate Communications.

The ESG Board will in future meet once a quarter to define measures and track the project’s implementation. The working group meets on a quarterly basis with the CFO and the COO of the Asklepios Group. In the 2022 financial year, the quarterly meetings of the working group on sustainability took place regularly. The ESG Board held three meetings.

ESG organisation

Our focus topics and action areas

In order to focus on the most relevant CR topics for Asklepios and to develop a systematic approach for our CR activities, we conducted a materiality analysis in 2021. In this structured, multi-stage process, we identified substantive issues for our Group and our stakeholder groups. In selecting relevant topics, we considered factors such as sector-specific and sustainability standards as well as existing requirements and entity-specific conditions. The Management Board and the specialist departments evaluated the topics based on three perspectives: ecological and social consequences emanating from Asklepios (inside-out perspective), economic effects for Asklepios (outside-in perspective) as well as the relevance from the stakeholders’ viewpoint (outside-in perspective). The Management Board and the working group on sustainability accepted the results of our Asklepios materiality analysis.

In 2022, we validated the material topics identified in 2021. This involved examining whether it was necessary to adapt or add to the topics due to internal or external developments. We discussed the findings of this research in a workshop of the Group ESG & Sustainability department – with the result that the material topics remained unchanged. There are two additional topics that we intend to examine more closely in the next materiality analysis: “Consolidation on the healthcare market” and “Partnerships and cooperations”. We also want to define the topic of “digital responsibility” more precisely for Asklepios. Final approval of the results was granted by the Management Board. We are planning to perform the next materiality analysis in 2023, taking account of the requirements of the Corporate Sustainability Reporting Directive (CSRD).

Seven material topics

The seven material CR topics forms the basis for our CR roadmap. These are: raising awareness for the code of conduct/principles of conduct, patient satisfaction, patient safety, employee health, reducing waste, reducing CO₂ and reducing water consumption.

Graphic presentation of the materiality matrix

Other important topics for Asklepios will also be dealt with as part of a holistic presentation. These include supply chain management, digitalisation, data protection, training and education for our employees and promoting a family-friendly workplace.

Patients, employees and the environment – our key action areas

As one of the leading healthcare providers in Germany, we have a special responsibility to our patients, our employees and the environment. In addition to responsible corporate governance, our sustainability strategy therefore focuses on these three action areas:

• Patients The focus at Asklepios is on people. We take responsibility for patient welfare and are committed to delivering the highest quality of treatment. Digitalised processes help us make patient care more efficient, faster and better. In doing so, we are also permanently focused on protecting patient data.

• Employees Qualified, dedicated personnel are fundamental to guaranteeing the best treatment quality and patient satisfaction. As a result of the ongoing demographic change, we are confronted with increasing patient numbers and a simultaneous decline in the availability of qualified and skilled personnel. We want to increase our attractiveness as an employer and actively promote the health and education of our staff.

• Environment As a hospital group, we are responsible for the energy supply for our approximately 170 healthcare facilities. We can make a significant contribution to protecting our climate by way of efficient energy consumption. To ensure that we also contribute our fair share towards achieving global climate targets, we must increase the energy efficiency of our hospitals and help reduce our greenhouse gas emissions. We strive to conserve natural resources by reducing waste and using water carefully.

Our corporate responsibility roadmap

We firmly believe that we can achieve lasting success only by reconciling economic, ecological and social factors with one another. To satisfy this requirement, we set ourselves goals in 2021 that we plan to pursue with our corporate responsibility roadmap (“CR roadmap”) as part of our sustainability management.

The program picks up on our seven key CR topics, which we identified as part of a systematic materiality analysis and which we describe in this report.

• Raising awareness of the principles of conduct: Integrity is a top priority for Asklepios. All employees are to be regularly informed about the Asklepios principles of conduct by the Management Board and trained in this using a new e-learning tool. We introduced this tool in 2022 and will expand it further in 2023. An initial training course on compliance has already been carried out.

