Quarterlytics / Consumer Cyclical / Furnishings, Fixtures & Appliances / Smith & Nephew

Smith & Nephew

sn · LSE Consumer Cyclical
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Ticker sn
Exchange LSE
Sector Consumer Cyclical
Industry Furnishings, Fixtures & Appliances
Employees 10,000+
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FY2017 Annual Report · Smith & Nephew
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Supporting healthcare 
professionals 

ANNUAL REPORT 2017

OVERVIEW
OVERVIEW

OUR BUSINESS  
OUR BUSINESS  
& MARKETPLACE
& MARKETPLACE

OPERATIONAL 
OPERATIONAL 
REVIEW
REVIEW

FINANCIAL  
FINANCIAL  
REVIEW
REVIEW

RISK
RISK

GOVERNANCE
GOVERNANCE

ACCOUNTS
ACCOUNTS

GROUP AND OTHER 
GROUP AND OTHER 
INFORMATION
INFORMATION

CONTENTS

OVERVIEW

CHAIRMAN’S STATEMENT

CHIEF EXECUTIVE OFFICER’S REVIEW 

WHO WE ARE

OUR BUSINESS & MARKETPLACE

OUR BUSINESS MODEL

STRATEGIC PRIORITIES

OUR MARKETPLACE

OPERATIONAL REVIEW

OUR PRODUCTS

OUR RESOURCES

SUSTAINABILITY

FINANCIAL REVIEW

CHIEF FINANCIAL OFFICER’S REVIEW

FINANCIAL REVIEW

RISK

RISK REPORT

GOVERNANCE

OUR BOARD OF DIRECTORS

OUR LEADERSHIP

GOVERNANCE REPORT

NOMINATION & GOVERNANCE 
COMMITTEE REPORT

ETHICS & COMPLIANCE COMMITTEE REPORT

AUDIT COMMITTEE REPORT

DIRECTORS’ REMUNERATION REPORT

2

4

6

8

10

16

18

25

33

36

38

40

50

54

56

66

69

71

79

ACCOUNTS

STATEMENT OF DIRECTORS’ RESPONSIBILITIES

INDEPENDENT AUDITOR’S UK REPORT

CRITICAL JUDGEMENTS AND ESTIMATES

GROUP INCOME STATEMENT

GROUP STATEMENT OF  
COMPREHENSIVE INCOME

GROUP BALANCE SHEET

GROUP CASH FLOW STATEMENT

GROUP STATEMENT OF CHANGES IN EQUITY

NOTES TO THE GROUP ACCOUNTS

COMPANY FINANCIAL STATEMENTS

NOTES TO THE COMPANY ACCOUNTS

GROUP AND OTHER INFORMATION

GROUP INFORMATION

OTHER FINANCIAL INFORMATION

INFORMATION FOR SHAREHOLDERS

107

108

114

115

115

116

117

118

119

163

165

171

176

184

Front cover: Employees from Smith & Nephew’s Expert 
Connect Centre, Watford, UK – Natalia Zielinska (middle) 
Bioskills Laboratory Manager, Alejandra Alvarez Pineda (left) 
and Michael Mead, Bioskills Laboratory Specialists (right).

TRAINING & EDUCATION PAGE 32

We are a constituent of the UK’s FTSE100 and our shares are traded on the London 
Stock Exchange and through American Depositary Receipts on the New York 
Stock Exchange (LSE: SN, NYSE: SNN).

The Strategic Report, which has been prepared in accordance with the requirements 
of the Companies Act 2006, comprises the first five sections above and has been 
approved and signed on behalf of the Board. The Directors’ Report comprises pages 6, 
16–17, 25–28, 33–39, 42–78, 107, 140–142, 158 and pages 171–193 of the Annual Report.

SMITH & NEPHEW ANNUAL REPORT 2017 SMITH & NEPHEW ANNUAL REPORT 2017 1

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

Smith & Nephew is a global medical technology 
business that has been supporting healthcare 
professionals to improve patients’ lives since 1856.

DRIVING  PERFORMANCE 
PIONEERING  INNOVATION 
& ENSURING  TRUST

We do this by taking a pioneering approach to the  
design of our advanced medical products and services, 
by securing wider access to our diverse technologies 
for more customers globally, and by enabling better 
outcomes for patients and healthcare systems.

We have leadership positions in:

Orthopaedic Reconstruction and Trauma 
Joint replacement systems for knees and hips and products  
to help repair broken bones

Advanced Wound Management  
Treatment and prevention products for hard-to-heal wounds

Sports Medicine  
Implants and enabling technologies for minimally invasive  
repair of the joint

FIND MORE ONLINE
To learn more about Smith & Nephew,  
to register to receive our news,  
or to explore opportunities to join us,  
please visit www.smith-nephew.com

OVERVIEW

SMITH & NEPHEW ANNUAL REPORT 2017 2

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

CHAIRMAN’S STATEMENT

PROVIDING

LEADERSHIP

The Board approaches 2018 with optimism. 
Olivier has built a strong foundation and 
we expect to attract someone of the highest 
calibre to accelerate business performance 
from this base.

DEAR SHAREHOLDER
One of the core duties of a Board is to 
ensure that companies evolve to meet the 
ever changing challenges and opportunities 
they face. A Board must set the pace in this, 
refreshing and strengthening its membership 
with deeper expertise, new perspectives and 
greater diversity. 

Since becoming Chairman in 2014 I am 
pleased with the evolutionary changes we 
have made at Smith & Nephew. I believe 
these build on the successes of the past and 
position the Company well for further progress.

STRENGTHENING THE BOARD
We have been able to attract new Non-
Executive Directors of high calibre to replace 
Board members retiring after completing 
their service. 

Angie Risley, who joined in September 2017, 
is currently Group HR Director of J Sainsbury 
plc and was previously Non-Executive Director 
of Arriva plc, Biffa plc and Serco plc where 
she was also chairman of the Remuneration 
Committee. Marc Owen, recently retired from 
the Executive Committee of Fortune 500 
healthcare business McKesson Corp, where 
he was Chairman of Celesio AG and  
President of McKesson Speciality Health, 
and previously a healthcare and technology 
specialist at McKinsey, joined in October  
2017. Roland Diggelmann, Chief Executive 
Officer at Roche Diagnostics and a member  
of the Corporate Executive Committee of  
F. Hoffmann-La Roche Ltd, and previously a 
senior executive at Zimmer GmbH, will join 
on 1 March 2018. 

Marc and Roland strengthen the Board’s 
knowledge of commercial healthcare and the 
medical devices sector while Angie will provide 
effective leadership to our Remuneration 
Committee when Joe Papa steps down 
at the AGM in April. Joe has been a highly 
valued colleague and exemplary steward 
of Smith & Nephew. On behalf of the whole 
Board, I thank him for his service. 

CHIEF EXECUTIVE OFFICER 
In October Olivier Bohuon notified the 
Board of his intention to retire by the end 
of 2018, after seven years as Chief Executive 
Officer. Under Olivier’s leadership Smith 
& Nephew has undergone important and 
necessary change and he has significantly 
strengthened the foundations of our Company. 
As Smith & Nephew enters its next chapter, 
the Board is determined to build on this. 

SMITH & NEPHEW ANNUAL REPORT 2017 3

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
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FINANCIAL  
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GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

CHAIRMAN’S STATEMENT continued

Olivier continues to lead Smith & Nephew 
and drive the Company’s growth initiatives 
and operating plans. In this he is supported by 
our new Chief Financial Officer, Graham Baker, 
who joined in March 2017. 

The Board has been impressed with 
Graham’s strong start as he quickly developed 
his understanding of the business and 
we welcome his commercial acumen and 
attention to detail. Our views of Graham have 
been echoed by the positive shareholder 
feedback we have received.

GOVERNANCE AND CULTURE 
In 2017 the Board invested significant time 
meeting local management and employees 
and understanding market dynamics. 
These included visiting our offices in Dubai, 
Tokyo and Hull, as well as some Board 
members spending time with our salesforce 
to better appreciate their role and meeting 
customers. In addition to giving us commercial 
insight, such activities let us get anecdotal 
evidence of the culture at Smith & Nephew, 
something the Board puts great value on. 
We strive to set the tone from the top, and 
review data to demonstrate performance, 
but it is only by meeting employees from all 
levels of the Company that we can be certain 
that Smith & Nephew’s values of I perform, 
I innovate and I earn trust are being lived 
across the business. 

We conducted our regular review of strategy 
and Group structure at our annual strategy 
meeting in October, ensuring the continued 
close alignment of Board and management 
on our expectations and current direction. 
We upgraded our Risk Management process 
and strengthened our internal team in this area. 
Our Senior Independent Director, Ian Barlow, 
conducted a Board Effectiveness Review which 
identified some areas of further improvement 
which we are focusing on, such as deepening 
our knowledge of the competitive landscape 
to enable us to better support management 
develop and deploy resources to win in our 
chosen markets. I encourage you to read 
more about these and other matters in our 
Governance section starting on page 50.

2017 PERFORMANCE
The Board receives regular updates on the 
performance of the business from the CEO 
and CFO, together with members of the senior 
management team attending Board meetings 
over the course of the year. 

We could clearly see areas of the business 
where the Company excelled in 2017, 
such as Global Operations where we have 
improved quality and supply, and R&D, where 
we have an exciting new product pipeline.  
It is no coincidence that both of these areas 
of the business have effective leaders who 
impressed the Board during 2017.  

Whilst the trading performance of the Group 
was better than in 2016, and we delivered 
within our guidance, we continue to endorse 
the Chief Executive’s view that this business 
can and should deliver better results and 
reinforce the need for continued focus on 
driving better execution. 

The 2017 full year dividend of 35.0¢ per share  
reflects the strong growth in adjusted earnings 
per share.

The Board approaches 2018 with optimism. 
Olivier has built a strong foundation and we 
expect to attract someone of the highest 
calibre to accelerate business performance 
from this base. Thank you for your support 
and engagement in 2017 and the Board looks 
forward to serving you into an exciting next 
chapter for Smith & Nephew.

Yours sincerely,

Roberto Quarta
Chairman

FINANCIAL HIGHLIGHTS

$4,765m

Revenue

+2%
Reported

+3%
Underlying1

35.0¢

Dividend per share

+14%

Group revenue was up 2% on a reported basis (including -1% headwind 
from the 2016 Gynaecology business disposal) and 3% on an underlying 
basis, in line with guidance. 

The 14% year-on-year increase reflects the strong growth in adjusted 
earnings per share.

$934m 
Operating profit

+17%

$1,048m 
Trading profit1

+3%

87.8¢ 
Earnings per share (EPS)

0%

Operating profit margin of 19.6% is up  
240bps year-on-year due to more favourable 
non-trading items.

Trading profit margin1 was 22.0%, up 
20bps year on year, in line with guidance.

In 2016 EPS benefited from the gain on 
the disposal of the Gynaecology business.

94.5¢ 
Adjusted Earnings per share1 (EPSA)

+14%

14.3% 
Return on Invested Capital1 (ROIC)

+280bps

5%
R&D expenditure

Reflects one-off tax benefits, improvements in 
trading profit margin and the tax rate on trading1.

Reflects improvements in operating profit,  
the lower tax rate and a stable asset base.

To drive innovation, we maintain our investment 
in R&D at around 5% of Group revenue.

1  These non-IFRS financial measures are explained and reconciled to the most directly comparable financial measure prepared in accordance with IFRS on pages 178–181.

FINANCIAL REVIEW PAGE 36  OUR BOARD OF DIRECTORS PAGE 50  GOVERNANCE PAGE 56

SMITH & NEPHEW ANNUAL REPORT 2017  
 
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OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

CHIEF EXECUTIVE OFFICER’S REVIEW

A STRONGER 
SMITH & NEPHEW

In 2018, I expect Smith & Nephew to build on 
2017 by delivering another year of improved 
performance driven by our strong product 
portfolio and pipeline of innovative products.

DEAR SHAREHOLDER
We delivered on our promises to improve 
the top and bottom line in 2017. Our healthy 
balance sheet, good cash generation and 
increased dividend demonstrate the robust 
foundations underpinning our business. 
In 2018, I expect Smith & Nephew to build on 
2017 by delivering another year of improved 
performance driven by our strong product 
portfolio and pipeline of innovative products.

STRATEGIC PRIORITIES
In my first year as Chief Executive, in 2011, 
we set five strategic priorities that have shaped 
a fundamental management and operational 
restructuring of the Group as a foundation 
to improving its growth and profit profile. 
Through these priorities we continue to drive 
our business forward. 

In 2017 I was pleased with the resultant 
commercial performance in many areas. 
In Knee Implants we had an outstanding year, 
Trauma and Extremities and Advanced Wound 
Devices also, and we returned the Emerging 
Markets to double-digit revenue growth. 

Of course, there are some areas that did not 
meet my expectations, such as in Arthroscopic 
Enabling Technologies and European Wound 
Care. These are not because of new issues, 
but they are taking longer to improve than 
expected. We are attacking the underlying 
issues with renewed vigour in 2018. 

You can read more about our performance 
against each of the strategic priorities in 
the next few pages (pages 10–15). I would 
like to draw your attention to how our strong 
new product portfolio reflects our decision 
of a few years ago to increase our investment 
in disruptive R&D and technology acquisitions. 

SMITH & NEPHEW ANNUAL REPORT 2017 5

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GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

CHIEF EXECUTIVE OFFICER’S REVIEW continued

OUR STRATEGIC PRIORITIES
Our strategic priorities guide our actions 
to support healthcare professionals and 
transform our growth profile.

BUILD A STRONG POSITION 
IN ESTABLISHED MARKETS

FOCUS ON EMERGING 
MARKETS

INNOVATE FOR VALUE

SIMPLIFY AND IMPROVE  
OUR OPERATING MODEL

SUPPLEMENT ORGANIC  
GROWTH WITH ACQUISITIONS

STRATEGIC PRIORITIES UPDATE PAGE 10

OUR PEOPLE PAGE 25

Our survey tool is the Great Place to Work 
Institute’s Trust Index, and in 2017 we performed 
strongly across the dimensions of vision, 
recognition, pride and equality. We now  
have nine countries accredited as a Great 
Place to Work. 

We put great store by our culture, and work to 
embrace diversity, encourage progression, and 
reward success. We also want our employees 
to put something back into their communities. 
Our People section on pages 25–28 describes 
our commitments and actions across all of 
these areas. 

LOOKING TO THE FUTURE 
In October 2017 I announced my decision 
to retire from Smith & Nephew by the end of 
2018. As I looked ahead to the next long-term 
phase of growth, I decided that it was the 
right time to announce my retirement plans, 
providing ample time to identify a successor 
and ensure a smooth transition. 

In the meantime, I remain resolutely focused 
on delivering our commitments for 2018, while 
positioning the Company for further success. 
Looking further ahead, our greater focus on 
commercial execution gives us confidence 
we will outgrow our markets and the new 
APEX programme supports our expectation 
of improved trading profit margin.

Yours sincerely,

Olivier Bohuon
Chief Executive Officer

One of our best recent achievements was to 
create a global R&D organisation that became 
fully operational in 2017 and is building 
on these successes. We now have greater 
visibility across our development portfolio 
to ensure we back the winners of the future 
in areas such as digital, robotics and biologics. 
We are making better decisions and hitting 
milestones consistently, and this will underpin 
our success for many years to come.

ACCELERATING PERFORMANCE 
& INNOVATION
As we have transformed Smith & Nephew, 
so our markets and industry have changed. 
We are seeing an increasingly competitive 
environment: new selling models, new 
entrants, pricing pressure and increasing 
costs – which in some markets are outpacing 
our growth. We also see great opportunity to 
invest behind pioneering technologies which 
take market share, offer a wider selection 
of commercial terms to suit more customers, 
expand our reach in the emerging markets 
and start to realise the benefits of the digital 
revolution for our industry. 

In late 2017 we undertook a review of 
our business to look for opportunities to 
achieve higher growth targets, strengthen 
our competitive position, and make us more 
agile to changes in the market. As a result, 
in early 2018 we introduced the APEX 
programme, which stands for ‘Accelerating 
Performance and Execution’. APEX will make 
key enhancements to our business and ways 
of working over the next five years. We expect 
this programme to deliver $160 million of 
annualised benefits by 2022. APEX is now 
possible because of the work put in to create 
our strong Group structure, and it will build on 
this robust base. More information on APEX 
can be found on page 14.

BUILDING A WINNING CULTURE 
Our success as a Company is made possible 
by talented employees working together for 
our shared mission: to support healthcare 
professionals in their efforts to improve 
patients’ lives. This is why being a great place 
to work is important to us, and why every 
two years we measure our progress toward 
this goal with our Global Employee Survey. 

SMITH & NEPHEW ANNUAL REPORT 2017 6

OVERVIEW

WHO WE ARE

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
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ACCOUNTS

GROUP AND OTHER 
INFORMATION

ONE GLOBAL 
BUSINESS

WITH MORE THAN 15,000 EMPLOYEES

OUR VALUES AND HOW WE ACT
Our values shape everything that we do as a business and  
form the basis of our relationships with all our stakeholders. 

Performance
Performance means being responsive  
to the needs of our customers and their patients, 
setting ourselves clear goals and standards 
and achieving them.

Innovation
Innovation means being energetic, creative  
and passionate about everything we do, 
anticipating customers’ needs and overcoming 
barriers and developing opportunities.

Trust
Trust is something we understand that  
we have to earn and we strive to operate  
with integrity and take an ethical  
approach to business.

AN INTEGRATED BUSINESS

UNITED STATES (US)

OTHER ESTABLISHED MARKETS

EMERGING MARKETS

The United States is the Group’s largest 
market representing 48% of our global 
revenue. Due to its commercial importance 
to the Group, its revenue is reported 
separately. The United States is also home 
to a number of our manufacturing facilities.

Other Established Markets comprise 
commercial operations in Europe, 
Australia, Japan, Canada and New 
Zealand. We have manufacturing facilities 
in the UK, Germany and Switzerland.

Emerging Markets include our commercial 
businesses in China, Asia, India, Russia, 
Middle East, Africa and Latin America. 
These generated 16% of Group revenue 
in 2017. We have manufacturing facilities 
in China, Costa Rica, India, Russia 
and Curaçao.

2017 revenue

$2,306m

0%  
Reported  

+2%
Underlying1

2017 revenue

$1,678m

0%  
Reported  

0%
Underlying1

2017 revenue

$781m

+13%   +12%
Reported  

Underlying1

ORTHOPAEDIC RECONSTRUCTION AND TRAUMA

SPORTS MEDICINE

ADVANCED WOUND MANAGEMENT

GLOBAL FUNCTIONS2

1  These non-IFRS financial measures are explained and reconciled to the most directly comparable financial measure prepared in accordance with IFRS on pages 178–181.

