Our five year strategy

We invest in a healthier society.

Our model is to take real-world insights on how to address health inequalities and embed them into how wider systems operate.

Over the past five years we have developed new capabilities and partnerships to understand what really works in improving health for everyone. For our 2022-27 strategy, we aim to build the platforms to take this impact to a much greater scale.

Over the next decade, for our charitable work this would mean raising £100m of annual donations for the patients, staff and communities of Guy’s and St Thomas’. For our urban health work this would mean contributing to £10bn of additional health value. For our investment work this would mean engaging over £1tn of institutional assets to act on the health impacts of their investments.

To support this, we believe we can develop 100s of the leaders needed to build a fairer, healthier world.

This is an asset-based strategy, building on the unique advantages of our place and its partners, our relationship with Guy’s and St Thomas’, and our financial resources. These allow us to have a global impact from a local starting point.

Our mission at Guy’s and St Thomas’ Foundation is to invest in a healthier society. Our aspiration is to be a global beacon for health equity — inspiring others to act to build a fairer, healthier world.

Health is a collective outcome. It is created by the environments around us, supported by the agency of individuals and communities, and maintained through access to quality healthcare. Health is also distributed unevenly across the population, in ways that are avoidable and unfair. Our work as a Foundation responds to both. Working in wide partnership, we pioneer new approaches to health. We learn what works where and why. We then share that widely with those with the ability to affect change. We do so in a way that is enterprising, collaborative and delivery minded.

Our 2022-27 strategy is about reach. Its goal is to leverage insights from our practical, real-world work to influence change at a much wider level.

This represents the second five years of a 30-year strategy. The first five years focused on testing how best to have impact. We built new methods, capabilities and partnerships. Our work is now more data-informed, human-centred, experimental and replicable. We also developed an approach that supports this way of working — combining humility with ambition, long-term thinking with tenacity, and open-mindedness with focus.

These second five years aim to build the platforms for this impact at scale. Our goal is to become more influential and to leverage wider resources in support of our mission. To do so, this strategy also gives greater attention to our internal operations, focusing on how we maintain agility, invest in our people as an asset for our long-term mission, and embed principles of inclusion more deeply across our work.

The aim of the next 20 years of our strategy will be to reduce health inequalities at a national, and then international, scale. Few organisations have achieved this goal. We believe that with the right partnerships, insights and values, that we can.

This is an asset-based strategy, building on the unique advantages of our place and its partners, our relationship with the Trust, and our resources. These allow us to have a global impact from a local starting point. For example, our area of inner-city London is exceptionally dynamic, diverse and unequal. It is a mirror to the world’s future population. Work here on health equity is relevant for a global audience. At the same time, Guy’s and St Thomas’ NHS Foundation Trust is the UK’s largest healthcare institution. It provides both world-leading innovations and local community services. This creates opportunities for health impact at both local and national scale. Finally, our charitable endowment is one of the largest in the UK. This gives us standing with institutional asset owners. By targeting impact through these assets, we can leverage action on health from investors and companies across the world.

While our strategy aims for clear delineation in our activities, in practice there is a great deal of cross-over in our work as a philanthropy, fundraising charities and a responsible investor. For example, our property developments through our endowment provide real world exemplars for our urban health programmes; our insights from working with a wide range of local employers bring fresh angles to the design of our support for Trust staff; and our close partnership with the Trust helps us to become a more effective investor in life sciences and medical technologies.

Three high-level assumptions have informed this strategy. First, everyone benefits from everyone being healthier. Yet while we are in a period of increased awareness of health inequalities, the same factors contributing to this — a global pandemic, economic insecurity, stalling life expectancy, low productivity — make addressing them more uncertain. Second, there is a need to show how change is possible. There are clear gaps in understanding of what works to build a healthier society. Practically this means learning for ourselves is our most effective route to influencing others. Third, the process of building health equity needs to be equitable itself. This a much deeper task than it can appear, and we as a Foundation are only at the beginning of the process.