• Guaranteeing patient safety: We want to ensure consistently safe, high-quality patient care. In addition to the Critical Incident Reporting System used in all hospitals, Asklepios has been working for five years with the medical law prevention format “Sicher Arbeiten Vertrauen Erhalten” (Work Safely, Gain Trust – S.A.V.E.), which aims to ensure that all employees working in Asklepios delivery rooms are optimally prepared for rare obstetric emergencies.

• Improving patient satisfaction: We want our patients to be completely satisfied with their stay with us and with our healthcare services. We are aiming to achieve an annual recommendation rate of 90% by 2026.

• Promoting employee health: Our employees’ health is very important to us. To enable all employees to use the health promotion offers, we want to implement corresponding programmes in the action areas of exercise, nutrition and stress management at all facilities.

• Reducing CO₂ emissions: We aim to steadily reduce the relative CO₂ emissions of our facilities by 2030. To this end, we record the percentage decrease in CO₂ emissions in tons each year as compared to the previous year. As part of the Group-wide ESG strategy, measures have been validated for this and will gradually be implemented at our healthcare facilities.

• Reducing waste: Our goal is to conserve resources as much as possible throughout the Group. By 2030 we aim to reduce the annual volume of waste in tons in relation to the number of patients at our facilities. Where appropriate, we plan to change over to 100% recycled bottles for the drinking water for our patients throughout the Group. The goal is to establish closed-loop material recycling.

• Reducing water consumption: Water is a precious resource, including for the operation of healthcare facilities. We aim to steadily reduce our annual clean water consumption in litres in relation to the number of patients throughout the Group by 2030. We have conducted a case study to reduce the water and energy consumed for cleaning – for example, by using thinner mop covers and filling washing machines higher.

Detailed measures for achieving our goals will be developed in 2023 on the basis of our CR roadmap.

Our contribution to the UN Sustainable Development Goals (SDGs)*

* This represents additional information that does not form part of the limited assurance engagement performed in accordance with ISAE 3000 rev.

In 2015, the United Nations adopted 17 Sustainable Development Goals (SDGs) that the international community is aiming to achieve by 2030. The SDGs address the biggest economic, social and environmental challenges of our time. They trigger a change in society and call on governments, companies and civil society worldwide to take action. The objective is a life of dignity and opportunity for all people – within the scope of our planet’s possibilities.

As a leading healthcare group in Germany, Asklepios wants to contribute to achieving these sustainability goals. We therefore take account of the SDGs in our sustainability strategy, focussing on the goals that are particularly relevant to our business activities. We identified these goals in 2022 and assigned our material topics and existing measures to them. The Group ESG & Sustainability department coordinated the selection process with the involvement of the Management Board. The SDG mapping was approved by the Management Board in November 2022.

Asklepios will contribute as a company to the following seven SDGs in particular:

SDG 3 – Good Health and Well-Being

The primary task of our healthcare facilities is to provide our patients with the best possible care – around the clock. With our services and medical research, we contribute to many people’s health and well-being. At the same time, we look after our employees’ physical and mental health. It is also important to us not to endanger the quality of life of our fellow human beings with our business activities. For this reason, we continuously reduce environmental impacts such as our CO₂ emissions and waste volume.

SDG 4 – Quality Education

Qualified employees are our most valuable asset – especially in times of demographic change and the current shortage of specialist staff. For this reason, we invest in high-quality training and education for our employees: We manage 12 training centres for nursing, medical and therapeutic training roles. In addition, we offer business and IT training and dual study programmes – as well as operating the Asklepios Campus Hamburg as a branch of the medical faculty of Semmelweis University in Budapest.

SDG 8 – Decent Work and Economic Growth

At our facilities and along our supply chain, we attach great importance to safe and fair working conditions and respect for human rights. With our supplier management, we have a certain influence when it comes to setting social and environmental standards. We aspire to make efficient use of resources such as energy and water. As an employer and a training company, we contribute to creating jobs and supporting junior staff.