2 

 Commercial Excellence including Global Marketing, R&D, Manufacturing & Supply Chain, Central Support. 

SMITH & NEPHEW ANNUAL REPORT 2017 7

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WHO WE ARE continued

SELLING NINE PRODUCT FRANCHISES

KNEE IMPLANTS

SPORTS MEDICINE JOINT REPAIR

ADVANCED WOUND CARE

HIP IMPLANTS

ARTHROSCOPIC ENABLING 
TECHNOLOGIES

ADVANCED WOUND BIOACTIVES

TRAUMA & EXTREMITIES

OTHER SURGICAL BUSINESSES

ADVANCED WOUND DEVICES

SUPPORTING HEALTHCARE PROFESSIONALS IN MORE THAN 100 COUNTRIES

UNITED STATES

OTHER ESTABLISHED MARKETS

EMERGING MARKETS

Revenue by products

A  KNEE IMPLANTS 

B  HIP IMPLANTS 

C  TRAUMA & EXTREMITIES  

$984m

$599m

$495m

D  SPORTS MEDICINE JOINT REPAIR 

$627m

E  ARTHROSCOPIC ENABLING

TECHNOLOGIES 

$615m

F  OTHER SURGICAL BUSINESSES 

$189m

G  ADVANCED WOUND CARE 

$720m

H  ADVANCED WOUND BIOACTIVES  $342m

I  ADVANCED WOUND DEVICES 

$194m

I

H

D

G

F

E

A

C

B

Revenue by geography

A  UNITED STATES 

$2,306m

B  OTHER ESTABLISHED MARKETS  

$1,678m

C  EMERGING MARKETS 

$781m

C

L
A
N
O

I

T

A

B

N

R

E

T

N

I

U

N

I

T

E

D

S
T
A
T
E
S

A

SMITH & NEPHEW ANNUAL REPORT 2017  
 
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OVERVIEW

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REVIEW

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GROUP AND OTHER 
INFORMATION

OUR BUSINESS MODEL

HOW WE  
CREATE VALUE

A FOCUS ON
PERFORMANCE

OUR VALUE PROPOSITION 
Our mission is to support healthcare professionals by providing 
advanced medical devices that they use in their daily efforts to 
improve the lives of their patients. 

PIONEERING  
APPROACH

We take a pioneering approach 
to the design of our products and 
services. Smith & Nephew has 
a long history of innovation, dating 
back to our foundations in the 
19th century, and today we support 
customers to manage and prevent 
disease states, and enable swifter 
recovery for their patients.

ENSURING  
WIDER ACCESS

We strive to secure wider access 
to our advanced technologies 
for more customers globally. 
In emerging markets we have 
built an entrepreneurial business 
resourced to reach and support an 
ever greater number of customers 
in delivering affordable healthcare.

ENABLING BETTER  
OUTCOMES

We seek to enable better 
outcomes for patients and 
healthcare systems, providing high 
quality products and appropriate 
training to improve clinical 
outcomes, enabling healthcare 
professionals to treat more patients 
and improving the economic 
outcome for payers.

THE RESOURCES WE NEED

OUR PEOPLE
Engaging, developing and retaining  
our more than 15,000 employees is important 
to us and we work hard to be a great place 
to work as well as a responsible 
corporate citizen.

RESEARCH & DEVELOPMENT
Innovation is part of our culture and  
we invest 5% of our revenue to develop  
new products that will help improve 
patients’ lives.

MANUFACTURING & QUALITY
We operate our global manufacturing  
efficiently, and at the highest possible 
standards, to ensure product quality  
at competitive pricing.

SALES & MARKETING
We support our customers in over 
 100 countries. Our commercial teams  
are highly specialised with an in-depth 
knowledge across the full range of 
product franchises. 

ETHICS & COMPLIANCE
We are committed to doing business  
the right way and apply strict  
business principles to the way we  
deal with our customers and partners.

TRAINING & EDUCATION
Every year, thousands of healthcare  
professionals attend our training  
courses around the world. Education  
is fundamental to how 
we support our customers.

THE RESOURCES WE NEED PAGE 25

OUR BUSINESS & 
MARKETPLACE

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OUR BUSINESS MODEL continued

CREATING
PRODUCTS

FOR OUR
CUSTOMERS

We service our customers 
through our dedicated and highly 
trained global sales force and 
selected third party sellers: 

 – Surgeons

 – Nurses

 – Nurse specialists

 – Physicians, GPs

 – Healthcare systems

 – Procurement groups

 – Payers, administrators

 –  Retail, consumers, patients

We have leadership positions 
in Orthopaedic Reconstruction 
and Trauma, Advanced 
Wound Management and 
Sports Medicine:  

 – Knee Implants

 – Hip Implants

 – Trauma & Extremities

 – Sports Medicine 

Joint Repair

 – Arthroscopic Enabling  

Technologies

 – Other Surgical Businesses

 – Advanced Wound Care

 – Advanced Wound  

Bioactives

 – Advanced Wound Devices

OUR PRODUCTS PAGE 18

THE OUTPUT OF WHAT WE DO

FINANCIAL PERFORMANCE
Targeting higher revenue growth  
and a better trading profit margin.

$4,765m

Revenue

$934m
Operating Profit

$1,048m
Trading Profit1

CAPITAL ALLOCATION 
FRAMEWORK
Prioritising the use of cash and ensuring  
an appropriate capital structure.
$269m
Dividend

IMPROVED QUALITY  
OF PATIENTS’ LIVES
Providing our advanced medical  
devices in more than 100 countries.
100+
countries

TRAINING & EDUCATION
Supporting HCPs and ensuring the safe  
and effective use of our products.
45,000+
surgeon training instances

GREAT PLACE TO WORK
Supporting and encouraging  
employees to live our values.
15,000+
employees

A SUSTAINABLE BUSINESS
Working in a sustainable, ethical and  
responsible manner everywhere we operate.
160+
years of proud history

1  These non-IFRS Financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

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STRATEGIC PRIORITIES

MAXIMISING OUR 
PERFORMANCE

Smith & Nephew has a clear vision to build 
a successful, sustainable business. This vision 
is encapsulated in our corporate value proposition 
– supporting healthcare professionals by taking a 
pioneering approach to the design of our advanced 
medical products and services, by securing wider 
access to our diverse technologies for more customers 
globally, and by enabling better outcomes for patients 
and healthcare systems.

We are focused on transforming the growth profile 
of the business while delivering this proposition. 
We are working to rebalance the Group towards 
higher growth opportunities. Over the last five years, 
Smith & Nephew has materially improved the mix 
of higher growth potential to lower growth businesses, 
shifting from one-third higher growth to over 50% today.

Our strategic priorities, introduced in 2011, guide 
our actions in delivering these twin aspirations 
of supporting healthcare professionals and 
transforming our growth profile. 

OUR STRATEGIC PRIORITIES

BUILD A STRONG POSITION 
IN ESTABLISHED MARKETS

Build on existing strong positions, win 
market share through greater product 
and commercial innovation and drive 
efficiencies to liberate resources.

PAGE 11

FOCUS ON EMERGING MARKETS

Deliver leadership in the Emerging Markets by 
building strong, direct customer relationships, 
widening access to our premium products 
and developing portfolios designed for the 
economic mid-tier population.

PAGE 12

INNOVATE FOR VALUE

Deliver pioneering products and business 
models that improve clinical and health 
economic outcomes and widen access 
across geographies and patient groups.

PAGE 13

SIMPLIFY AND IMPROVE  
OUR OPERATING MODEL

Pursue maximum efficiency in everything we do, 
streamline our operations and manufacturing, 
remove duplication and build strong global 
functions to support our commercial teams.

PAGE 14

SUPPLEMENT ORGANIC  
GROWTH WITH ACQUISITIONS

Build our platform by acquiring complementary 
products or businesses in our higher growth 
segments and manufacturing and distribution 
capabilities in the Emerging Markets.

PAGE 15

SMITH & NEPHEW ANNUAL REPORT 2017 11

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FINANCIAL  
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BUILD A STRONG POSITION  
IN ESTABLISHED MARKETS

Established Markets for Smith 
& Nephew are the US, Europe, 
Australia, Japan, Canada and 
New Zealand. Smith & Nephew 
delivered 84% of its revenue from 
these countries in 2017. 

In the United States, our single largest country 
representing 48% of global revenue, reported 
revenue growth was flat and underlying growth 
was 2%. The Other Established Markets 
growth rate was flat on both an underlying  
and reported basis.

In 2017 we focused on improving our 
commercial execution. With a simpler and 
more agile commercial structure in each 
country, supported by global functions, we 
sought to drive improved performance and 
greater efficiency. This was supported by sales 
force excellence initiatives including a sharper 
focus on both health economic and clinical 
evidence to support our products. 

In Reconstruction, the Knee Implants franchise 
performed well, with the JOURNEY™ II Total 
Knee System driving good growth, as did 
the LEGION™ Revision Knee System. In Hip 
Implants, the new REDAPT™ Revision and 
POLARSTEM™ Cementless Stem systems were 
well received. In Trauma & Extremities, new 
clinical evidence supported increased uptake 
of our TRIGEN™ INTERTAN™ hip fracture system.

Sports Medicine Joint Repair performance 
was driven by good demand for our 
shoulder repair portfolio, and we added an 
exciting new technology when we acquired 
Rotation Medical (see page 15 for more). 
Arthroscopic Enabling Technologies was 
impacted by continued softness in mechanical 
resection. The roll-out of our LENS™ visualisation 
and WEREWOLF™ COBLATION™ systems are 
underway and we expect an increasing 
contribution from these in 2018.

In the US, and other countries, we are seeing 
a shift towards day-case surgery for total joints 
starting to take place in Ambulatory Surgery 
Centre (ASCs), something Smith & Nephew 
is uniquely positioned to benefit from. Through  
Sports Medicine we are already a partner 
to many ASCs. We believe we can leverage 
this customer knowledge and relationships to 
improve the performance of our knee implants 
franchise. Our portfolio is well-suited for ASCs 
where early mobility and efficiency are key, 
as is our robotic NAVIO™ Surgical System due 
to its small footprint, portability and cost.

The Advanced Wound Care franchise delivered 
strong growth in the US, but was held back by 
softer market conditions in Europe. In Advanced 
Wound Bioactives, SANTYL™ benefited from 
a new analysis demonstrating its effectiveness 
in advancing pressure ulcers through the healing 
process2, improving performance in the second 
half of the year. Advanced Wound Devices 
performed strongly across the year, led by the 
continued success of our single use negative 
pressure wound therapy (sNPWT) device PICO™.

$3,984m

Revenue from Established Markets

2015

2016

2017

$3,919m

$3,978m

$3,984m

84%

of Group revenue
0%
Reported

+1%
Underlying1

WHY THIS KPI IS IMPORTANT
We use this KPI to track the relative strength 
of our position in these markets.

HOW WE PERFORMED
Growth in the US, our largest market, was 
offset somewhat by softer conditions in 
some other markets.

1   These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 38 and 178–181.

2  Advances in Wound Care. Gilligan, A.M., et al. Comparative 

effectiveness of Clostridial Collagenase Ointment to medicinal 
honey for treatment of pressure ulcers. Volume 6, Number 4 
(April 2017).

SUPPORTING CUSTOMERS 
AT THE ECC
 “It’s very humbling to know we are 
helping improve patients’ outcomes.”
Natalia Zielinska Bioskills Laboratory Manager

Smith & Nephew is proud to support surgeons and 
nurses by enabling them to learn from experts in their 
field of speciality. We do this at our state-of-the art training 
and innovation centres. In early 2017 we opened the 
Expert Connect Centre (‘ECC’) in Croxley Park, Watford,  
on the outskirts of London, UK. This is already establishing 
itself as a flagship destination for healthcare professionals 
from the UK, Europe and the Emerging Markets.

SMITH & NEPHEW ANNUAL REPORT 2017 12

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FOCUS ON EMERGING MARKETS

Our Emerging Markets represent 
those outside the Established 
Markets, including Brazil, Russia, 
India and China. The Emerging 
Markets accounted for 16% of 
Smith & Nephew’s revenue in 2017.

In 2017 we returned our Emerging Markets 
business to sustainable double-digit revenue 
growth, up 13% on a reported basis and 12% 
on an underlying basis. This was a significant 
improvement over the flat underlying 
performance of 2016. 

In China, our largest Emerging Markets country, 
we delivered double-digit revenue growth 
as we improved our commercial execution. 
In the oil-dependent Gulf States we returned 
to growth by focusing on securing more private 
healthcare business to compensate for the 
reduction in government tenders. The majority 
of our other Emerging Markets continued to 
do well across 2017. 

We have been early investors in many 
of the Emerging Markets. There continue 
to be quarterly fluctuations in the growth rates, 
and differences in performance between 
countries, so we look at the longer term 
trends when making decisions, and those 
are very favourable.

We also see the next wave of sustained 
growth coming from the ‘mid-tier’, essentially 
growth from widening access to a greater 
proportion of the population in these countries. 
We are addressing this by steadily building 
a dedicated product portfolio and specific 
distribution model.

We are well positioned to continue to  
drive strong growth from the Emerging 
Markets over the medium term. The much 
improved performance in 2017 is in line with 
where we see the medium term prospects 
for this increasingly important segment of 
Smith & Nephew’s business.

$781m

Revenue from Emerging Markets

2015

2016

2017

$715m

$691m

$781m

16%

of Group revenue
+13%
Reported

+12%
Underlying1

WHY THIS KPI IS IMPORTANT
We use this KPI to track the growth of 
Emerging Markets relative to global growth.

HOW WE PERFORMED
Performance in the Emerging Markets 
improved strongly over the previous year.

1   These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 38 and 178–181.

RETURNING CHINA  
TO GROWTH
 “We have seen a return to double-digit 
growth in the attractive Chinese market.”
Olivier Bohuon Chief Executive Officer

China is our largest Emerging Market country. Here we 
faced challenges in 2016 as the market growth slowed 
down. In 2017 we improved our commercial execution and 
management of, and involvement in, the channel inventory. 
Looking to the medium term, we believe that our growth 
prospects in China remain very attractive.

SMITH & NEPHEW ANNUAL REPORT 2017 13

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INNOVATE FOR VALUE

In 2017 we began to benefit from 
a suite of exciting new products, 
solutions and business models as 
we deliver on our strategic priority 
to innovate for value.

In robotics, NAVIO is a unique and compelling 
system. In 2017 we successfully extended its 
indications and introduced it to new countries 
such as India. We launched the total knee 
arthroplasty (TKA) application for our JOURNEY 
II, LEGION and GENESIS™ II Total Knee Systems. 
Surgeons completed the world’s first robotics-
assisted bi-cruciate retaining total knee 
replacement procedures. This new approach 
used NAVIO to implant the new JOURNEY II 
XR (bi-cruciate retaining total knee system) 
currently in limited market release. This is the 
first and only bi-cruciate retaining robotics 
application commercially available. 

In the Emerging Markets we continue to build 
our mid-tier portfolio. Our ANTHEM™ Total Knee 
System, which, alongside the ORTHOMATCH™ 
Universal Instrumentation Platform, has been 
designed to provide wider market access to 
affordable knee treatments, performed well 
following its 2016 launch. During the year we 
launched into more markets, including Russia 
and Saudi Arabia, and introduced a new 
Cruciate Retaining (CR) variant, extending  
the options available to surgeons. 

In Sports Medicine our new LENS™ Surgical 
Imaging System and WEREWOLF™ COBLATION™ 
System for resecting soft tissue are being 
rolled out to customers. In Reconstruction 
we expanded our REDAPT™ Hip and LEGION™ 
Knee revision systems. In Advanced Wound 
Management our pioneering disposable 
single-use negative pressure wound therapy 
(sNPWT) device PICO™ continued to perform 
strongly and we extended our ALLEVYN 
LIFE foam dressing range with a new non-
border version. 

We also focus on providing customers with the 
evidence that demonstrates the effectiveness 
of our innovative products. In 2017, PICO 
benefited from new clinical evidence showing 
its effectiveness at reducing surgical site 
infections1 and the TRIGEN™ INTERTAN™ hip 
fracture system also performed strongly 
supported by new clinical evidence2. 

We continue to develop new business models 
to address changing or unmet customer 
needs. During 2017 we ran the first study 
of our innovative Episode of Care Assurance 
Program (eCAP) that combines our hip and 
knee implants with PICO and ACTICOAT™  
Flex 7 Antimicrobial Barrier Dressings.  
The first results showed eCAP delivering  
a 97% decrease in hospital readmission  
rates following total joint replacement surgery 
(based on 1,380 joint arthroplasties with 
only two readmissions, a readmission rate 
of only 0.145% as compared to published 
rates of 5.3% or more). 

$223m

R&D expenditure

2015

2016

2017

5%

of Group revenue

$222m

$230m

$223m

WHY THIS KPI IS IMPORTANT
Through this KPI we monitor our investment 
in R&D.

HOW WE PERFORMED 
The strong new product portfolio reflects 
increased investment in R&D and 
technology acquisitions. 

1   O’Leary, D.P. et al, Prophylactic negative pressure dressing use 
in closed laparotomy wounds following abdominal operations. 
A randomised, controlled, open-label trial: The PICO Trial. 
Annals of Surgery, published online 06 December 2016. 

2  Smith & Nephew INTERTAN claims brochure “The evidence is in ...”

WORLD-CLASS R&D IN HULL
 “Britain is a global leader in medical technology innovation. 
Partnerships such as this between Smith & Nephew and 
University of Hull further strengthen our position at the 
forefront of global medical research and development.”
Emma Hardy MP for Hull West & Hessle

In 2017 we announced a long-term partnership with the University of Hull  
to create one of the world’s largest Wound Care Research Clusters with  
the aim of developing scientific insights and innovative treatments. 

This includes the creation of eight PhD studentships and a programme  
of collaboration between Smith & Nephew’s new Hull Research &  
Development centre and the University’s new Health Campus.

SMITH & NEPHEW ANNUAL REPORT 2017 14

OVERVIEW

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FINANCIAL  
REVIEW

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GROUP AND OTHER 
INFORMATION

STRATEGIC PRIORITIES continued

SIMPLIFY AND IMPROVE  
OUR OPERATING MODEL

Since 2011 Smith & Nephew has 
undertaken two successful efficiency 
programmes that have delivered 
significant savings and created an 
integrated Group structure.