Where we grow up, live and work hugely influences our health. And in urban areas, we see the best and worst health outcomes, often just roads away from each other. We’re focused on improving health in inner-city areas by understanding and changing how inequalities impact our health. We work to have direct impact on the health of people in Lambeth & Southwark and inspire and influence wider change — so that impact reaches more people, in more places, for longer.

We have this impact through what we call our ‘programmatic approach’. We take on the biggest, most complex issues of health inequality affecting Lambeth & Southwark and relevant for diverse, dynamic, unequal urban areas around the world. Many of these issues are important for economic and climate resilience too. We find a new way into those issues, reframing the problem, and identifying the relevant social and commercial determinants of health on which we can have the most impact. We fund a portfolio of projects and partners to find new solutions and approaches to the issue. Because we pick the hardest issues, we know that many things we try won’t work and so we are comfortable with taking informed risks. We bring others on board with our approach to get solutions to more people for the long-term. That means working in partnership and increasing our influence to take things to scale and have an impact beyond the life of our programmes.

Our family of three Charities work to create better health by supporting the patients, staff and communities of Guy’s and St Thomas’ NHS Foundation Trust, the UK’s largest healthcare institution.  Evelina London Children’s Charity supports the compassionate, trailblazing care of Evelina London, with an ever-growing family of staff, families and supporters helping to fuel incredible moments every day. Guy’s Cancer Charity helps the outstanding Guy’s Cancer team advance care that enhances lives. We support the person behind every moment of progress, so Guy’s Cancer can continue to transform lives. Guy’s & St Thomas’ Charity works to ensure that care never stands still, supporting Guy’s and St Thomas’ incredible staff and exceptional healthcare.

We generate income for our Charities through fundraising — from large philanthropic donations from other Foundations or private individuals through to corporate and public donations. We achieve impact by deploying these funds in two ways. We invest in staff wellbeing, so that the remarkable team at Guy’s & St Thomas’ can thrive and are cared for. We do this through the most extensive staff health and wellbeing programme in the NHS. We also improve patient experience by pioneering healthcare and health research. We support a wide range of projects from bright ideas that enhance care, to state of the art technology that speeds up recovery or transformational programmes of work that push the boundaries of care.

For our 2022-27 strategy, our focus is on raising significantly more income for our charitable support for Guy’s and St Thomas’ staff and patients. We believe that within 10 years, collectively our charities could be amongst the leaders within the NHS — raising c. £100m a year.

The mission of investing in a healthier society means deploying all our assets to this end. As much as 80% of people’s health is shaped by their environment — the jobs they do, the things they consume, the places they live. A wide range of companies influence this, which means both the private and investment sector have a critical role to play. To recognise this, we set our c. £1bn endowment the dual objectives of achieving financial returns and health impact. Our long-term vision is to measure and incorporate impact into every aspect of the portfolio. In this work, we know to consider not only the health impact we achieve directly with our investments but also the impact generated by other investors who we can bring along on our journey.

We achieve impact through an integrated investment strategy that combines impact investments, ESG (Environmental, Social and Governance) integration and engagement across both our securities and property portfolios. As well as prioritising healthcare sector investments such as medical innovation and life sciences, we place considerable emphasis on key social sectors including housing, community infrastructure, education, training and employment, financial inclusion, environment, food and nutrition. Our land and properties are long-term assets, which brings unique opportunities to help improve places over many generations. In managing and investing in properties, we consider how these assets contribute to the health of individuals, the health of communities and the health of the environment. Finally, we leverage our capital by creating momentum amongst institutional investors for putting health impact and health equality at the forefront of their portfolio objectives.

For our 2022-27 strategy, our focus is on embedding our mission across our endowment. We believe that over the next 5 years we can attract over £1tn of assets to consider and act on the health impacts of their investments.