SDG 9 – Industry, Innovation and Infrastructure

As one of Germany’s leading private hospital operators, Asklepios is an important part of the nationwide healthcare infrastructure and supports all-encompassing healthcare. Our comprehensive risk management and high compliance standards make our company resilient. With research at our own Asklepios Campus and the expansion of digital health services, we promote sustainable innovation in the healthcare sector.

SDG 11 – Sustainable Cities and Communities

With our approximately 170 healthcare facilities, we contribute to the provision of medical care throughout Germany, including in rural and poorly connected regions. We are also promoting the expansion of sustainable mobility at the company: We plan to switch our vehicle fleet to electric mobility and are expanding the charging structure accordingly. In this way, we are reducing emissions and improving the air quality in cities and communities.

SDG 12 – Responsible Consumption and Production

To ensure a reliable supply for our healthcare facilities, we build on a global procurement network. By requiring our suppliers to comply with environmental and social standards, we promote sustainable production worldwide. We take care to ensure sustainable and resource-efficient consumption in day-to-day hospital work, for example by increasingly focusing on the circular economy and waste reduction.

SDG 13 – Climate Action

Asklepios wants to contribute to limiting climate change. We therefore continuously reduce our CO₂ emissions in the areas of heating, ventilation and lighting. For example, current climate protection measures include optimising ventilation systems and replacing boilers.

In 2023, we want to deal more intensively with aligning our corporate strategy with the SDGs in order to strengthen the positive impact of our business activities and reduce negative effects. We intend to address this topic in a strategy workshop in the first half of 2023.

In dialogue with our stakeholders

Asklepios engages regularly with its key stakeholders. These include patients, employees and investors since they have a significant influence on business activities at Asklepios. This constant engagement with our stakeholders enables us to better understand and live up to their expectations from us. We use various channels to engage in dialogue with our stakeholders.

• Patients We share information with our patients, for example, using our website and the disclosures published there from our healthcare facilities, through our social media channels, at patient events on specific health topics, in a patient newsletter and in the digital health magazine “Gesund werden. Gesund leben” (Get well. Live well). Since 2019, we have published the podcast “Die digitale Sprechstunde” (The Digital Consultation) jointly with German daily newspaper “Hamburger Abendblatt”. In regular episodes, our doctors share information about medical symptoms and offer health advice. We also use a range of complaint mechanisms such as questionnaires or electronic feedback systems to engage with our patients.

• Employees We share information with our employees throughout the company through our staff magazine and our intranet AskMe. There, they can stay abreast of important news about current developments at our hospitals, prevention or health options or the current COVID-19 situation at Asklepios healthcare facilities. We also use AskMe to encourage our employees to submit their own suggestions for projects that are deserving of our support.

• Investors We provide regular, prompt and transparent information to our investors regarding our business development, assets, liabilities, financial position and financial performance. We do this by publishing consolidated quarterly and interim reports from the Group, our annual report and corporate news. Our long-established banking day was hosted once again in May 2022 together with investors and bank representatives. The event gave Asklepios an opportunity to report on business performance during the previous financial year and to hold transparent and detailed discussions with its stakeholders. We also informed our investors and business partners about our half-year results in a virtual investor conference.

• Memberships In addition, we consult with other companies, organisations, networks as well as associations and clubs on economic, social and environmental matters. These include Deutsche Krankenhaus Gesellschaft e.V., Bundesverband Deutscher Privatkliniken e.V., Hessische Krankenhausgesellschaft e.V., Hamburger KHG, Wirtschaftsrat der CDU e.V, Wirtschaftsforum der SPD e.V. or Grüne Wirtschaftsdialog. As part of these memberships, Asklepios advocates strongly for public debate around health topics, the mutual exchange of experience and support for scientific research.