As announced with our Third Quarter 2017 
Results, we believe that we now have the 
Group structure to allow us to strengthen 
our competitive position by driving further 
opportunities to accelerate performance 
through better execution, while at the same 
time realising savings through greater efficiency. 

In 2017 we completed our assessment of 
these opportunities and started to implement 
a programme called APEX – Accelerating 
Performance and Execution in early 2018. 

APEX is expected to deliver an annualised 
benefit of $160 million by 2022, with around 
three-quarters of this expected by 2020, for  
a cash cost of up to $240 million, of which  
a charge of around $100 million is expected 
in 2018.

APEX has three workstreams:

1. MANUFACTURING, 
WAREHOUSING AND DISTRIBUTION 
We have already made significant 
improvements over the last two years, and see 
further opportunities to simplify in line with best 
practices to reduce overall cost, while improving 
quality and delivery through: 

 – A best practice facility footprint with larger 

manufacturing hubs supported by speciality 
facilities where appropriate.

 – A product portfolio that meets the needs 
of our customers and complies with 
regulations, while minimising cost, complexity 
and inventory.

 – A supply chain that is streamlined and 
efficient so that we are positioned to  
achieve the highest levels of delivery  
at benchmark cost.

2. GENERAL AND ADMINISTRATIVE 
(G&A) EXPENSES 
We have improved our G&A expense ratio over 
the last five years, but with our global function 
structure we are now able to identify additional 
areas of opportunity to reduce costs and 
improve service through:

 – Best-in-class Global Business Services 
that includes a full-spectrum of support 
services delivered quickly and efficiently, 
enabling full focus on our customers and 
business objectives.

 – Service hubs in locations that align to our 
regional needs and deliver the best value 
for money.

 – System infrastructure that drives maximum 

efficiency, including rationalisation of legacy IT 
systems and adopting a ‘cloud-first’ strategy.

3. COMMERCIAL EFFECTIVENESS
Whilst the commercial opportunities and 
competitive environment continue to evolve 
with changing customer expectations, new 
go-to-market approaches and price pressure, 
we expect to improve overall productivity and 
accelerate top line growth through: 

 – Increased sales and marketing effectiveness.

 – Selective refinement of structures 

and territories to meet customer and 
market demands.

 – Being more responsive to customers’ use of 

tenders and changing service level demands. 

 – More accurate demand forecasting to 

improve inventory management.

19.6% 

Operating Profit Margin

2015

2016

2017

13.6%

17.2%

19.6%

22.0%

Trading Profit Margin1

2015

2016

2017

23.7%

21.8%

22.0%

WHY THIS KPI IS IMPORTANT
We use this KPI to track our underlying 
profit growth and trading profitability.

HOW WE PERFORMED
Trading profit margin was up 20bps,  
in line with guidance.

1   These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

A MORE AGILE STRUCTURE
 “Based on the preliminary work undertaken when I took over  
as CFO, we undertook a thorough review of our business over the 
last few months. Our objective was to look afresh at opportunities 
to strengthen our competitive position and be more efficient.
“We have now substantially completed this analysis and 
begun executing our programmes…”
Graham Baker Chief Financial Officer

SMITH & NEPHEW ANNUAL REPORT 2017 15

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FINANCIAL  
REVIEW

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INFORMATION

STRATEGIC PRIORITIES continued

SUPPLEMENT ORGANIC  
GROWTH WITH ACQUISITIONS

Whilst our focus in 2017 has been 
on improving our execution across 
our existing business, we have 
made one acquisition and a number 
of strategic agreements that give us 
access to new technologies. 

In 2017 we acquired Rotation Medical, Inc., 
the developer of a novel tissue regeneration 
technology for shoulder rotator cuff repair, 
for an initial cash consideration of $125 million 
and up to $85 million over the next five 
years, contingent on financial performance. 
Its bioinductive implant is highly complementary 
to our Sports Medicine portfolio, serving an 
unmet clinical need and providing a compelling 
new treatment option for our customers2,3,4.

We signed distribution agreements with Leaf 
Healthcare, a developer of a unique wireless 
patient monitoring system for pressure  
ulcer/injury prevention, and MolecuLight i:XTM, 
a handheld point-of-care imaging device that 
uses fluorescence imaging to display potentially 
harmful concentrations of bacteria in wounds 
in real-time. 

2017 marked the third anniversary of our largest 
acquisition, ArthroCare. This strengthened 
our Sports Medicine business, with highly 
complementary product portfolios and 
customer relationships.

ArthroCare also had a strong pipeline of 
innovations, many of which have been 
launched since the acquisition. The ArthroCare 
acquisition has met all of the three-year targets 
that we set, many ahead of time. 

The Board periodically reviews all acquisitions to 
evaluate longer-term performance and capture 
lessons learned to help improve strategy 
and process. Collectively we are pleased 
with the performance of the technology and 
Emerging Markets acquisitions we have made. 
We continue to seek further opportunities to 
strengthen our technology and product portfolio 
and Emerging Markets business. 

1  These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

2  Preliminary investigation of a biological augmentation of rotator 
cuff repairs using a collagen implant: a 2-year MRI follow-up 
Bokor, Sonnabend, Deady, Cass, Young, Van Kampen, Arnoczky 
published in Muscles, Ligaments and Tendons Journal 5(3):144-150 
(2015).

3  Histologic Evaluation of Biopsy Specimens Obtained After Rotator 
Cuff Repair Augmented With a Highly Porous Collagen Implant 
Arnoczky, D.V.M., Shariff K. Bishai, D.O., M.S., F.A.O.A.O., Brian 
Schofield, M.D., Scott Sigman, M.D., Brad D. Bushnell, M.D., 
M.B.A., Jan Pieter Hommen, M.D., and Craig Van Kampen, Ph.D. 
Arthroscopy: The Journal of Arthroscopic and Related Surgery, 
33(2):278-283 (2016).

4  Evidence of healing of partial-thickness rotator cuff tears following 
arthroscopic augmentation with a collagen implant: a 2-year MRI 
follow-up. Bokor, Sonnabend, Deady, Cass, Young, Van Kampen, 
Arnoczky. Muscles, Ligaments and Tendons Journal 6(1):16-25 
(2016).

ARTHROCARE
In 2014 we acquired ArthroCare 
for $1.5 billion to strengthen our 
Sports Medicine business through 
complementary product portfolios 
and customer relationships. 

$50m+
of additional sales from cross-selling

$85m
of total synergies on trading profit1 level

WHY THIS KPI IS IMPORTANT
We use this KPI to demonstrate the returns 
from acquisitions.

HOW WE PERFORMED
ArthroCare has met or exceeded all of the 
three-year targets, many ahead of time. 
We achieved both the cost and revenue 
synergies totalling $85m on a trading profit 
level, and the Return on Invested Capital in 
year three exceeded our target.

STRENGTHENING SPORTS MEDICINE
 “We are proud of the impact our technology has made in 
healthcare and are excited by the opportunity to reach many 
more customers and their patients as an integrated part 
of Smith & Nephew’s extensive Sports Medicine portfolio.”
Martha Shadan Chief Executive Officer, Rotation Medical, Inc.

The bioinductive implant from Rotation Medical, Inc. has shown the ability  
to heal by inducing the growth of new tendon-like tissue2,3,4. With its small  
sales force, Rotation Medical, Inc. achieved revenue of $17m in 2017. 

We expect rapid growth as we roll out the product across our large  
Sports Medicine sales force, first focusing on the US where the product  
has FDA approval. 

SMITH & NEPHEW ANNUAL REPORT 2017 16

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OUR MARKETPLACE

ATTRACTIVE  
LONG-TERM TRENDS

$34 billion

Smith & Nephew’s addressable 
segment in medical devices1

4%

Annual growth rate of Smith & Nephew’s 
addressable segment1

HEALTHY FUNDAMENTALS, 
BUT COST REMAINS AN ISSUE
According to a study commissioned by the Bill 
and Melinda Gates Foundation (Lancet, April 
2017) global healthcare spend, amounting to  
c. $9 trillion in 2014, is set to grow at a real rate 
of c. 3% per annum per capita, reaching  
c. $16 trillion in 2030 and c. $24 trillion in 2040, 
representing c. 8% of the global economy.

The medical devices and supplies segment 
of healthcare is today worth approximately 
$340 billion per annum. Within that, 
Smith & Nephew’s addressable segment 
is approximately $34 billion, growing at 
around 4% annually. 

The main drivers for healthcare demand 
include demographic shift towards older 
populations, increases in lifestyle related 
ailments such as obesity, advances in 
technology leading to increased scope for 
treatment, and economic growth increasing  
the access and demand for healthcare 
– especially in the Emerging Markets. 
Additionally, patients increasingly seek to 
influence the choice of care as they become 
more and more informed about the range  
and nature of treatment options available. 

Today healthcare expenditure already 
constitutes a significant share of the overall 
global economy, especially in developed 
markets where populations are ageing rapidly. 
As an example, the share of US GDP spent 
on healthcare has reached nearly 17% and 
is set to continue to rise (Lancet, April 2017). 
As a result, cost and cost control remain 
the dominant issues across the sector and 
healthcare systems increasingly shift towards 
more efficient and effective value-based care. 

SHIFT TOWARDS VALUE 
RATHER THAN VOLUME
The traditional approach to healthcare provision 
has been symptom and volume (fee-for-service) 
oriented which – in combination with current 
demographic trends – has put upward pressure 
on healthcare costs. In response, stakeholders 
are increasingly seeking to shift the focus from 
‘break-fix’ to a more holistic and value-based 
approach focused on disease prevention  
and treatment results (fee-for-outcome). 

Healthcare practitioners are no longer the 
only decision-makers, but are part of larger 
multi-stakeholder purchasing processes. 
Economic stakeholders have increasing 
influence on the purchase process for 
medical devices. New payment models, 
such as bundled procedure payments, risk 
sharing, or quality incentives/penalties, are 
shifting the focus from clinical utility and 
safety alone to clinical outcomes and health 
economic performance, which in turn drives 
demand for Health Economic and Outcomes 
Research (HEOR) to demonstrate clinical end 
economic value.

As an example, the US Centers for Medicare 
& Medicaid Services (CMS) aims by 2018 to 
spend 50% of its Medicare fee-for-service 
payments through alternative payment models 
and link 90% of its fee-for-service to quality 
(CMS, Jan 2015).

FOCUS ON LOWERING COSTS 
AND INCREASING EFFICIENCY
The desire to lower costs and increase 
efficiency gives rise to several trends including, 
for example: healthcare providers increasingly 
seeking to treat patients in outpatient 
or community settings; the increasing use 
of digital technologies to ensure that care 
is as efficient and effective as possible; the 
acceptance of ‘good enough’ products in some 
circumstances; and the sector increasingly 
seeing efforts to cooperate across the value 
chain. As an example, the UK National Health 
Service (NHS) is automating data exchange 
between its institutions and suppliers and 
has mandated all suppliers to provide 
pricing information through the Global Data 
Synchronization Network (GDSN) by October 
2018 (NHS, Feb 2016).

SMITH & NEPHEW ANNUAL REPORT 2017 17

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GROUP AND OTHER 
INFORMATION

OUR MARKETPLACE continued

GOVERNMENTS, REGULATIONS 
& COMPLIANCE
Governments and other public bodies are key 
stakeholders in our marketplace. 

In the US, where healthcare spending is 
higher as a percentage of GDP than most 
other countries, politicians and regulators 
are focused on reducing cost and simplifying 
the regulatory burden on the industry. 
Although common ground is hard to find, there 
is a general consensus that the US healthcare 
system needs to be restructured.

In 2017, the European Union reached 
agreement on a new set of Medical Device 
Regulations which entered into force on 
25 May 2017. These have a three-year 
transition period; therefore will fully apply 
in EU Member States from 26 May 2020. 
These regulations will impose tougher 
requirements of market entry and post 
market surveillance of medical devices. 
Although healthcare systems are less costly 
in Europe than in the US, strained government 
budgets and demographic challenges are 
driving an increased focus on value-based 
healthcare and requirements to demonstrate 
the value of innovation through evidence. 
Additionally, some uncertainty exists around 
the UK’s exit from the European Union where 
the regulatory impact is not yet clear. 

In China, which in recent years has focused 
on, and succeeded with, increasing access 
to healthcare, there is a strong focus on 
compliance and cost control. In 2017 the 
country introduced the two invoices system 

which effectively limits length of the supply 
chain thus increasing transparency and 
lowering cost to the end consumer. Also in 
2017 Chinese regulators initiated a process 
to lower prices on medical devices. The initial 
focus of these efforts is on hip implants, drug-
eluting stents and implantable cardioverter-
defibrillators (ICDs).

The major regulatory agencies for Smith 
& Nephew’s products include the Food and 
Drug Administration (FDA) in the USA, the 
Medicines and Healthcare products Regulatory 
Agency (MHRA) in the UK, the Ministry of 
Health, Labour and Welfare in Japan, the 
China Food and Drug Administration and the 
Australian Therapeutic Goods Administration.

Legislation covering corruption and bribery, such 
as the UK Bribery Act and the US Foreign Corrupt 
Practices Act, applies to all our global operations. 
We, and other companies in the industry, are 
subject to regular inspections and audits by 
regulatory agencies and notified bodies, and in 
some cases remediation activities have required, 
and will continue to require, significant financial 
and resource investment.

SEASONALITY
Orthopaedic reconstruction and sports 
medicine procedures tend to be higher 
in the winter months when accidents 
and sports related injuries are highest. 
Elective procedures tend to slow down in 
the summer months due to holidays. Due to 
the nature of our product range, there is little 
seasonal impact on our Advanced Wound 
Management franchises.

In the US, out-of-pocket costs for health 
insurance plans are tied to medical expenses 
in a calendar year. As a result, households 
who have reached their deductible (or out-of-
pocket) cap may find that accessing care later 
in the year comes at a lower cost, which can 
encourage more of them to try and schedule 
any required treatments or procedures in the 
final months of any given year.

COMPETITION
Across our franchises we have a number of 
competitors which differ with respect to both 
product focus, geographic reach and overall 
scale. Whereas our key surgical competitors 
are generally larger and more exposed to the 
US, our key wound competitors are generally 
not US centric. 

In Orthopaedic Reconstruction and Trauma 
we are one of four leading players as we 
compete against Stryker (US), Zimmer Biomet 
(US) and Johnson & Johnson (US). In Sports 
Medicine we hold a leading position behind 
Arthrex, while also competing against the 
aforementioned companies.

Our Advanced Wound Management business 
is the second largest in our marketplace. 
We lead the somewhat fragmented Advanced 
Wound Care sub-segment alongside 
Mölnlycke (Sweden). In Advanced Wound 
Devices we are the primary challenger to 
US based NWPT incumbent Acelity (US). 
In Advanced Wound Bioactives our key 
products lead their respective categories.

MARKET SIZE1
$5.5bn
Sports Medicine2

+6%

E

C

D

A

B

$8.5bn
Advanced Wound Management Hip & Knee Implants (Recon)

$14.5bn

+5%

+2%

$5.5bn
Trauma & Extremities

+4%

A

E

A

E

A

E

B

D

C

D

C

D

C

B

A  SMITH & NEPHEW 

B  ARTHREX 

C  DEPUY (MITEK)3 

D  STRYKER 

E  OTHERS 

22%

32%

14%

11%

21%

A  SMITH & NEPHEW 

B  ACELITY 

C  MOLNLYCKE 

D  CONVATEC 

E  OTHERS 

15%

17%

10%

7%

51%

A  SMITH & NEPHEW 

11%

A  SMITH & NEPHEW 

B  ZIMMER BIOMET 

C  DEPUY SYNTHES3 

D  STRYKER 

E  OTHERS 

33%

21%

20%

B  DEPUY SYNTHES3 

C  STRYKER 

D  ZIMMER BIOMET 

15%

E  OTHERS 

1  Data used in 2017 estimates generated by Smith & Nephew is based on publicly available sources and internal analysis and represents an indication of market shares and sizes.
2  Representing access, resection and repair products.
3  A division of Johnson & Johnson.

B

9%

45%

26%

11%

9%

SMITH & NEPHEW ANNUAL REPORT 2017 18

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OUR PRODUCTS

THE PRODUCTS WE  
TAKE TO MARKET

Smith & Nephew has nine 
global product franchises

I

H

G

F

E

D

A

C

B

A  KNEE IMPLANTS 

B  HIP IMPLANTS 

C  TRAUMA & EXTREMITIES  

D  SPORTS MEDICINE JOINT REPAIR 

E  ARTHROSCOPIC ENABLING TECHNOLOGIES 

F  OTHER SURGICAL BUSINESSES 

G  ADVANCED WOUND CARE 

H  ADVANCED WOUND BIOACTIVES 

I  ADVANCED WOUND DEVICES 

$984m

$599m

$495m

$627m

$615m

$189m

$720m

$342m

$194m

KNEE  
IMPLANTS
2017 revenue

$984m +6%

Reported

+5%
Underlying1

Smith & Nephew offers an innovative range 
of products for specialised knee replacement 
procedures. Knee replacement surgery 
involves replacing the worn, damaged or 
diseased portion of a knee with an artificial 
joint. Every year more than two million 
patients receive total, partial or revision knee 
replacements worldwide.

Smith & Nephew’s knee systems include 
the LEGION/GENESIS II Total Knee System, 
a comprehensive system designed to allow 
surgeons to address a wide range of knee 
procedures, and our JOURNEY II family of 
Active Knees. The anatomical shape of 
the JOURNEY II is designed to reproduce 
normal knee kinematics and thereby delivers 
improved functional outcomes and high 
patient satisfaction.

In 2017 we progressed the limited market 
release of our JOURNEY II XR, an innovative 
bi-cruciate retaining knee implant, which 
is designed to retain the anterior and 
posterior cruciate ligaments (ACL/PCL) and 
deliver normal perception of movement and 
muscle control2.

These systems also feature VERILAST™ 
Technology, our advanced bearing surface. 
The LEGION Primary Knee with VERILAST 
Technology has been laboratory-tested to 
30 years of simulated wear. While lab testing 
is not the same as clinical performance, the 
tests showed significant reduction in wear 
compared to conventional technologies. 

Our knee systems utilise our VISIONAIRE™ 
Patient-Matched Instrumentation, whereby 
a patient’s MRI and X-Rays are used to create 
customised cutting guides that allow the 
surgeon to achieve optimal alignment of the 
new implant.