We know that we can scale our impact through the endowment by working on five core areas over the next five years:

• taking a portfolio approach to impact — by increasing our impact allocation to £100m, learning how best to make higher-risk catalytic investments, and building our methodology for assessing impact across all types of investments, sectors, strategies and time horizons
• centering ESG considerations — developing practices that integrate strong ESG policies, actions and portfolio outcomes into the work of our fund managers; and biasing our selection toward ESG outperformers, diverse managers and mission adjacent sectors
• engaging institutional capital — by using our insights and voice to promote health focused investing amongst major asset owners. Where we are particularly credible, we will take a leadership role; in other areas, such as DEI and climate change, we will lend our support to those investor coalitions that are already in the vanguard
• promoting life sciences — by using our London property development sites to accelerate the development of the life sciences industry in South London, working in close partnership with industry, the NHS, local and central government, as well as local communities and educational providers
• supporting energy transition — through a combination of investment, engagement, and divestments. We are committed to reaching net zero greenhouse gas emissions by 2050, halving emissions across our financial investments by 2030, investing £50m of our portfolio in climate solutions and strategies, and exiting fossil fuels before the end of the decade

To support this, we are committed to building a learning approach and capability that, over time, will enable the incorporation of health impact across the entire endowment. Alongside this focus on impact, we will continue to target sustainable financial returns of 4% above inflation.

Success for this strategy will be investing over £150m in impact and climate transition opportunities. We will have built a significant portfolio of diverse and ESG activist managers. Our property assets will be significant contributors to environmental sustainability and health impact. We will have achieved important changes to business practice in critical industries affecting health inequalities. Our portfolio will be achieving sustainable financial returns. Through this, we will have established the Foundation as a leading actor in the movement towards integrating health in investments.

The most important factor in the achievement of our strategy is our people. We have recruited a growing and talented team with increasingly diverse perspectives on what we do, how we do it, and who we do it with. Our culture values being enterprising, collaborative and delivery minded. This allows us to come at our mission of investing in a healthier society from different angles, bringing fresh thinking, new partnerships, and the momentum needed to secure change. Much like how we have developed our dual approach to the Endowment, we increasingly see our people as a long-term asset for health impact — attracting and developing future leaders who can help build a healthier society beyond their time at the Foundation.

We achieve impact by enabling our people and using all the tools that we have as an organisation to help them succeed. This ranges from very tangible things that affect people every day, such as our processes, training and reward, to less tangible things, such as our culture and values and how we work together. Throughout this work we aim for a healthy balance between our values, explicit connection with our mission, and diversity, equity and inclusion as a golden thread linking our ambitions.

For our 2022-27 strategy, our focus is on investing in our people to support our mission. We believe that over the next 10 years we can develop hundreds of the leaders needed to build a healthier society.

We know that we can support all our strategic aims over the next five years by working on four core areas:

• investing in our culture — for our organisation to succeed, we plan to invest in a culture that is fully grounded in the values that support our mission – being collaborative, enterprising and delivery minded – and to live those values through our day-to-day work
• refining how we work together — over the past five years we have grown in size and sophistication. We aim to develop our process and practises so that the way we work together remains effective, high-performing, and inclusive
• improving the team journey — by investing in a compelling employee proposition, and one that will secure for us as an organisation the diverse talent we need to succeed
• focusing on mission impact — by long-term planning on the impact our people can have beyond their journey with us. We aim to develop the breadth of our early career opportunities as well as our support for placements, exchanges and talent development

To support this, we are committed to building a more diverse team of backgrounds and perspectives. We will lead our people work in an evolutionary way — focusing in short bursts on a small set of specific topics, advancing and integrating them as business as usual, and then refocusing on other areas.

Success for this strategy will be a strong and inclusive culture. We will have structures and ways of working that support both our values and mission. We will have a great employee proposition that is attractive to a diverse range of talent. Through this, we will be establishing the Foundation as one of the best places to work in the UK for those dedicated to a healthier society.