Compliance management:

Ensuring integrity

Integrity is a prerequisite for us to be considered a reliable partner. For this reason, we regard compliance as a cornerstone of responsible corporate governance. We follow strict anti-corruption policies that go beyond the legal requirements and adhere to high ethical standards. The leadership style and way we do business at Asklepios are built on the values of integrity, trust, loyalty, quality, innovation and social responsibility. To ensure compliant conduct at the company, we continuously further develop our compliance management system. The goal is to recognise relevant risks early on, establish actions to minimise these risks and thus support and protect both management and employees in making decisions to take action.

Overall responsibility for compliance rests with the Head of Compliance, who is attached to the Group Medical Law, Insurance and Compliance division. He reports directly to the Chief Financial Officer (CFO) and shares information with the Management Board at regular intervals. The local management at the Asklepios hospitals and companies acts as a multiplier for compliance topics, especially when it comes to communicating standards and requirements to the employees. Those responsible for compliance at the hospitals support the local management teams.

Raising awareness of compliance among employees

Raising awareness of compliance topics among our employees also remains a key focus of our compliance management. With the slogan “Compliance protects – compliance supports”, we draw attention to the importance of cooperation between the Group level and the hospitals in recognising risk-relevant matters early on and being able to respond appropriately. In addition to the procedural instructions with an organisational focus that were implemented in 2021, we also started to prepare the compliance guideline on general regulations for avoiding corruption in 2022. The aim of this guideline is to raise awareness among those responsible for compliance at Asklepios and to put compliance aspects and measures into the relevant context for Asklepios.

Whistle-blowing system: reporting compliance violations anonymously

At the beginning of 2022, we set up a tool-based whistle-blowing system: Employees have the option of contacting the Compliance division either anonymously or under their own name to report possible compliance violations. We systematically follow up all reports, while attaching great importance to confidentiality: Whistle-blowers do not have to fear any negative consequences for their job.

We have publicised the tool-based whistle-blowing system within the Group in the Management Board’s information for the management and on the intranet. Basic information on its use is provided in the procedural instructions “The Asklepios whistle-blowing system – reports and rules”. We also refer to the possibility to report violations in the chapter on “What to do in the event of violations” in the Asklepios principles of conduct. In addition, we draw attention to the tool in the compliance e-learning course “The Asklepios principles of conduct” and during classroom training and other events.

Compliance reports were received in the 2022 financial year and have been reviewed and processed. There has been no significant increase in reports as a result of the whistle-blowing system.

Raising awareness of the principles of conduct

The Asklepios principles of conduct implemented in January 2020 remain in place. The other decisions in connection with the principles of conduct also apply: As part of the materiality analysis conducted in 2021, raising awareness of the principles of conduct was defined as a key CR topic and incorporated as such into the CR roadmap. The key message behind this change is that compliance at Asklepios is not merely a matter of adhering to legal requirements but rather a question of attitude and the basis of responsible corporate governance.

The principles of conduct contain stipulations regarding general business conduct as well as topics such as compliance with legislation, avoiding conflicts of interest, data protection, taking on social responsibility and environmental protection. They apply to all employees, management staff and members of the executive bodies at the Asklepios hospitals and its subsidiaries. The rules of conduct ensure that uniform benchmarks apply throughout the group of companies to help our employees make the right decisions during their everyday work.

Managers set an example

New procedural instructions and other compliance measures and activities that are relevant to the employees are communicated on a top-down basis. Management staff thus carry a special responsibility in terms of implementing standards of conduct at Asklepios. Not least for this reason, we have also incorporated binding leadership principles into our principles of conduct throughout the company. These emphasise the exemplary function of the management staff and require them to treat employees with fairness and respect, to communicate transparently, to promote internal cooperation and to act in a target-oriented and results-driven manner. The principles of conduct are available in our document control tool and can also be accessed by all employees on the compliance page of our intranet AskMe and by external parties on the internet.