In 2017 we expanded the geographic scope 
of the ANTHEM Total Knee System, which, 
alongside the ORTHOMATCH Universal 
Instrumentation Platform, has been designed 
to provide a wider market access to affordable 
knee treatment. ANTHEM is tailored to meet 
the anatomical needs of patients from Asia, 
the Middle East, Africa and Latin America and 
the ORTHOMATCH instrumentation platform 
reduces weight, footprint and unnecessary 
cost without compromising on quality or 
clinical outcomes. In 2017 we expanded the 
geographic scope of the system which is now 
available in many markets including India, 
South Africa, Mexico, Colombia, Chile, Russia 
and the Middle East. We began the limited 
market release of a cruciate retaining version 
in 2017. 

In early 2017 we launched the NAVIO Total 
Knee Arthroplasty (TKA) system, adding to 
the indications offered on our leading robotics 
platform. In the fourth quarter, we initiated 
the limited market release for the NAVIO 
XR system, which we believe will be a key 
technology enabler for the JOURNEY II XR 
knee. The robotics team continues to expand 
to major geographies such as India, South 
Africa and Australia. For more information 
on NAVIO see page 22.

In 2017 performance in this franchise was 
driven by strong demand for the JOURNEY 
II Total Knee System supported by growth 
from the LEGION Revision Knee System and 
ANTHEM Total Knee System. 

1  These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

2  Moro-Oka, Taka-Aki, Marc Muenchinger, Jean Pierre Canciani, 
and Scott A Banks. ‘Comparing in Vivo Kinematics of Anterior 
Cruciate-retaining and Posterior Cruciate-retaining Total Knee 
Arthroplasty’. Knee Surgery, Sports Traumatology, Arthroscopy 
15.1. (2007):93:99 Web.

OPERATIONAL 
REVIEW

SMITH & NEPHEW ANNUAL REPORT 2017 19

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

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ACCOUNTS

GROUP AND OTHER 
INFORMATION

OUR PRODUCTS continued

JOURNEY II BCS

JOURNEY II CR

JOURNEY II XR

JOURNEY PFJ

JOURNEY UNI

RENEWING 
ACTIVE LIFESTYLE

Today’s fastest growing segment 
of knee replacement patients 
is seeking a return to a more 
active lifestyle1 

HIP  
IMPLANTS
2017 revenue

$599m 0%

Reported

0%
Underlying1

Smith & Nephew’s Hip Implants franchise 
offers a range of specialist products for 
reconstruction of the hip joint. This may be 
necessary due to conditions such as arthritis 
causing persistent pain and/or as a result of 
hip fracture. Every year more than two million 
patients worldwide undergo total, resurfacing 
and revision hip replacement procedures.

For Hip Implants, Smith & Nephew has 
developed a range of primary hip systems. 
Core systems include the ANTHOLOGY™ 
Hip System, SYNERGY™ Hip System, the 
POLARSTEM Femoral Hip System, the R3 
Acetabular System and the POLARCUP™ Dual 
Mobility Hip System. This diversity exemplifies 
our commitment to providing surgeons with 
implant and instrumentation options that meet 
the specific demands of their patients and 
preferred surgical approach, most notably the 
direct anterior or posterolateral approach. 

Traditional knee replacement options don’t 
meet the need for higher functionality, 
improved motion or long-term durability2,3,4,5.
Most significantly, these systems fall short 
in providing a return to a normal pattern of 
motion meaning less satisfaction for patients. 

JOURNEY II is a seamless, next generation 
family of partial and primary knee designs, 
including a new bi-cruciate retaining  
JOURNEY II XR. JOURNEY II is intended to 
restore patients to an unmatched level of 
function, motion and durability.

For orthopaedic surgeons seeking 
treatment solutions beyond traditional knee 
replacements, JOURNEY II Active Knee 
Solutions have been engineered to empower 
patients to return to an active lifestyle. 

We also market the BIRMINGHAM HIP 
Resurfacing (BHR) System, an important option 
for surgeons treating suitable patients. 

Smith & Nephew’s portfolio also includes the 
REDAPT Revision Femoral System. 

The need to perform a revision can occur 
for a variety of reasons including infection, 
dislocation, or failure of the implants to 
achieve biologic fixation. REDAPT is designed 
to turn such complex hip revisions into 
efficient, reproducible surgeries, allowing 
surgeons to effectively recreate a patient’s 
unique functionality, while quickly and easily 
addressing issues such as poor bone quality. 

The REDAPT Revision Femoral System 
comprises a monolithic stem and a Fully 
Porous Shell. A Fully Porous Acetabular Cup 
with CONCELOC™ Technology was introduced 
in 2016. To allow ingrowth, an additive, or 3D 
printing, manufacturing process is used to 
produce an entirely porous implant that mimics 
the structure of cancellous bone. The 3D 
printing method allows for complex design 
geometries that would be difficult, expensive 
or impossible to achieve with traditional 
manufacturing methods. For example, solid 
reinforcements can be built directly into the 
porous structure to provide extra strength in 
precise locations.

In 2017 we introduced a number of REDAPT 
Augments to be used in conjunction with the 
fully porous shell which will allow surgeons to 
treat more difficult acetabular revisions. 

In 2017 performance in this franchise was 
better in the second half of the year, driven 
by new REDAPT Revision and POLARSTEM 
Cementless Stem systems. 

1  These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

RENEWING ACTIVE LIFESTYLE
1   US Department of Health and Human Services Agency (HHSA) for 
Healthcare Research and Quality (AHRQ) Knee Replacements Up 
Dramatically Among Adults 45 to 64 Years Old. AHRQ News and 
Numbers, November 3, 2011. Agency for Healthcare Research 
and Quality, Rockville, MD.

2   Phil Noble et al; Does total knee replacement restore normal knee 

function? 2005; CORR. (431): 157-65.

3   Huch K, Müller KA, Stürmer T, Brenner H, Puhl W, Günther KP. 

Sports activities 5 years after total knee or hip arthroplasty: the Ulm 
Osteoarthritis Study. Ann Rheum Dis. 2005 Dec; 64 (12):1715-20.

4   Comparing patient outcomes after THA and TKA: is there a 
difference? Bourne RB, Chesworth B, Davis A, Mahomed N, 
Charron K. Clin Orthop Relat Res. 2010 Feb; 468(2):542-6. Epub 
2009 Sep 4.

5  Functional comparison of posterior cruciate-retained versus 

cruciate-sacrificed total knee arthroplasty. Dorr LD, Ochsner JL, 
Gronley J, Perry J. Clin Orthop Relat Res. 1988 Nov; (236):36.

SMITH & NEPHEW ANNUAL REPORT 2017 20

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OUR PRODUCTS continued

TRAUMA &  
EXTREMITIES
2017 revenue

$495m +4%

Reported

+4%
Underlying1

Our Trauma & Extremities franchise supports 
healthcare professionals by pioneering 
solutions for surgeons to stabilise severe 
fractures, correct bone deformities, treat 
arthritis, and heal soft tissue complications. 

For Trauma, the principal internal fixation 
products are the TRIGEN family of 
intramedullary (IM) nails (TRIGEN META-NAIL 
System, TRIGEN Humeral Nail System and 
TRIGEN INTERTAN), EVOS™ Plating System 
and the PERI-LOC™ Plating System. In 2016 
we unveiled new evidence showing that the 
TRIGEN INTERTAN hip fracture system allows 
patients to experience lower risk of implant 
failure and re-operation; faster time to fracture 
union; and a high return to pre-fracture status2.

The EVOS Mini Fragment Plate and Screw 
System is a dedicated Trauma mini fragment 
system. This is a stainless steel highly versatile 
system with a multitude of plate geometries 
and longer screw lengths than standard mini 
fragment systems. In 2017, we introduced 
the EVOS Small Fragment system for lower 
extremity fractures and general trauma 

FIRST AND ONLY

First and only bi-cruciate  
retaining robotics application

2017 saw the world’s first robotics-assisted 
bi-cruciate retaining total knee replacement 
procedures, utilising our NAVIO robotics-
assisted surgical system and the JOURNEY II 
XR bi-cruciate retaining total knee system.

The JOURNEY II XR has the potential to 
deliver the best possible outcome for the 
surgeon and patient through the preservation 
of important anatomical structures such 
as the Anterior Cruciate Ligament (ACL). 
The NAVIO robotics-assisted surgical system 
enables accurate tibial implant placement 
to deliver a more reproducible surgical 
technique. We are proud to be the only 
company to offer the unique combination of 
NAVIO robotics-assistance and the JOURNEY 
II XR Knee System.

utilisation. This new system features more 
points of fixation and greater breadth of plate 
options. EVOS Small takes an evolutionary 
approach to simplifying and unifying small 
fragment plating systems.

For extremities and limb restoration, we offer 
the TAYLOR SPATIAL FRAME™ Circular Fixation 
System as well as a range of plates, screws, 
arthroscopes, instrumentation, resection 
and suture anchor products including foot 
and ankle and hand and wrist specialists. 
In addition, we introduced INVISIKNOT™, 
a unique syndesmotic fixation device for 
the ankle.

2017 saw the global launch of the ATLAS™ Hip 
Fracture Nail in South Africa and India. It is the 
first Smith & Nephew nail specifically designed 
for the Emerging Markets.

In 2017 performance in this franchise 
was driven by growth from our TRIGEN 
INTERTAN hip fracture system where new 
clinical evidence continued to support 
increased uptake. 

1  These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

2  Smith & Nephew INTERTAN claims brochure “The evidence is in ...”

SPORTS MEDICINE 
JOINT REPAIR
2017 revenue

$627m +7%

Reported

+6%
Underlying1

Our Sports Medicine Joint Repair franchise 
offers surgeons a broad array of instruments, 
technologies and implants necessary to 
perform minimally invasive surgery of the 
joints, including the repair of soft tissue injuries 
and degenerative conditions of the knee, 
hip and shoulder. Our franchise operates 
in a large, growing market where unmet 
clinical needs lend room for procedural and 
technological innovation. Smith & Nephew is 
well positioned both to innovate and to reach 
customers globally. 

Key products for knee repair include the 
FAST-FIX™ family of meniscal repair systems, 
the ENDOBUTTON™ and ULTRABUTTON™ fixed 
and adjustable loop devices for knee ligament 
reconstruction, BIOSURE™ interference screws 
for ligament procedures, and CARGEL™ for the 
repair of articular cartilage.  

NAVIO
The power of robotics

SMITH & NEPHEW ANNUAL REPORT 2017 21

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OUR PRODUCTS continued

For shoulder, Smith & Nephew markets a 
suite of products for Rotator Cuff Repair (RCR), 
one of the most common sports medicine 
procedures. These include ULTRATAPE™, a 
suture that provides greater tendon-to-bone 
contact when compared to traditional #2 
suture and may enhance repair2, FIRSTPASS™ 
ST, a sterile-packaged retrograde suture 
passer that eliminates the steps of loading and 
unloading needles and cartridges; MULTIFIX™ 
S, an all-PEEK knotless screw-in anchor; 
and HEALICOIL™, a family of suture anchors 
featuring open architecture that allows new 
bone to fill the fenestrations between screw 
threads. All these products can be used 
together or in conjunction with other existing 
products from the Smith & Nephew portfolio in 
a single procedure, significantly expanding the 
breadth of our RCR Solutions.

In 2017 we acquired Rotation Medical, Inc., 
the developer of a novel tissue regeneration 
technology for RCR, for an initial cash 
consideration of $125 million and up to 
$85 million over the next five years, contingent 
on financial performance. The Rotation 
Medical Rotator Cuff System incorporates 
a breakthrough technology and technique 
that balances biomechanics and biology to 
enhance the body’s natural healing response, 
helping tendons heal by inducing growth of 
new tendon-like tissue4,5,6. Rotation Medical is 
highly complementary to our Sports Medicine 
portfolio, serving an unmet clinical need and 
providing a compelling new treatment option 
for our customers. 

The Smith & Nephew joint repair portfolio 
includes two next-generation anchors made 
of soft, all-suture material – Q-FIX™ and 
SUTUREFIX™. The Q-FIX All-Suture Anchor is 
ideal for a variety of arthroscopic shoulder 
and hip repairs, offering fixation performance 
superior to commonly used all-suture anchors 
and traditional anchors7,8. The SUTUREFIX Ultra 
anchor is an attractive option for procedures in 
which anatomic space is very limited9 while still 
delivering high fixation strength10,11,12.

Smith & Nephew offers joint repair implants 
made from REGENESORB™, including versions 
of the HEALICOIL™ suture anchors for shoulder 
repair and BIOSURE™ interference screws for 
knee repair. REGENESORB™ is an advanced 
biocomposite material shown to be absorbed 
and completely replaced by bone within 
24 months in pre-clinical studies13,14.

Smith & Nephew supports specific joint repair 
procedures for shoulder, knee and hip with 
a line of instruments, positioners and holders, 
including SPIDER2™/T-MAX procedure-
enabling limb positioning systems and 
ACUFEX™ Hand Held Instruments.

In 2017 performance in this franchise was 
driven by strong demand for our leading 
shoulder repair portfolio. 

ARTHROSCOPIC 
ENABLING TECHNOLOGY
2017 revenue

$615m -3%

Reported

-3%
Underlying1

Our Arthroscopic Enabling Technologies (AET) 
franchise includes high definition imaging 
solutions, industry leading energy based and 
mechanical resection platforms, and fluid 
management and access portfolios. 

AET platforms work in concert to facilitate 
access to various joint spaces, visualise the 
patient’s anatomy, resect degenerated or 
damaged tissue and prepare the joint for a 
soft tissue repair. Products in this franchise are 
often used in conjunction with products from 
our Sports Medicine Joint Repair franchise.

Key AET products include the LENS™ Integrated 
visualisation system which provides 
outstanding image quality and functionality 
in a simple three-in-one Console (CCU, LED 
Light Source and Image Management System), 
Camera Head and iPad application. 

We also offer the WEREWOLF and QUANTUM™ 
2 COBLATION™ controllers and a wide range 
of high performance COBLATION Technology 
radio frequency (RF) wands to precisely ablate, 
resect and coagulate soft tissue and enable 
haemostasis of blood vessels. 

The WEREWOLF COBLATION System is 
the latest innovation in our market-leading 
COBLATION technology. Featuring an all 
new controller and designed to support a 
broad variety of wands, WEREWOLF delivers 
an unparalleled range of performance 
capabilities and advanced safety features – 
WEREWOLF carries broad indications across 
Sports Medicine. 

DYONICS™ Shaver blades provide superior 
resection due to their sharpness and 
reduce clogging with their debris evacuation 
capabilities, GoFLO™ and Double® Pump 
RF fluid management consoles expand the 
joint space while providing haemostasis and 
maintaining the saline environment necessary 
to perform arthroscopic procedures. 

Within an operating room, our AET products 
are typically kept together in an arthroscopic 
tower, often comprising a visualisation or 
camera system, COBLATION or energy based 
resection controllers, mechanical resection 
or blade controllers and fluid management 
or pump components. Because of the 
strong link between the arthroscopic tower 
and consumables, we will showcase our 
industry leading tower components, such 
as LENS, COBLATION and DYONICS shaver 
blades, when selling the broader Sports 
Medicine portfolio.

In 2017 performance in this franchise was 
impacted by continued softness in mechanical 
resection and the legacy RF technology during 
the year. Our new LENS visualisation system 
and WEREWOLF COBLATION system are 
growing in share within our portfolio and we 
expect a gradual improvement in 2018. 

1   These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

2   Shive, M., MD, et al. BST-CarGel Treatment Maintains Cartilage 
Repair Superiority over Microfracture at 5 Years in a Multicenter 
Randomized Controlled Trial. Cartilage 2015; Vol 6(2) 62-72.

3  Potter L, Moore C. Increased contact area utilizing the ULTRATAPE 
Suture for rotator cuff repair. Bone&JointScience: Our Innovation 
in Focus. 2014;4(3):1-4. Lit no: 02056. 

4  Preliminary investigation of a biological augmentation of rotator 

cuff repairs using a collagen implant: a 2-year MRI follow-up Bokor, 
Sonnabend, Deady, Cass, Young, Van Kampen, Arnoczky published 
in Muscles, Ligaments and Tendons Journal 5(3):144-150 (2015).
5  Histologic Evaluation of Biopsy Specimens Obtained After Rotator 
Cuff Repair Augmented With a Highly Porous Collagen Implant 
Arnoczky, D.V.M., Shariff K. Bishai, D.O., M.S., F.A.O.A.O., Brian 
Schofield, M.D., Scott Sigman, M.D., Brad D. Bushnell, M.D., 
M.B.A., Jan Pieter Hommen, M.D., and Craig Van Kampen, Ph.D. 
Arthroscopy: The Journal of Arthroscopic and Related Surgery, 
33(2):278-283 (2016).

6  Evidence of healing of partial-thickness rotator cuff tears following 
arthroscopic augmentation with a collagen implant: a 2-year MRI 
follow-up. Bokor, Sonnabend, Deady, Cass, Young, Van Kampen, 
Arnoczky. Muscles, Ligaments and Tendons Journal 6(1):16-25 (2016).

7  ArthroCare Report #P/N 54231-01 Rev. A; ArthroCare Report 

#P/N 49193-01 Rev. A; ArthroCare Report #P/N 51963-01 Rev. A.

8  Douglass NP, Behn AW, Safran MR. Cyclic and Load to Failure 
Properties of All-Suture Anchors in Synthetic Acetabular and 
Glenoid Cancellous Bone. Arthroscopy (26 January 2017). 

9  Smith & Nephew Evaluation Reports 15002113, 15002112, 15002117.
10  Smith & Nephew 2011. Validation REPORT ULTRABRAID II SUTURE 

– BIOCOMPATIBILITY – 15001076.

11  Smith & Nephew 2013. Competitive Claims REPORT, SutureFix – 

15002059.

12  Smith & Nephew 2013. Validation REPORT, Hip Suturefix XL – 

15001076.

13  Data on File, Smith & Nephew report 15000897.
14  Results of in vivo simulation have not been shown to 

quantitatively predict clinical performance.

SMITH & NEPHEW ANNUAL REPORT 2017 22

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OUR PRODUCTS continued

OTHER SURGICAL  
BUSINESSES
2017 revenue

$189m -11%

Reported2

+7%
Underlying1

The Other Surgical Businesses franchise 
includes our Ear, Nose & Throat (ENT) business 
and the NAVIO robotic surgical business, 
acquired at the start of 2016. 

In ENT we offer surgeons a wide variety of 
market leading technologies to address 
some of the most common pathologies in 
otolaryngology. Our COBLATION technology 
has been used to remove tonsils and adenoids 
for over 15 years and is preferred by surgeons 
and patients for its ability to remove tissue 
at low temperatures with minimal damage to 
surrounding tissue. 

With its ease of use and strong clinical history, 
COBLATION Technology is also marketed for 
use in turbinate and laryngeal procedures. 

Our RAPID RHINO™ Carboxymethylcellulose 
(CMC) Technology is featured in both 
dissolvable and removable nasal and sinus 
dressings and epistaxis treatment products. 
When mixed with water, CMC forms a 
cushioning gel that naturally drains from the 
body after several days and supports healing 
by maintaining a moist physical environment.

The NAVIO Surgical System is a next 
generation handheld robotics platform 
designed to aid surgeons with implant 
alignment, ligament balancing and bone 
preparation. Furthermore, the NAVIO 
robotics-assisted system does not require 
a preoperative image, such as a CT scan. 
This allows patients to receive the benefits of 
robotics-assistance without the extra steps, 
costs and radiation associated with additional 
preoperative imaging.

In 2017 we successfully expanded the NAVIO 
platform into total knees, which comprise 80% 
of all knee replacement surgeries globally. 
The total knee arthroplasty (TKA) application 
supports Smith & Nephew’s JOURNEY II, 
LEGION Primary and GENESIS II Total 
Knee Systems. 

Also during 2017 surgeons completed the 
world’s first robotics-assisted bi-cruciate 
retaining total knee replacement procedures. 
With this launch, NAVIO now offers both partial 
and total knee options that include the first 
and only robotics-assisted bi-cruciate retaining 
knee procedure, commercially available today. 

In 2017 performance in this franchise was 
driven by the Ear, Nose & Throat business and 
continued demand for our hand-held robotics 
NAVIO Surgical System including the new Total 
Knee Application. The decline in reported 
revenues reflects the impact of the disposal  
of the Gynaecology business in 2016.

ADVANCED 
WOUND CARE
2017 revenue

$720m 0%

Reported

0%
Underlying1

The Advanced Wound Care (AWC) franchise 
consists of several groups of brands, including 
exudate management, infection management 
and our cornerstone range of products. 

Exudate management products focus on 
providing appropriate wound fluid absorption 
and evaporation properties to promote an 
optimal wound healing environment. This will 
reduce the burden a wound has on the 
patients and help them to get on with their 
lives and at the same time diminish costs for 
materials and nursing time.

Our key growth brand in this space is ALLEVYN 
LIFE, an innovative dressing designed to 
improve the quality of life for patients with 
chronic wounds, as well as helping healthcare 
professionals reduce the costs of frequent 
dressing changes. Further research was 
published in 2017, with a Randomised 
Controlled Trial (RCT) showing how the use of 
ALLEVYN LIFE, when combined with standard 
care, reduced the rate of pressure ulcers in the 
sacrum by 71%3.

Silver and iodine drive our infection 
management portfolio. 

Our silver-based products (ACTICOAT, 
DURAFIBER™ Ag and ALLEVYN Ag) provide 
clinicians with a range of solutions to address 
individual patient needs in managing wound 
infection. ACTICOAT is well positioned 
to address the need for highly effective, 
fast-acting local antimicrobials in the care 
of serious infection on a wide range of 
wounds, including surgical incisions and 
chronic wounds.

Our cadexomer iodine based product, 
IODOSORB™, has a unique mode of action 
to deliver low level, slow release elemental 
iodine without cytotoxic effects and effectively 
eradicates biofilms. A recent expert consensus 
showed biofilms contribute to the delay in 
healing of chronic wounds4. 

Smith & Nephew’s cornerstone range offers 
a wide selection of wound care products, 
which means we have one of the most 
comprehensive ranges of wound care 
solutions in the industry. These products 
include our film and post-operative dressings, 
skincare products and gels.

OPSITE™ is one of our most pioneering 
products and has become the global standard 
of care in post-operative dressings. IV3000™, 
a specialist premium dressing for intravenous 
lines, continues to perform well. PROSHIELD™ 
& SECURA™ are proven preventative skin care 
products which help maintain and protect 
skin integrity. 

In 2017 performance in this franchise was 
impacted by softer market conditions in 
Europe, which offset strong growth in the US. 

1  These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

2  Reflects reduction in revenue following sale of Gynaecology 

business in 2016 (2016 Gynaecology revenue: $37m).
3   Forni C., D’Alessandro F., Gallerani P., Genco R., Bolzon A,, 

Bombino C., Mini S., Rocchegiani L., Notarnicola T., Vitullia A., 
Amodeo A., Celli G. Effectiveness of Using a New Polyurethane 
Foam Multi-layer Dressing in the Sacral Area to Prevent the 
Onset of Pressure Ulcer in the Elderly with Hip Fractures. Poster 
presented at EPUAP 2017.

4  Schultz G., Bjarnsholt T., James G. A., Leaper D. J., McBain A. J., 
Malone M., Stoodley P., Swanson T., Tachi M., Wolcott R. D. for 
the Global Wound Biofilm Expert Panel. Consensus guidelines for 
the identification and treatment of biofilms in chronic non-healing 
wounds International Journal of Tissue Repair and Regeneration 
(in press).

SMITH & NEPHEW ANNUAL REPORT 2017 23

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OUR PRODUCTS continued

LEAF

MOLECULIGHT i:X

OWN THE DISEASE

Helping customers 
get closer to zero... 

Smith & Nephew supports healthcare 
professionals in reducing the human and 
economic cost of wounds through pioneering 
solutions that improve outcomes and at the 
same time conserve resources for health 
systems. Our aim is to help our customers 
get closer to zero surgical site complications, 
pressure ulcer incidence, delay in wound 
healing, diabetic foot amputations, and 
waste of healthcare. Customer insights 
have confirmed the need to augment our 
treatment offering with solutions that support 
the clinician in making informed decisions 
and achieving consistency of practice. 

In 2017 we entered two distribution 
relationships for innovative products in the 
Pressure Ulcer Prevention and Infection 
Management categories – Leaf and 
MolecuLight i:X – which extended  
our solutions beyond treatment options. 

LEAF
An estimated 2.5 million pressure ulcers/
injuries are treated each year in US acute 
care facilities alone1, with the cost to treat a 
single full thickness pressure ulcer/injury as 
high as $70,0002 and an estimated annual 
burden of $11 billion3. Proven prevention 
strategies focus on protecting vulnerable 
areas, maintaining skin integrity and 
consistent offloading through patient turning. 

However, despite the best efforts, 
maintaining these schedules with a 
consistent execution is often difficult. 
In particular, turning regimes for patients at 
high risk can be difficult to adhere to, going 
against the latest best practice guidance. 
The Leaf Patient monitoring system is 
a patient worn wireless sensor which 
monitors the patient’s position. The constant 
processing of the positional data facilitates 
real time alerts to patient needs and turning 
schedules. This data can help reduce the 
incidence of hospital-acquired pressure 
injuries and help improve operational 
efficiency as part of a full protocol of care. 

In an independently conducted RCT4 
evaluating optimal patient turning, Leaf 
induced a 43% relative increase in turning 
protocol compliance in high-risk patients. 
Patients treated with Leaf were 73% less likely 
to develop a pressure injury. 

MOLECULIGHT i:X
Currently wound assessments are made with 
the naked eye which can lack the accuracy 
required to most effectively guide clinical 
decision making.5 Using fluorescence, 
MolecuLight i:X quickly, safely, and easily 
visualises potentially harmful bacteria6,7,8 
in wounds which may otherwise lack signs 
or symptoms of infection. It enhances 
a clinician’s ability to choose the right 
therapy, at the right time for their patient6,7 
and can help to guide wound sampling 
and debridement6,9,10, monitor wound 
progression7,8, improve patient engagement5,9 
and simplify wound documentation6.

Clinical data from wound assessments 
demonstrates that incorporating the 
MolecuLight i:X into standard of care 
facilitated more objective medical decision 
making and led to up to nine times faster 
wound healing6 and 54% more accurate 
swabbing.11 MolecuLight i:X is not yet 
available in the US. 

1   Sen et al. Wound Rep Reg 2009. 17:763-771.
2  Reddy et al. Preventing Pressure Ulcers: A Systematic Review. 

JAMA, August 23/30 2006 Vol 296, No 8 (Reprinted).

3  Russo et al. Hospitalizations Related to Pressure Ulcers, 2006. 

HCUP Statistical Brief #64. December 2008.  
Agency for Healthcare Research and Quality, Rockville, MD. 
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb64.pdf.

4  Pickham D. et al. Effect of a wearable patient sensor on 

care delivery for preventing pressure injuries in acutely ill 
adults: A pragmatic randomized clinical trial (LS-HAPI study). 
International Journal of Nursing Studies 80 (2018) 12–19.

5  Hoeflok J et al. Pilot clinical evaluation of surgical site 

infections with a novel handheld fluorescence imaging device. 
Proceedings of the Annual Military Health System Research 
Symposium (MHSRS); 2014 Aug 18–21; Fort Lauderdale, FL.
6  DaCosta RS et al. Point-of-care autofluorescence imaging for 
real-time sampling and treatment guidance of bioburden in 
chronic wounds: first-in-human results. PLoS One. 2015 Mar 
19;10(3). 

7   MolecuLight Inc. PN 1189 MolecuLight i:X User Manual. 2016. 
8   MolecuLight Inc. Case Study 0051 Track Wound Size and 

Bacterial Presence with the MolecuLight i:X. 2016.

9  Raizman R. Point-of-care fluorescence imaging device guides 
care and patient education in obese patients with surgical 
site infections. Presented at: CAWC 2016. Proceedings of the 
Annual Canadian Association of Wound Care Conference 
(CAWC); 2016 Nov 3-6, Niagara Falls, ON.

10  Raizman R. Fluorescence imaging positively predicts bacterial 
presence and guides wound cleaning and patient education in 
a series of pilonidal sinus patients. Proceedings of the Annual 
Wounds UK Conference; 2016 Nov 14-16; Harrogate, UK. 
11  Ottolino-Perry K et al. Improved detection of wound bacteria 

using fluorescence image guided wound sampling in diabetic 
foot ulcers. Int Wound J. 2017 Feb 28. doi: 10.1111/iwj.12717.

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OUR PRODUCTS continued

ADVANCED 
WOUND BIOACTIVES
2017 revenue

$342m 0%

Reported

0%
Underlying1

Our Advanced Wound Bioactives (AWB) 
franchise focuses on the commercialisation 
of novel, topical biologic and skin substitute 
products that provide a unique approach 
to debridement, dermal repair and 
tissue regeneration. 

Currently, our AWB portfolio includes 
Collagenase SANTYL Ointment (the only 
FDA-approved biologic enzymatic debriding 
agent for chronic dermal ulcers and severe 
burns), OASIS® Wound Matrix and Ultra Tri-
Layer Matrix (naturally-derived, extracellular 
matrix replacement products indicated for the 
management of both chronic and traumatic 
wounds) and REGRANEX® (becaplermin) Gel 
0.01% (an FDA-approved platelet-derived 
growth factor for the treatment of lower 
extremity diabetic neuropathic ulcers). 

Our most significant product by sales is 
SANTYL Ointment, which plays an integral  
role in removing necrotic or dead tissue in 
chronic dermal ulcers (such as pressure 
ulcers, diabetic ulcers, and venous ulcers)  
and severely burned patients. 

SANTYL Ointment is often considered as the 
reference debridement product, especially 
in the hospital and nursing home markets. 
Additionally, in 2017 we continued to see 
growth in the use of SANTYL Ointment by 
office-based physicians and have been able 
to stabilise the nursing home market. 

In 2017 the evidence base supporting PICO 
in our target surgical indications continued 
to build. A Level 1 meta-analysis containing 
10 Randomised Controlled Trials and 1,863 
patients demonstrated significant reduction 
in surgical site infections (58% reduction, 
p<0.0001), significant reduction in dehiscence 
(26% reduction, p<0.01) and significant 
reduction in length of stay (0.47 days 
reduction, p<0.0001)3. This summation of the 
evidence demonstrates the positive impact 
PICO is having on patient outcomes and 
system costs.

For our traditional NPWT system, RENASYS™, 
evidence was published demonstrating the 
effectiveness in the treatment of challenging 
wounds and its compatibility with ACTICOAT, 
where high bacterial burden is impacting 
wound progression4. 

This franchise also includes the VERSAJET™ 
Hydrosurgery system, a surgical debridement 
device used by surgeons to excise and 
evacuate non-viable tissue, bacteria and 
contaminants from wounds, burns and soft 
tissue injuries. 

In 2017 performance in this franchise was led 
by PICO, which continued to perform strongly 
across the year.

1  These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

2  Hurd, T., et al. Use of a portable, single use, negative pressure 

wound therapy device in home care patients with low to 
moderately exuding wounds. A case series. Ostomy Wound 
Management. March 2014. Vol.60. Issue 3.

3   V. Strugala & R. Martin, Meta-analysis of comparative trials 

evaluating a prophylactic single-use negative pressure wound 
therapy system for the prevention of surgical site complications. 
Surgical Infections (2017). DOI 10.1089/sur.2017.156.

4  Hurd, T., et al. A Retrospective Comparison of the Performance 
of Two Negative Pressure Wound Therapy Systems in the 
Management of Wounds of Mixed Etiology. Adv Wound Care 
(New Rochelle). 2017 Jan 1;6(1):33–37.

We continue to focus on further establishing 
the value of SANTYL Ointment in treating 
patients. We are also working to lower overall 
treatment costs, improve outcomes and patient 
satisfaction, and further educate physicians, 
patients, and payers on the critical role that 
SANTYL Ointment plays in moving patients 
forward through the healing process.

The wound bioactives market growth 
continues to be impacted by changes in the 
reimbursement landscape that are driving 
increases in out-of-pocket expenses for 
patients and access in general across all sites 
of care.

The US is the largest market and represents 
the current focus for our AWB franchise. 
SANTYL Ointment is also available in Canada. 
OASIS is accessible in a number of other 
Established Markets.

In 2017 performance in this franchise reflected 
SANTYL returning to growth in the second half 
of the year as it benefited from new analysis of 
its effectiveness in advancing pressure ulcers 
through the healing process offset by the 
reimbursement environment for OASIS which 
remained a headwind, as expected. 

ADVANCED 
WOUND DEVICES
2017 revenue

$194m +13%

Reported

+13%
Underlying1

Our Advanced Wound Devices (AWD) 
franchise is comprised of our Negative 
Pressure Wound Therapy (NPWT) and surgical 
debridement businesses.

The PICO system, our pioneering single-
use, canister-free NPWT solution brings the 
effectiveness of traditional NPWT in a modern, 
small portable system2. It is designed for both 
open wounds such as pressure ulcers and 
closed incisions and leverages our leading 
dressing technology.

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OUR RESOURCES

THE RESOURCES WE NEED  
TO DELIVER OUR PRODUCTS

OUR PEOPLE
Engaging, developing and retaining 
our more than 15,000 employees is 
important to us and we work hard to 
be a great place to work as well as a 
responsible corporate citizen.

SEE OPPOSITE

RESEARCH & DEVELOPMENT
Innovation is part of our culture and  
we invest 5% of our revenue to develop 
new products that will help to improve 
patients’ lives.

PAGE 28

MANUFACTURING & QUALITY
We operate our global manufacturing 
efficiently, and to the highest possible 
standards, to ensure product quality at 
competitive pricing.

PAGE 29

SALES & MARKETING
We support our customers in over 100 
countries. Our commercial teams are 
highly specialised with an in-depth 
knowledge across the full range of 
product franchises.

PAGE 30

ETHICS & COMPLIANCE 
We are committed to doing business 
the right way and apply strict business 
principles to the way we deal with our 
customers and partners.

PAGE 32

TRAINING & EDUCATION
Every year, thousands of healthcare 
professionals attend our training  
courses around the world. Education  
is fundamental to how  
we support our customers. 

PAGE 32

OUR  
PEOPLE

WE ARE PIONEERS WITH A PURPOSE
Smith & Nephew is a company of pioneers, 
extending access to advanced medical 
technologies and enabling better outcomes 
for patients globally. We’ve been doing this 
since 1856. 

From our beginnings as a small family 
pharmacy in Hull, England, we have grown in 
size and scope. Over the past six years, we 
have fundamentally changed the structure 
of our Company, creating greater alignment 
and presenting one face to our customers. 
We have brought pioneering products and 
technologies to market, such as JOURNEY II 
and PICO, and have successfully completed 
many significant acquisitions, widening our 
customer base around the world. 

We are proud of the work we do and share a 
mission to support healthcare professionals in 
their daily efforts to improve the lives of their 
patients. We achieve this by working together 
to deliver our strategic priorities. 

Every employee has a role in our success, and 
so it is crucial that all employees feel engaged 
in their work and know its importance. We start 
each year by setting clear and measurable 
objectives based on our strategy scorecard. 

CELEBRATING
EXCELLENCE

The personal objectives of the Chief Executive 
Officer are cascaded through the organisation, 
with each employee setting aligned objectives 
according to his or her role. 

Through this process, each employee can 
clearly see how their efforts contribute to the 
overall success of the business, which drives 
execution, accountability and engagement. 

This engagement is measured through a 
biennial Global Employee Survey using the 
Great Place to Work Trust Index. In 2017, 88% 
of our global employees participated in this 
survey, providing meaningful results that have 
driven actions for improvement. We track our 
progress against these actions using regular 
pulse surveys. 

In 2017 we raised our overall Trust Index score 
by five percentage points, to 67%, meeting  
our target for improvement. We achieved  
Great Place to Work recognition in a further  
five countries, ahead of our target of two  
more. In total we have received recognition  
in nine countries. 

In addition to the Trust Index, we have 
implemented a culture dashboard which 
includes key metrics such as employee 
retention, business performance and feedback 
from new hires. The foundation of this 
dashboard is our values: to Perform, Innovate 
and Earn Trust. It provides a clear framework 
for our senior leaders to track progress and 
identify areas for additional focus, action 
or reinforcement. 

The CEO Awards salute employees 
at all levels who make outstanding 
contributions for the benefit of 
Smith & Nephew.

In 2017 Lorraine Belleville, a Packaging 
Operator and Team Coordinator at our 
Mansfield facility in the US, was recognised 
for her significant contributions to 
Mansfield’s improvement of ‘Finished Goods’ 
production by nearly 30% since 2016. 
Lorraine took initiatives to improve the flow of 
work at the facility by introducing important 
tools such as a tracking scheme, daily 
production sheet and visual management.

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WE ENCOURAGE AND REWARD 
HIGH PERFORMANCE
We set ambitious targets and we achieve them 
by creating a sense of purpose and urgency. 
While achievement of these targets is crucial, our 
Performance Management Process measures 
not only what was achieved, but also that the 
behaviours displayed in doing so match our 
core values.