E-learning on principles of conduct

Compliance is a regular topic at various internal training, further education and information events. Since mid-2022, the goal of ensuring familiarity with the Asklepios compliance standards throughout the Group has also been supported by a corresponding e-learning course. In a pilot project, the compliance e-learning course “The Asklepios principles of conduct” has been uploaded and advertised on the AskNow training platform implemented by the Group. This mandatory compliance training has the aim of informing all employees. The AskNow training team is currently seeking to coordinate with the relevant divisions to find a solution for this administrative challenge in the context of the goal of our CR roadmap.

Risk management:

opportunities and risks in focus

Asklepios pursues a comprehensive opportunity and risk management approach: We assess risks and opportunities in combination in order to identify, evaluate and control them at an early stage. The focus in this context is on financial and non-financial risks and opportunities that can influence the achievement of our goals – at both Group and hospital level. In this way, we aim to secure our long-term economic success and meet the requirements of our patients and society while also offering our employees secure jobs.

Since we follow a comprehensive risk management approach, we can also identify and evaluate non-financial risks based on the analysis of financial risks. We still did not include MediClin and Rhön in the non-financial risks recorded in the 2022 reporting year. We are currently preparing to implement suitable structures to enable the collective assessment of non-financial risks for all Asklepios healthcare facilities in the future.

Asklepios summarises the non-financial risks according to section 289c(3) of the German Commercial Code (HGB), as well as additional possible CSR risks that may affect third parties, under the heading of ESG or sustainability risks and allocates them in line with the five aspects according to section 315c in conjunction with section 289c to 289e HGB: environmental matters, employee matters, social matters, respect for human rights, as well as combating corruption and bribery.

Standardised process for risk assessment

In the 2022 financial year, we set up the software-based assessment of non-financial risks based on their probability and their possible effects (ESG risk reporting). The specified Group divisions and departments submit their assessment as at 30 September each year and an update as at 1 January of the following year. In doing so, they take account of established countermeasures and the key CR topics. Using this standardised process, we can centrally document and track both the risk assessment and the measures – and evaluate not only the development of non-financial risks over time, but also the effectiveness and efficiency of the measures initiated.

At the beginning of the 2023 financial year, we will transfer ESG risk reporting to the continuous improvement process. We have outlined our risk management approach and process as well as the responsibilities in detail in our CR Report 2022 on page 19 and in the Annual Report 2022 starting on page 71.

Assessment of sustainability risks

The period under review in accordance with section 289c(3) HGB covers the current financial year and a five-year outlook.

In relation to the environmental concerns referred to by section 289c(2) HGB, we consider the risk to the Asklepios Group to be minor at this time.

At present, there are no significant non-financial risks for the company in the area of employee matters. In addition, no significant non-financial risks were identified with regard to social matters that have an impact at company level.

We also consider the protection of human rights to be a part of our business operations. The topic of anti-corruption and bribery matters is managed by the compliance function at the Asklepios Group. No significant and thus no reportable risks were identified in either area.

COVID-19: still a risk

Generally speaking, the Asklepios Group is still exposed to the risk that the spread of the coronavirus (COVID-19) will have consequences for internal procedures, processes and also for patients and employees. Due to the current dynamic environment, supply bottlenecks for medical products may arise in connection with COVID-19. Asklepios carries out ongoing and intensive checks on the effects.

Thanks to the diverse measures implemented in different areas of our company, we believe we are in a strong position to significantly reduce the COVID-19 risk for patients and employees. Generally speaking, adverse effects on patients (and on the population as a whole) are possible in the event of a sharp deterioration in the COVID-19 situation. Taking the current state of affairs into account, our mitigation measures can bring about an appropriate reduction in these effects. Subject to ongoing developments and based on the current state of affairs, we do not currently envisage any significant negative consequences in the Asklepios Group as regards the non-financial risks defined in 289c(2) HGB.

At the present time, we do not see any non-financial risks with a high likelihood of serious consequences.