Smith & Nephew’s compensation philosophy 
is to pay for performance. This means 
compensating employees for sustained 
performance that helps deliver timely and 
tangible results to drive the business forward. 
By following this philosophy we have found that 
we not only attract, retain, and motivate talent, 
but it also helps drive better business results and 
provides an equitable work environment. We are 
Living Wage Accredited in the UK, voluntarily 
paying above the government required minimum 
as we believe employees should receive fair 
compensation for the work they do.

The Company’s ‘Going the Extra Mile’ global 
employee recognition programme is used by 
executives, managers and employees alike to 
recognise and reward performance and our 
corporate values.

We are committed to working with employees 
to develop each individual’s talents, skills 
and abilities. 

Employee advancement is merit-based, reflecting 
performance as well as demonstration of core 
competencies which include our values, with an 
emphasis on ethics and integrity. We prioritise 
the development and promotion of existing 
employees whenever possible. Each year Smith 
& Nephew conducts a comprehensive global 
development and capability review process to 
identify high potential employees and ensure 
they have well defined career development 
plans. The Board reviews succession plans for 
key executive roles and such plans are in place 
for other critical positions across our business.

In 2017, we added to our development 
programme three new opportunities: 
Leadership Edge, Pioneer and Continuous 
Learning Journeys. In 2017, 560 employees have 
participated in these programmes. These are 
designed to embed and enhance essential 
leadership skills for new and experienced 
managers, respectively through a combination 
of guided and self-service learning tools. Our 
‘myLearning’ self-directed online learning portal 
was nominated for a Learning Technologies 
Award for the ‘Best Online Distance Learning 
Programme’ this year.

Employees are provided with opportunities 
to develop their skills and career through new 
assignments and on the job experiences.  

BUILDING A LEADERSHIP CAREER

Laura Whitsitt has built a leadership career at Smith & Nephew. 

Laura Whitsitt began her career at  
Smith & Nephew as an intern in product 
development. Thirty years later and now 
Senior Vice President of Research & 
Development for Orthopaedics, Laura says 
she still sees opportunities for growth and 
development. “I am often asked why I have 
stayed at the same company for so long. 
It’s important to me to learn and grow and 
be challenged, and I’ve always had those 
opportunities at Smith & Nephew.”

In the male-dominated industry of 
orthopaedics, Laura says she has 
always felt respected for her expertise. 
Among the highlights of her career is 
designing the Company’s first and only 
spinal systems and managing them through 
to successful launch. 

NUMBER OF EMPLOYEES1 2017

15,933

Total employees

804
Senior managers2 and above

12
Board of directors

Far from a barrier, Laura believes her 
perspective as a female leader has worked 
in her favour, and has added value. “As a 
woman I bring a different viewpoint to the 
table, and that’s especially important in 
R&D,” she says.

Laura says she has seen real progress over 
her career in adding more female leaders  
to the ranks at Smith & Nephew, but  
there is more to do. “Mentoring has been 
very valuable, and I have certainly seen  
a positive change in the number of females 
in managerial roles. The more diversity  
we have at higher levels of the Company,  
the more momentum we have to build on.”

59%
Male

74%
Male

75%
Male

41%
Female

26%
Female

25%
Female

1  Number of employees at 31 December including part time employees and employees on leave of absence.
2  Senior managers and above includes all employees classed as Directors, Senior Directors, Vice Presidents and Executive Officers 

and includes all statutory directors and Directors of our subsidiary companies.

SMITH & NEPHEW ANNUAL REPORT 2017 27

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Through our global intranet, we provide 
resources and tools to guide employees 
to make decisions that comply with the law, 
local industry code and our Company Code 
of Conduct. We require advance approval 
for significant interactions with healthcare 
professionals or government officials and 
we regularly assess existing and emerging 
risks in the countries in which we operate. 
See page 32 for more information on our 
global compliance programme.

WE VIEW INNOVATION 
AS AN ESSENTIAL SKILL
Innovation is owned by all of us who question 
the status quo, dare to propose new solutions 
and seek to be the best at what we do for the 
benefit of our customers.

At Smith & Nephew, we recognise that 
innovation includes the entire value chain within 
our organisation from R&D to engineering, 
manufacturing, distribution, sales, marketing, 
and even facility utilisation and investment 
strategy. We also acknowledge only a few 
innovations will be truly disruptive, while others 
will result in equally as important incremental 
changes. To help aid this, Smith & Nephew has 
introduced an Innovation Council to support its 
culture of innovation and signal its importance 
in the Company’s continued success. 

The Council consists of ‘Innovation 
Champions’ who reflect the diversity of the 
Smith & Nephew employee base and have 
a strong appetite for trying new things. 
These champions will be responsible for 
generating creative ways to embed this value 
and look for opportunities to raise innovative 
opportunities to the leadership team and to 
celebrate success.  

OUR RESOURCES continued

WE FOSTER AND EMBRACE DIVERSITY  
OF EXPERIENCE, BACKGROUND  
AND IDEAS
Smith & Nephew’s global diversity and inclusion 
programme, called ‘Valuing Difference’, is 
designed to highlight the value of bringing 
different ideas and perspectives in from our work 
and personal experiences. Through storytelling 
and manager tools and discussion guides, the 
programme encourages open dialogue and an 
appreciation of the benefits of diverse teams. 

We believe that diversity fuels innovation and 
are committed to employment practices based 
on equality of opportunity and the ability of the 
person to perform the essential functions of the 
job, regardless of colour, creed, race, national 
origin, sex, age, marital status, sexual orientation 
or mental or physical disability. 

When we recognise and appreciate these 
differences, they can help us better reflect the 
wide range of cultures, customers, and patients 
we serve, so we can better meet their needs 
and be a better business – thereby building 
credibility with all. Diversity is regarded as an 
asset and it is further guarded by our global 
policies regarding ‘Diversity and Inclusion’ and 
‘Respectful Workplace’.

Our Valuing Difference Programme is sponsored 
by Chief Executive Officer Olivier Bohuon, 
and Steering Committee members include 
our Chief Human Resources Officer, Members 
of the Executive Committee and Regional 
Presidents. Together, the committee agrees the 
strategy which is then executed at the regional 
and country-level in order to have the greatest 
possible impact. 

Local diversity councils meet regularly and work 
to translate strategy to local needs, execute 
specific actions and share best practice. 

An example of a Valuing Difference Initiative is 
the ‘Elevate’ programme, which was attended 
by more than 275 female professionals in 2017. 
Elevate is specifically designed to develop 
our female leaders and includes a mix of 
skill development and motivational support. 
The programme has been highly successful, with 
the majority of participants stating they prioritise 
making time to attend the monthly webinar 
sessions and more than one-third promoted 
or changed roles in the past year.

Gender diversity and equity are important areas 
of focus for us. Our goal is to have 33% women 
in senior management positions by 2020, in 
accordance with best practice as defined in the 
Hampton Alexander Report. Currently just over 
a quarter of senior management roles are held 
by women, in line with the FTSE100 average 
as defined by the 2017 Hampton Alexander 
Review. We are also committed to ensuring that 
our performance management and associated 
rewards are equitable and free from any 
unconscious gender bias. The UK government 
has introduced a requirement that all employers 
publish their gender pay ratio in the UK by 4 April 
2018, which we will do on our website.

We recruit, employ and promote employees 
on the sole basis of the qualifications and 
abilities needed for the work to be performed. 
We do not tolerate discrimination on any 
grounds and provide equal opportunity based 
on merit. We do not use any form of forced, 
compulsory or child labour. We support the 
Universal Declaration of Human Rights of 
the United Nations. This means we respect 
the human rights, dignity and privacy of 
the individual and the right of employees to 
freedom of association, freedom of expression 
and the right to be heard. As a global medical 
technology business, Smith & Nephew 
recognises that we have a responsibility to 
take a robust approach to preventing slavery 
and human trafficking. Smith & Nephew is 
committed to preventing slavery and human 
trafficking in its corporate activities, and its 
supply chains. Our full policy on preventing 
slavery is available on our website. 

WE DO THE RIGHT THING EVEN 
WHEN NO ONE IS WATCHING
All employees receive our Code of Conduct 
and Business Principles when they join 
the Company, and renew their training and 
commitment to the Code on an annual basis.

Smith & Nephew’s Global Compliance 
Programme not only helps our businesses 
comply with laws and regulations, but 
also creates the culture of trust we deem 
essential to our success. Our comprehensive 
programme includes: Board and executive 
oversight committees; global policies and 
procedures; on-boarding and annual training 
for employees and managers; training for 
third-party sellers; monitoring and auditing 
processes; and reporting channels and 
recognition for demonstrating our values. 
Annual training is required of all employees 
and any stakeholders who represent 
Smith & Nephew.

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WE CARE ABOUT EACH OTHER’S 
WELLBEING AND THE SUSTAINABILITY 
OF SMITH & NEPHEW
Each of us treats our Company’s resources 
and the world’s natural resources as if they 
were our own, and we take our responsibility 
to our communities seriously. Smith & Nephew 
not only applauds, but also supports the 
donations of employees’ time and resources. 

We encourage all our employees to volunteer 
their time and talents by providing eight 
hours per year paid time for volunteer 
efforts. Many functions structure their team 
building activities around group volunteering 
opportunities such as Make a Wish Foundation 
events and the Helping Hands Project which 
builds prosthetic hands for amputees in third-
world countries. 

Charity efforts are also coordinated across 
entire sites, and beyond. In 2017, Smith 
& Nephew brought together many local 
companies in Hull with a ‘More Together’ 
initiative to raise tens of thousands of pounds 
for local charities. Smith & Nephew was also 
a major sponsor of the Hull City of Culture 
celebrations, with employees contributing to 
and benefiting from the year of activities  
on-site and across the city.

Our social responsibility strategy is to 
materially contribute to the delivery of our 
Company Mission by engaging employees 
to prioritise philanthropic resources and 
efforts on areas that align with our business 
strategy and values. Resources include 
product donations, matching gifts, and 
employee volunteerism. 

We believe selection and management of 
charitable and non-profit organisations and 
activities is best accomplished at the local 
level within the framework of our social 
responsibility strategy. Each location’s Site 
Leadership Council and/or Camaraderie 
Council will design, construct, and operate 
the local programme, including arrangement 
of funding. These Councils build out the local 
social responsibility programme, selecting 
charitable organisations and activities that best 
engage the local employee population and 
underpin our Mission. 

We Innovate.  
We Perform.  
We earn Trust. 
We are Smith & Nephew.

Finally, we look to support our innovations with 
compelling evidence of clinical and economic 
value. The global R&D function includes our 
Clinical, Medical and Scientific Affairs teams, 
led by the Chief Medical Officer. This team 
ensures that, from conception, plans are 
developed to support product launches 
with the evidence increasingly required by 
clinicians, payers and regulators. Our products 
undergo clinical and health economic 
assessments both during their development 
and post-launch.

During 2017 we secured a long-term 
partnership with the University of Hull to 
create one of the world’s largest Wound 
Care Research Clusters with the aim of 
developing scientific insights and innovative 
treatments. This includes the creation of 
eight PhD studentships and a programme 
of collaboration between Smith & Nephew’s 
new Hull R&D centre and the University’s new 
Health Campus, both of which opened in 2017.

We also announced a three-year partnership 
with Imperial College London to develop 
enhanced surgical techniques relating to 
ligament function, biomechanics and soft 
tissue injuries of the knee, including the most 
common injuries of torn menisci and anterior 
cruciate ligament rupture. See page 29.

We also continue to invest in scouting for 
new technologies, identifying complementary 
opportunities in our core and adjacent 
segments. In addition, we invest in 
small companies developing compelling 
technologies in our franchise areas through 
our incubation fund, and provide our expertise 
to help the development process, including 
supporting clinical studies, and typically 
secure preferred access to technology as it 
nears market readiness. 

In 2017, we invested $223 million in R&D, in 
line with our commitment, set out in 2011, to 
maintain our investment level at around 5% of 
revenue. We expect to maintain this proportion 
going forward, but to realise greater benefit 
through our new structure and strategic focus.

RESEARCH &  
DEVELOPMENT (R&D)

$223m

Investment in R&D in 2017

Smith & Nephew has a single global R&D 
function, led by the President of Global R&D, 
reporting directly to the Chief Executive Officer. 
This team strives to increase value created 
by research and development by focusing on 
three imperatives: Disruptive Innovation that 
matters, flawless execution of new product 
development, and compelling evidence of 
clinical and economic value. 

The Portfolio Innovation Board drives our 
innovation strategy and framework. This Board  
identifies and selects only those projects 
that will make a meaningful difference to our 
customers and their patients. This includes 
continuing to invest in incremental innovation 
to improve existing products in a way that 
improves outcomes. It also involves driving 
greater efficiency through innovation, 
potentially reducing our costs of goods. 
For instance, by making instrument sets 
more procedure and patient-specific, we will 
reduce complexity and cost, to the benefit 
of customers and the Company. Finally, by 
seeking more meaningfully disruptive products 
and services, we will harness transformational 
innovation to provide access to new 
technologies to people across the world.

Second, the team challenges itself to execute 
flawlessly. This means developing the right 
product at the right cost and quality, supported 
by clinical evidence, in a timely manner. 
Our R&D experts in the UK, US, Europe, 
China and India have extensive customer 
and sector knowledge, which is augmented 
by ongoing interaction with our marketing 
teams. Strict criteria are applied to ensure 
new products fulfil an unmet clinical need, 
have a strong commercial rationale, and are 
technologically feasible. The R&D function 
works closely with the marketing, clinical, 
regulatory affairs, manufacturing and supply 
chain management teams to ensure we can 
produce new products to clinical, cost and 
time specifications. 

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MANUFACTURING  
& QUALITY

GLOBAL OPERATIONS
Smith & Nephew takes great pride in its 
expertise in manufacturing products to the 
highest quality and ensuring they reach our 
customers in a timely manner. We operate 
manufacturing facilities in a number of 
countries across the globe, and a number of 
central distribution facilities in key geographical 
areas. Products are shipped to individual 
country locations which hold small amounts of 
inventory locally for immediate supply to meet 
customer requirements. 

Manufacturing is a dynamic process and our 
Global Operation leadership team is focused 
on successfully supporting delivery of the 
Group’s strategic priorities by ensuring our 
footprint and expertise is ready to respond 
to geographical growth, new product 
development, greater external regulatory 
scrutiny and the commercial pressure to be 
ever more efficient. 

Quality has always been paramount to  
Smith & Nephew. We have a unified Quality 
Assurance and Regulatory Affairs team 
to ensure consistency across our country 
business units. Requirements of global 
regulatory agencies have become more 
stringent in recent years and we expect 
them to continue to do so. We are continuing 
to expand our portfolio globally through new 
product development and by registering our 
existing products in new markets. In order 
to meet the expectations of regulators and 
support this added complexity we continued 
to invest in our Quality and Regulatory 
expertise in 2017.  

INNOVATING THROUGH PARTNERSHIP

Smith & Nephew is working with Imperial College London  
to develop enhanced surgical techniques relating to ligament  
function, biomechanics and soft tissue injuries of the knee,  
including the most common injuries of torn menisci and anterior 
cruciate ligament rupture. 

“The partnership with Smith & Nephew is 
priceless for our work. It allows a strategic 
attack on the unanswered biomechanical 
issues in knee surgery. Knowing funding is 
secure for three years allows a step-by-step 
‘due diligence’ approach to investigating 
these issues rather than sporadic studies. 
This is the best way to translate from the 
lab to patient care” said Mr Andy Williams, 
Lead Surgical Researcher, Imperial College 
London and Fortius Clinic.

Meniscus repair is one of the greatest 
challenges of Sports Medicine. By  
combining the clinical expertise of Imperial 
College with our pioneering approach to 
new product development we expect to be 
able both to advance surgical techniques 
and accelerate the development of next 
generation products.

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INFORMATION

OUR RESOURCES continued

OUR MANUFACTURING FACILITIES
Our largest manufacturing operation 
is based in Memphis (Tennessee, US). 
The Memphis facilities produce key products 
and instrumentation in our Knee Implant, Hip 
Implant and Trauma franchises. These include 
the JOURNEY II and LEGION knees, the 
ANTHOLOGY Primary Hip System and key 
Trauma products such as the PERI-LOC Plating 
System, REDAPT and TRIGEN Intramedullary 
Nails. In addition to this, Memphis is home to 
the design and manufacturing process of the 
VISIONAIRE patient matched instrumentation 
sets, and OXINIUM™ Oxidised Zirconium. 
This patented metal alloy is available for many 
of our knee and hip implant systems as part of 
our VERILAST technology. 

In Sports Medicine, our Alajuela (Costa 
Rica) facility, opened in 2016, manufactures 
COBLATION technology. Our Mansfield 
(Massachusetts, US) facility manufactures 
products for minimally invasive surgery 
including the FAST FIX 360 Meniscal 
Repair System, FOOTPRINT™ PK Suture 
Anchor, DYONICS Platinum Shaver Blades, 
ENDOBUTTON CL Ultra and the HEALICOIL PK 
suture anchor.

The Aarau (Switzerland), Tuttlingen (Germany), 
Beijing (China) and Devrukh (India) facilities 
manufacture a number of surgical device 
products including key reconstruction and 
trauma products and the PLUS™ knee and hip 
range. The Warwick (UK) facility produces the 
BIRMINGHAM™ Hip Resurfacing System.

Our Oklahoma City (Oklahoma, US) facility 
produces and services electro/mechanical 
capital equipment as well as single use 
sterile devices and also assembles some of 
our NPWT devices using components from 
third parties. 

The majority of our wound management 
products are manufactured at our facilities 
in Hull, Suzhou and Curaçao. These include 
pioneering products such as PICO and 
ALLEVYN Life as well as our complex silver 
coating technology for ACTICOAT. In Suzhou, 
we also manufacture our wound care products 
for the mid-tier in the Emerging Markets. 
Manufacturing of our Advanced Wound 
Bioactive products takes place in Curaçao and 
at various third party facilities in the US. 

PROCUREMENT
We procure raw materials, components, 
finished products and packaging materials 
from suppliers in various countries. 
These purchases include metal forgings and 
castings for orthopaedic products, optical 
and electronic sub-components for sports 
medicine products, active ingredients and 
semi-finished goods for Advanced Wound 
Management as well as packaging materials 
across all product ranges.

Suppliers are selected, and standardised 
contracts negotiated, by a centralised 
procurement team wherever possible, with a 
view to ensuring value for money based on the 
total spend across the Group. On an ongoing 
basis, we work closely with our key suppliers 
to ensure high quality, delivery performance 
and continuity of supply.

We outsource certain parts of our 
manufacturing processes where necessary to 
obtain specialised expertise or to lower cost 
without undue risk to our intellectual property. 
Suppliers of outsourced products and services 
are selected based on their ability to deliver 
products and services to our specification, 
and adhere to and maintain an appropriate 
quality system. Our specialist teams work 
with and monitor suppliers through on-site 
assessments and performance audits to 
ensure the required levels of quality, service 
and delivery.

GLOBAL SUPPLY CHAIN
Our Global Supply Chain function ensures 
that our products reach our internal and 
external customers where and when they 
are needed, in a compliant and efficient 
manner. Bringing together people, knowledge 
and expertise helps us meet our objectives 
and our customers’ expectations, driving 
us to become more competitive, responsive 
and integrated. 

We operate three main holding warehouses 
for surgical products, one in each of 
Memphis, Baar (Switzerland) and Singapore. 
These facilities consolidate and ship to 
local country and distributor facilities. 
Our distribution hubs for advanced wound 
products are located in Neunkirchen 
(Germany), Derby (UK) and Lawrenceville 
(Georgia, US).

SALES &  
MARKETING

Our customers are the providers of medical 
and surgical treatments and services in 
over 100 countries worldwide, ranging from 
orthopaedic surgeons to wound care nurses, 
general practitioners and other clinicians, 
but increasingly also economic stakeholders. 
These include purchasing professionals 
in hospitals, healthcare insurers, materials 
managers and others. 

We serve these customers through our 
sales force and other channels. Our sales 
representatives are highly trained and skilled 
individuals. Becoming a sales representative 
requires intense training, including passing a 
strict certification programme. Depending on 
their area of specialism, representatives in 
our surgical businesses must be able to 
demonstrate a detailed knowledge of all 
the surgical instruments used to implant a 
device, or have specific understanding of the 
various surgical techniques a customer might 
use. In our advanced wound management 
business, sales representatives must have 
a detailed understanding of how patients 
live with wounds and how clinicians seek 
to prevent and treat them, as well as deep 
knowledge of the clinical and economic 
benefits of using our products within 
treatment protocols. 

Once a sales representative is certified, 
they typically spend the majority of their 
time working directly with and supporting 
customers, or identifying and contacting new 
customers. They help to provide in-hospital 
support to aid in the safe and effective use of 
our range of advanced medical technologies 
and techniques. 

Our Global Commercial Organisation oversees 
all commercial activities (sales, marketing, 
market access, and commercial strategy) 
across the Group for our full line of business. 
The organisation is led by two regional sales 
presidents for the US and International, and 
our Chief Marketing Officer (CMO). Within our 
International region there are several regional 
leaders for Europe & Canada, Asia Pacific and 
Latin America.

Our sales forces in the Established Markets 
are specialised by channel and consist of 
a mixture of independent contract workers 
and employees. In our Emerging Markets we 
operate through direct selling and marketing 
operations led by country managing directors, 
and through third party sellers.

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OUR RESOURCES continued

Smith & Nephew has three global marketing 
teams who set the strategic direction of 
our businesses, guide our research & 
development teams by specifying new 
products & services needed to realise those 
strategies, and develop the promotional assets 
and guidance to commercialise our products. 
They utilise a variety of traditional and novel 
means to market to our customers, including 
scientific congresses, commercial trade 
shows, advertising in medical journals and, 
increasingly, digital channels. These include 
product websites, social media channels, 
mobile applications and our professional 
educational platform called Education & 
Evidence.

Also reporting to our CMO is the global 
Commercial Excellence team, which drives 
numerous initiatives to strengthen commercial 
execution in both the sales organisation and 
our global marketing teams. There is a strong 
focus on Sales Force Excellence to increase 
efficiency and effectiveness of our sales 
teams, and on Pricing to increase discipline 
in our transactional pricing and define better 
value creation strategies for our innovative 
products. Other activities in Commercial 
Excellence include strategic planning, business 
intelligence and market research, digital 
marketing, and marketing communications.

In addition, our Health Economics and 
Outcomes Research (HEOR) team generates 
evidence on the economic impact of our 
products and provides supporting assets 
and tools to commercialise our products. 
They do this through collaboration with leading 
medical centres in the world as well as existing 
registries that track usage of our products. 
The HEOR team also reports to our CMO.

A DAY  IN THE LIFE…

Mustafa works as a Territory Manager in  
our Sports Medicine franchise in the UK. 

“Every day is different. My time is split 
between supporting customers and 
their operating theatre teams in hospitals, 
meeting with potential customers, learning 
and researching techniques and trends, 
and keeping in touch with my colleagues, 
the business and my existing customers.

“My favourite part of the job is the 
interactions I have with my customers. 
I believe that we sell solutions rather 
than products, so everything I do is about 

helping my customers to find answers to  
the problems they face, to enable better 
outcomes for their patients. 

“We’re very lucky in the UK to be able to offer 
an excellent training facility to the surgeons 
we support. It’s a great feeling to be able to 
support a consultant to refine their surgical 
techniques. I’m also a mentor providing 
expertise and guidance on our Resection 
and Camera products to my colleagues in 
the UK.”

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ETHICS &  
COMPLIANCE

CODE OF CONDUCT AND 
BUSINESS PRINCIPLES
Smith & Nephew earns trust with customers, 
healthcare professionals, government 
authorities, patients and the public by acting 
in an honest and fair manner in all aspects 
of its operations. 

We expect the same from those with whom 
we do business, including vendors who 
provide us with services and distributors and 
independent agents that sell our products. 
Our Code of Conduct and Business Principles 
governs the way we operate to achieve 
these objectives.

Smith & Nephew takes into account ethical, 
social, environmental, legal and financial 
considerations as part of its operating 
methods. We have a robust whistle-blowing 
system in all jurisdictions in which we operate. 
We are committed to upholding our promise 
in our Code of Conduct that we will not 
retaliate against anyone who makes a report 
in good faith. 

GLOBAL COMPLIANCE PROGRAMME: 
EXISTING ELEMENTS
Smith & Nephew has implemented what we 
believe to be a world-class Global Compliance 
Programme that helps our businesses comply 
with laws and regulations. This comprehensive 
compliance programme includes: Board and 
executive oversight committees; global policies 
and procedures; on-boarding and annual 
training for employees and managers; training 
for distributors and agents and higher-risk 
vendors; monitoring and auditing processes; 
reporting channels and employee-recognition 
for demonstrating our values in their 
everyday work.

We provide resources and tools to guide 
employees to make decisions that comply with 
the law, local industry codes and our Company 
Code of Conduct. We conduct review and 
approval in advance for significant interactions 
with healthcare professionals or government 
officials. We regularly assess existing and 
emerging risks in the countries in which 
we operate. 

We assess the compliance controls in 
Smith & Nephew’s businesses. We conduct 
audits, supported by data analytics, and local 
monitoring. We review the issues our testing 
generates to identify patterns. 

New distributors and other higher-risk 
third parties are subject to screening and 
are contractually obligated to comply with 
applicable laws and our Code of Conduct. 
Compliance training and certifications are 
included in this process.

Managing Directors are required to complete 
an annual certification to the Chief Executive 
Officer to confirm the implementation of 
required policies. Managers and employees 
make an annual compliance certification 
and conflict of interest disclosure. 
Executive management, managers and 
employees have a compliance performance 
objective customised to their role. 

GLOBAL COMPLIANCE PROGRAMME: 
NEW ELEMENTS IN 2017
In 2017, we created an Ethical Leadership 
model, which includes four pillars: Advise, 
Lead, Observe, and Coach or Report. 
We introduced this model during annual 
manager training, reinforced the model  
through further communications, and gave 
managers resources they can use to raise 
awareness of compliance risks and rules. 

We benchmarked our whistle-blower 
programme against industry metrics. 
The benchmarking confirmed that all 
Smith & Nephew reporting and substantiation 
rates met industry practices. We conducted  
a comprehensive review of the guidelines 
recently issued by the US Department of  
Justice on compliance programme effectiveness 
and by the International Organisation of 
Standards on Anti-Bribery Management 
Systems, and are also identifying any actions 
needed to align to this new guidance.

We applied enhanced standards prospectively 
for new, potential partners and retrospectively 
for existing distributors. We also developed 
new guidelines for distributors or agents 
who need to enter the operating room 
when acting on our behalf. We worked 
with our Procurement colleagues to integrate 
compliance controls into the Company’s 
new purchasing system. We also conducted 
a comprehensive review of the types 
of complementary workers we engage to 
ensure they receive appropriate anti-bribery 
and corruption compliance training and 
will implement an updated training strategy 
in 2018.

TRAINING &  
EDUCATION

Smith & Nephew is dedicated to helping 
healthcare professionals improve the quality 
of care for patients. We are proud to support 
the development of surgeons and nurses by 
providing skills training and education on our 
products and techniques.

In February 2017, we inaugurated our ‘Expert 
Connect Centre’ in the UK. This new centre 
for HCP training is a state-of-the-art learning 
environment with the latest audio-visual 
capabilities and 14-station bio-skills laboratory 
for all levels of HCPs from around the globe. 
In 2017, we provided more than 45,000 
instances of training to surgeons through our 
Smith & Nephew training centres in the US, UK 
and China, as well as running many courses at 
third party centres around the world. 

Working under expert guidance, attendees 
learn new techniques and refine skills, 
to ensure the safe and effective use of 
our products. 

These courses are attended by residents, 
fellows and practicing surgeons who work 
together to review, discuss and train on current 
and forward-looking surgical techniques in 
their areas of clinical expertise. Our courses 
help up-and-coming surgeons develop trust 
and gain the experience and confidence 
necessary to become experts in their field.

Thousands of nurses receive face-to-face 
training from Smith & Nephew representatives 
every year, including attending courses at 
our centres, and through our representatives 
visiting them at their place of work. 
In 2017 almost 45,000 clinicians in the 
US alone benefited from our wound care 
educational resources. 

In addition, we provide healthcare 
professionals our online resources such 
as the Global Wound Academy, The Wound 
Institute and, for surgeons, our Education 
and Evidence website. Recently we began 
utilising innovative, digital technologies 
to accelerate the learning experience of 
surgeons. In 2017 we doubled the number 
of healthcare professionals trained digitally 
on Smith & Nephew products and techniques 
to 180,000.

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SUSTAINABILITY
SUSTAINABILITY IS BETTER BUSINESS

SUSTAINABILITY 
VISION AND MISSION
We envision a world in which 
healthcare professionals have 
access to the solutions they 
need to help patients restore 
their health, engage in society, 
enhance the environment 
and improve their wellbeing.

Our sustainability strategy aims to achieve 
this vision. It outlines the steps we’ll take 
with a view to leading our industry in the 
development and use of products and 
services that:

 – Satisfy unmet health needs and 

promote greater access to treatment;

 – Offer easier, better, faster and more 

effective treatment, enabling productive 
engagement in society;

 – Prioritise materials that are reused, 

remanufactured, or recycled;

 – Are manufactured using raw materials 
sourced from an environmentally and 
socially sound supply chain;

 – Use natural resources efficiently;

 – Are manufactured by processes that 
are not hazardous to people or the 
environment; and

 – Implement the most sustainable 

product options.

Our plan focuses on both the 
foundational and competitive advantage 
elements required to deliver our value 
proposition sustainably. We employ a 
continuous improvement approach based 
upon the implementation of forward-
looking solutions (such as investing 
in new materials and processes that 
provide significant benefits with respect 
to human rights, safety, energy, waste 
and/or communities) and bridging 
technologies to secure future game-
changing performance.

TAKING SUSTAINABILITY TO 
THE CORE OF THE BUSINESS
We began to deliver in 2017 our commitment 
to sustainability embodied in our refreshed 
Group Sustainability Strategy. This strategy, 
approved in 2016, both drives and is driven 
by implementation of the Group Business 
Strategy, ensuring that all three main aspects 
of sustainability – economic prosperity, social 
responsibility and environmental stewardship 
– advance as one.

This is a summary report of our sustainability 
activities and progress in 2017. Our annual 
Sustainability Report, published at the 
same time as this Annual Report, describes 
the Group Sustainability Strategy and its 
associated goals in more detail. It also 
specifies targets to move our performance 
towards these goals, and provides further 
information regarding our 2017 progress.  
It is available on our website.

GROUP SUSTAINABILITY STRATEGY
Smith & Nephew has been and remains 
committed to working in a sustainable, 
ethical and responsible manner everywhere 
we do business. We are proud of our 
achievements over many years, as witnessed 
by our recurring inclusion in leading indices 
such as FTSE4Good and the Dow Jones 
Sustainability Index.

Sustainability is a journey, and in 2016 
we thought deeply about our destination 
for the longer-term. The result was a new 
Group Sustainability Strategy. At the heart 
of this are ten long-term aspirational goals. 
These encompass all aspects of our business, 
and will inform and drive our business strategy 
for years to come. The Board has endorsed 
these and executive management is behind 
them. These goals are set out overleaf.

The Board has evaluated the social and 
environmental risks as part of their ongoing 
risk management duties and has concluded 
that none of these risks are material in the 
context of the Group as a whole.

Longer term goals need medium-term SMART 
(specific, measurable, achievable, realistic 
and timebound) targets to ensure we are 
making the right progress. And we have taken 
such targets through 2020. These targets 
are discussed in more detail in the 2017 
Sustainability Report which is available on 
our website.

2017 was a year in which our refreshed 
sustainability strategy was put into action. 
We delivered improvements across our 
traditional areas of focus: employee health 
and safety, carbon emissions and water 
consumption. In addition, we began to get 
a fuller understanding of our impacts in 
the areas of material efficiency, life cycle 
environmental impacts, and labour practices.  
We adopted a social responsibility strategy 
which will drive employee engagement and 
improve the communities in which we operate. 

EMPLOYEE SAFETY, WELLNESS 
AND VOLUNTEERING
A healthy and safe working environment is 
fundamental to the way we work at Smith & 
Nephew. We must ensure that the safety of 
our employees and those who work with us 
is given the highest priority when we perform 
our daily activities in our offices around the 
world, when we visit customers and in our 
manufacturing environment.

Engagement with the communities in which 
we operate continued to broaden and deepen 
through the active attention of site leadership, 
establishment and empowerment of local 
camaraderie councils, broader application 
of company-paid volunteering allowance, 
and increase in the company match for 
employee donations to charity. We continue 
to strengthen and deepen employee wellness 
programmes with a focus on enabling healthy 
lifestyle choices.

SOCIAL RESPONSIBILITY 
STRATEGY IMPLEMENTATION
In 2017, we developed and adopted a social 
responsibility strategy aimed at improving 
the alignment of our charitable donation, 
volunteering, wellness and professional 
development with both our Group Business 
Strategy and the needs and desires of our 
employees. The aim is to positively impact both 
employee engagement and the quality of life 
in communities in which we operate. We have 
improved our understanding of compliance to 
labour standards in our value chain, product 
and service attributes which are important to 
customers and our employees’ view of the role 
of the organisation in society. In 2018, we will 
use these and other social success factors, 
informed by our Group Business Strategy 
as well as our Company values, to deploy a 
series of platforms and actions which advance 
our cause. 

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SUSTAINABILITY continued
OUR PERFORMANCE IN 2017

Our 10 long-term aspirational goals

2020 targets

Progress since 2016 

1 Zero work-related injuries and illnesses across 

the value chain.

2 Water: Total water impacts of our products and 
solutions are balanced with local human and 
ecosystem needs.

3 Waste: All materials are either shipped as part 
of product or returned for beneficial use.

 – 10% reduction in Total Injury Rate (TIR) from 

 – In 2016 the TIR = 0.52, in 2017 TIR = 0.35 (33% lower).

2016 actual.

 – Water footprint (1) available for products 
accounting for 75% of revenue and  
(2) considerations embedded in new  
product development process.

 – Total potable water consumption at S&N  

sites no higher than 2016 actual.

 – Total material efficiency estimated for 

products accounting for 75% of revenue
 – 80% or more of waste generated reused, 

recycled or recovered.

 – Products accounting for 75% of revenue identified. 

Water footprint tools identified. 

 – Work plan under development, will be approved and 

commenced in 2018.
 – Water reduction of 10%.

 – Products accounting for 75% of revenue identified. 

Material efficiency tools identified. 

 – Work plan under development, will be approved and 

commenced in 2018.

 – We currently reuse, recycle or recover energy from 

77% of our total waste, up from 74% in 2016.

4 Carbon: 80% absolute reduction in total life 
cycle greenhouse gas emissions by 2050.

5 Ethical Business Practices: All activities are 
conducted in compliance with applicable 
International Labour Organization (ILO) 
conventions, involve no environmental 
degradation, and are free from corruption.

6 Zero Product-related and service-related 

patient injuries.

 – Estimate total life cycle greenhouse gas 

 – Products accounting for 75% of revenue identified. 

emissions of products accounting for 75% 
of revenue.

Total lifecycle greenhouse gas emissions 
tools identified. 

 – Total Scope 1 & 2 greenhouse gas emissions 

 – Work plan under development, will be approved and 

reduced by 10% from 2016 actual.

commenced in 2018.

 – In 2017 the reduction is 7%.

 – Labour practices throughout the supply 

chain associated with products accounting 
for 75% of revenue compliant with applicable 
ILO conventions.

 – Products accounting for 75% of revenue identified. 
Gap assessment to applicable ILO conventions 
completed for internal operations. Engagement with 
upstream suppliers and downstream distributors and 
agents ramping up.

 – Robust system in place to detect, record, 
investigate and eliminate root cause 
of product-related and service-related 
patient injuries.

 – Systems are in place to detect, record and investigate 
patient injury incidents. Patterns in the data are being 
used to craft models which will allow identification of 
at-risk attributes.

7 Robust social responsibility programmes that 
contribute to the attraction and retention of 
top talent.

 – Social responsibility strategy which aligns 
philanthropy, employee volunteering and 
wellness to the business strategy in place.

 – Social responsibility strategy in place. Alignment  
of current initiatives to the strategy under way.

8 Products and services are aligned to market 

economic, social and environmental 
expectations and anticipate future market 
conditions:
–   All products have identified and clearly-

described sustainability attributes.

–   R&D and NPD processes deliver 

environmental-, social-, and healthcare 
economically-advantaged innovations.

 – Sustainability attributes described for 

products accounting for 75% of revenue 
Robust emphasis on sustainability attributes 
of new products/services in place.

 – Products accounting for 75% of revenue identified. 
Product/service sustainability attributes agreed. 
 – New product development (NPD) sustainability focus 

planning under way.

9 Strategic risks and opportunities are 

understood and business activities are aligned 
to risk appetite.

 – Enterprise risk management arrangements 
are embedded in the routine business 
decision-making process.

 – Risk register reinvigorated. Deep dive programme 

instituted with focus on both assurance that all relevant 
risks have been identified and effectiveness of 
mitigating actions is accurately assessed. 
 – Actions to further embed into the business  

decision-making process are planned for 2018.

10 Environmental, social, and economic impacts 
of (1) potential acquisitions, (2) technologies to 
be extended to Emerging Markets, (3) innovative 
business models, (4) cost-of-quality reduction 
initiatives, and (5) manufacturing siting, 
functional optimisation and site utilisation 
alternatives are fully understood and 
appropriately balanced.

 – Formal programmes in place to measure/

 – Launched our Enterprise Risk Management Policy 

assess the economic, social and 
environmental impacts of (1) potential 
acquisitions, (2) technologies to be extended 
to Emerging Markets, (3) innovative 
business models, (4) cost-of-quality 
reduction initiatives, and (5) manufacturing 
siting, functional optimisation and site 
utilisation alternatives.

and Manual.

 – Trained our risk champions in risk identification 

and mitigation.

 – Introduced a product focused approach to 

risk management.

 – Conducted a number of ‘deep dives’ into several 

key risks.

 – Tools and standards to address new technologies are 
being developed to support our NPD work above. 

These targets are discussed in more detail in our 2017 Sustainability Report which is available on our website.

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SUSTAINABILITY continued

CO2e REPORTING 

CO2e emissions (tonnes) from:
Direct emissions
Indirect emissions
Total
Intensity ratio
CO2e (t) per $m sales revenue
CO2e (t) per full-time employee

GETTING SERIOUS 
ABOUT SOLAR

2017

2016

2015

9,451
76,107
85,558

17.8
5.2

9,822
82,415
92,237

19.6
5.9

11,011
77,191
88,202

19.2
6.0

Revenue: 2017: $4.8bn; 2016: $4.7bn; 2015: $4.6bn. 
Full-time employee data: 2017: 16,333; 2016: 15,584; 2015: 14,686.

Notes
2015 data adjusted to exclude acquisitions in Russia and Colombia.
2017 data includes all data, including acquisitions since 2016.

CO2e reporting methodology, materiality and scope. 

We report the carbon footprint of our Scope 
1 and 2 greenhouse gas (GHG) emissions in 
tonnes of CO2 equivalent from our business 
operations for the calendar year ended 
31 December 2017. Our focus is on the areas 
of largest environmental impact including 
manufacturing sites, warehouses, R&D sites 
and offices. Smaller locations representing 
less than 2% of our overall emissions are 
not included. Acquisitions completed 
before 2017 are included in the data, with 
more recent ones being excluded and this 
is in line with our established policy for 
integration of acquired assets. Each year we 
work with an independent partner to verify 
our sustainability data and gain assurance.

Our GHG emissions reporting represents 
our core business operations and 
facilities which fall within the scope of 
our consolidated financial statements. 
Primary data from energy suppliers has 
been used wherever possible.

We report our emissions in two ‘scopes’.

Scope 1 figures include: Direct sources of 
emissions mainly comprise the fuels we use 
on-site, such as gas and heating oil and 
fugitive emissions arising mainly from the 
losses of refrigerant gases.

Scope 2 figures include: Indirect sources of 
emissions such as purchased electricity and 
steam we use at our sites.

Location-based emissions are calculated 
in compliance with the WRI/WBCSD 
GHG Protocol Corporate Accounting 
and Reporting Standard and have been 
calculated using carbon conversion factors 
published by BEIS/DEFRA for 2017. We have 
applied the emission factors most relevant 
to the source data, including DEFRA 2017 
(for UK locations), IEA 2015 (for overseas 
locations) and for the US we have used the 
US EPA ‘Emissions & Generation Resource 
Integrated Database’ (eGrid) for the regions 
in which we operate. All other emission 
factors for gas, oil, steam and fugitive 
emissions are taken from DEFRA, 2017.

In line with our aspiration to 
reduce carbon emissions, we 
are investing in more efficient 
energy solutions, such as 
solar power. 

Devrukh, India 
At our Devrukh site in India, we are 
running one of our largest renewable 
energy projects. 

By installing the 426 kVA roof top solar 
panel system, we aim to produce enough 
energy to provide the site with free power 
for 25 years, whilst reducing carbon 
emissions by up to 44% per annum. 
We are already achieving a cost saving 
of 44% per year and expect a return on 
investment in less than five years.

The 1,330 solar panels will also enable 
us to reduce the inside temperature of 
the manufacturing floor by five to ten 
degrees celsius, creating a safer and 
more pleasant working environment for 
our employees. 

Suzhou, China
In April 2017, we installed 24 sets of solar 
water heater units on the roof of one of 
our buildings in Suzhou. The system can 
produce around 12 tonnes of 55˚C hot 
water every day for the site’s hot water 
system and will save 291 tonnes of steam 
every year. 

SMITH & NEPHEW ANNUAL REPORT 2017  
 
 
 
 
36

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

CHIEF FINANCIAL OFFICER’S REVIEW

BUILDING A MORE 
COMPETITIVE 

BUSINESS

I am excited by the prospects for 2018 
and beyond as we realise the opportunities 
in front of us. 

DEAR SHAREHOLDER
I am delighted to address you for the first time in 
the Annual Report as your Chief Financial Officer. 

Under Olivier’s leadership, Smith & Nephew 
has made significant organisational changes 
to create a strong global business. I believe 
that we are just starting to see the benefits 
of these changes, and I am excited by the 
prospects for 2018 and beyond as we realise 
the opportunities in front of us. I am very 
much looking forward to working with Olivier 
and, in due course, his successor, to make 
this happen.

2017 PERFORMANCE
Group revenue in 2017 was $4,765 million, 
an increase of 2% on a reported basis and 
3% on an underlying basis1. This was an 
improvement from underlying growth of 2% 
in 2016. Trading profit1 was $1,048 million, and 
the trading profit margin1 was 22.0%, up 20bps 
on 2016. I am pleased to report that both 
our underlying revenue growth and trading 
profit margin improvements were in-line with 
our guidance. 

The reported operating profit for 2017 was 
$934 million, up from $801 million in 2016, with 
the year-on-year increase primarily reflecting 
a gain of $54 million from the settlement of an 
intellectual property matter, no restructuring 
charges and lower amortisation and 
impairment of acquisition intangibles in 2017.

The tax rate on trading results1 was 17.1% 
(2016: 23.8%). This is a considerable  
reduction on the 2016 rate and is mainly due  
to a one-off benefit following the conclusion  
of a US tax audit, further progress in improving 
our tax rate, tax provision releases following 
expiry of statute of limitations and a beneficial 
geographical mix of profits. The reported 
tax rate of 12.7% was a result of the lower 
tax rate on trading results and also included 
a $32 million net benefit from US tax reform.

Adjusted earnings per share1 (EPSA) was up 
14% at 94.5¢ as a result, and this is reflected 
in the 14% increase in our full year dividend 
distribution for 2017. Basic earnings per share 
(EPS) was 87.8¢ in line with the previous year.

FINANCIAL 
REVIEW

SMITH & NEPHEW ANNUAL REPORT 2017 37

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

CHIEF FINANCIAL OFFICER’S REVIEW continued

FINANCIAL HIGHLIGHTS

$4,765m
Revenue
+3%
+2%
Underlying1
Reported

87.8¢ 
Earnings per share EPS

0%

94.5¢ 
Adjusted earnings per share (EPSA)1

+14%

1  These non-IFRS financial measures are explained and 
reconciled to the most directly comparable financial 
measure prepared in accordance with IFRS  
on pages 178–181.

APEX is expected to deliver an annualised 
benefit of $160 million by 2022, with at least 
half of this expected by 2020, for a one-off 
cash cost of up to $240 million.

SUCCESSFUL ACQUISITION 
During the year, we continued to seek further 
opportunities to strengthen our technology 
and product portfolio. In December we 
acquired Rotation Medical, Inc., the developer 
of a novel tissue regeneration technology 
for shoulder rotator cuff repair, for an initial 
cash consideration of $125 million and up to 
a further $85 million over the next five years, 
contingent on financial performance. I am 
excited by the potential for this new technology 
and we remain alert to further opportunities 
to bring other disruptive innovations into 
the Group.

OUTLOOK
We expect the overall dynamics in our markets 
to be similar in 2018 to those seen in 2017. 
Against this backdrop, the Group expects to 
continue to deliver an improved performance 
in 2018 driven by our by our strong product 
portfolio and pipeline of innovative products.

In terms of revenue, we expect our underlying 
growth to be in the range of 3% to 4% (which 
equates to 7% to 8% in reported terms at 
exchange rates prevailing on 2 February 2018). 
In terms of trading profit margin we expect to 
drive a further 30-70bps improvement over 
2017. As a result of the recently enacted US tax 
reform, we expect a tax rate on trading results 
in the range 20% to 21%, barring any changes 
to tax legislation or other one-off items.

In 2018, we will continue to push for further 
success as we build a more competitive 
Smith & Nephew. I look forward to helping to 
drive this, and to delivering on our commitments 
for the benefit of all of our stakeholders.

Yours sincerely,

Graham Baker
Chief Financial Officer

I am pleased to report that trading cash flow1 
was $940 million, up from $765 million in 2016, 
with a higher trading profit to cash conversion 
ratio1 of 90% as we improved our working 
capital management.

As the result of improved operating profit, the 
lower tax rate and a stable asset base we saw 
an improvement in Return On Invested Capital1 
(ROIC – as defined on page 39) from 11.5% in 
2016 to 14.3% in 2017. 

CAPITAL RETURNS
The appropriate use of capital on behalf 
of shareholders is important to Smith & 
Nephew. The Board believes in maintaining 
an efficient, but prudent, capital structure, 
while retaining the flexibility to make value-
enhancing acquisitions. 

This approach is set out in our Capital 
Allocation Framework which we used to 
prioritise the use of cash and ensure an 
appropriate capital structure. 

Our commitment, in order of priority, is to:

 – Continue to invest in the business to drive 

organic growth; 

 – Maintain our progressive dividend policy; 

 – Realise acquisitions in-line with strategy; and 

 – Return any excess capital to shareholders.

This is underpinned by maintaining leverage 
ratios commensurate with solid investment 
grade credit metrics.

IMPROVING COMPETITIVENESS
On joining Smith & Nephew I was asked 
by Olivier and the Board to look afresh at 
efficiency opportunities within our business. 
Some preliminary analysis highlighted a 
number of areas of opportunity, and we 
conducted a detailed assessment of these 
during the final months of 2017. 

Our conclusion was that we now have the 
Group structure in place which lets us act on 
these further opportunities. Through better 
execution and efficiency we can and will 
strengthen our competitive position. 

We are calling this work the APEX programme, 
standing for ‘Accelerating Performance and 
Execution’, and we completed our planning 
and started to take action in early 2018. 
Our three workstreams are focused on 
clear and obtainable improvements in the 
Group’s manufacturing, warehousing and 
distribution footprint, reducing our general and 
administrative expenses, and driving greater 
commercial effectiveness. More details on 
APEX and each of these workstreams can be 
found on page 14.

SMITH & NEPHEW ANNUAL REPORT 2017 38

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

FINANCIAL REVIEW
DELIVERING ON OUR COMMITMENTS

GROUP PERFORMANCE

HIGHLIGHTS FOR THE YEAR ENDED 31 DECEMBER

Consolidated income statement
Revenue
Operating profit
Trading profit1
Profit before tax
Attributable profit
EPS
EPSA1
Consolidated balance sheet
Goodwill and intangible assets
Other non-current assets
Current assets
Total assets
Total equity
Non-current liabilities
Current liabilities
Total liabilities
Total liabilities and equity
Net debt1
Consolidated cash flow statement
Cash flows from operating activities 
Trading cash flow1
Free cash flow1

2017
$ million

2016
$ million

Change
$ million

4,765
934
1,048
879
767
87.8¢
94.5¢

3,742
1,393
2,731
7,866
4,644
1,876
1,346
3,222
7,866
1,281

1,273
940
714

4,669
801
1,020
1,062
784
88.1¢
82.6¢

3,599
1,216
2,529
7,344
3,958
2,038
1,348
3,386
7,344
1,550

1,035
765
457

96
133
28
(183)
(17)
(0.3¢)
11.9¢

143
177
202
522
686
(162)
(2)
(164)
522
(269)

238
175
257

NON-IFRS MEASURES
The underlying increase in revenues, by market, reconciles to reported growth, the most directly 
comparable financial measure calculated in accordance with International Financial Reporting 
Standards (IFRS), as follows:

2017 
$ million

2016 
$ million

Reported 
growth 
%

Underlying 
growth 
%

Acquisitions/ 
Disposals 
%

Currency 
impact 
%

Reconciling items

US
Other Established Markets
Emerging Markets
Total

2,306
1,678
781
4,765

2,299
1,679
691
4,669

0%
0%
13%
2%

2%
0%
12%
3%

(2%)
0%
0%
(1%)

0%
0%
1%
0%

Trading profit reconciles to operating profit, the most directly comparable financial measure 
calculated in accordance with IFRS, as follows:

Operating profit
Acquisition-related costs
Restructuring and rationalisation costs
Amortisation and impairment of acquisition 
intangibles
Legal and other
Trading profit

2017 
$ million

934
(10)
–

140
(16)
1,048

2017 
%

19.6%
(0.2%)
–

2.9%
(0.3%)
22.0%

2016 
$ million

801
9
62

178
(30)
1,020

2016 
%

17.2%
0.2%
1.3%

3.8%
(0.7%)
21.8%

RESULTS OF OPERATIONS
In 2017, we delivered reported revenue 
growth of 2% and underlying revenue growth1 
of 3%. Revenue growth on a reported basis 
was flat across our US and other Established 
Markets, with a strong performance in Japan 
driven by Sports Medicine and Knee Implants 
counterbalanced by a soft wound care market 
in the UK where we have now taken steps to 
adapt our business in response. 

In our Emerging Markets reported revenue 
growth was 13% and underlying growth1 was 
12% in 2017. In China, our largest Emerging 
Markets country, we delivered double-digit 
revenue growth as we improved our channel 
management. In the oil-dependent Gulf 
States we returned to growth by focusing on 
securing more private healthcare business to 
compensate for the reduction in government 
tenders. We are well positioned to continue to 
drive strong growth from the Emerging Markets 
over the medium term. 

Operating profit of $934 million (2016: 
$801 million) is after integration and acquisition 
costs, as well as amortisation and impairment 
of acquisition intangibles and legal and other 
items. The year-on-year increase in operating 
profit primarily reflects a gain of $54 million 
from the settlement of an intellectual property 
matter, no restructuring charges and lower 
amortisation and impairment of acquisition 
intangibles in 2017. The sale of the rights 
to distribute certain non-core products 
contributed $19m to operating profit in 2017.  
In 2016 similar product disposals along with 
provision releases from favourable legal matter 
outcomes contributed $18m.

Trading profit1 was $1,048 million (2016: 
$1,020 million). Trading profit margin1 was 
22.0%, up 20bps year-on-year, in line 
with guidance.

In 2017, selling, general and administrative 
expenses included a $10 million credit 
relating to acquisition-related costs (2016: 
$9 million charge), $16 million credit for 
legal and other costs primarily related to 
the settlement of patent litigation (2016: 
$30 million credit for legal and other primarily 
related to a $44 million curtailment credit 
related on UK post-retirement benefits) and 
$140 million charge for amortisation and 
impairment of acquisition intangibles (2016: 
$178 million charge).

Research and development expenditure 
as a percentage of revenue remained 
broadly consistent at 4.7% (2016: 4.9%) with 
expenditure of $223 million in 2017 compared 
to $230 million in 2016.

SMITH & NEPHEW ANNUAL REPORT 2017 39

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

FINANCIAL REVIEW continued

Profit before tax in 2016 includes the 
$326 million profit on disposal of the 
Gynaecology business. 

The Group has completed its review of the 
new US tax reform legislation, as enacted in 
December 2017, including the reduction of the 
US federal tax rate from 35% to 21%, which 
came into effect on 1 January 2018. As a result, 
the Group expects a positive impact on its 
tax charge for future years in addition to 
the one-off tax benefit in 2017 as discussed 
below. Parts of the new legislation are subject 
to questions of interpretation, and further 
regulations may be issued in the future to 
clarify or change certain elements, which  
may affect future tax charges. 

Included in the total tax charge is a $32 million 
net benefit as a result of US tax reform 
legislation which comprises a benefit from 
a revaluation of deferred tax balances included 
within changes in tax rates, partially offset by 
a current tax charge relating to the deemed 
repatriation of foreign profits not previously 
taxed in the US.  

Our reported tax rate of 12.7% (2016: 26.2%) 
has decreased due to the $32 million net 
benefit in 2017 from US tax reform, the lower 
tax rate on trading results and the impact of 
the Gynaecology disposal in 2016. Our trading 
tax rate1 is 17.1% (2016: 23.8%) with the 
reduction due to a one-off benefit following the 
conclusion of a US tax audit, further progress 
in improving our tax rate, tax provision releases 
following expiry of statute of limitations and 
a beneficial geographical mix of profits.

BALANCE SHEET
Goodwill increased by $183 million as a result 
of $132 million arising on the acquisition of 
Rotation Medical, Inc. and favourable currency 
movements of $51 million. Intangible assets 
decreased by $40 million with net movements 
relating to additions, disposals and transfers 
of $70 million relating to intellectual property, 
distribution rights and software acquired 
together with $61 million recognised with 
the acquisition of Rotation Medical, Inc. 
Amortisation and impairment during 2017 
was $202 million and there were favourable 
currency movements of $31 million.

Other non-current assets increased by 
$177 million primarily due to a $67 million 
increase in property, plant and equipment 
with additions offsetting depreciation, and 
the recognition of retirement benefit assets 
of $62 million for our UK and US pension 
schemes. Current assets increased by 
$202 million with trade and other receivables 
increasing $73 million primarily due to 

$45 million of foreign exchange, inventories 
increasing $60 million primarily due to foreign 
exchange and cash increasing $69 million due 
to the timing of receipts. 

Non-current liabilities decreased by 
$162 million primarily due to payments 
made against our borrowing facilities. 
Current liabilities decreased by $2 million 
as a $73 million increase in trade and other 
payables arising from a $37 million foreign 
exchange increase and a $28 million timing 
difference on the payment of expenses 
associated with a patent litigation gain, which 
was partially offset by a $59 million decrease 
in bank overdrafts and loans and $18 million 
decrease in provisions. 

CASH FLOW
Cash generated from operations of 
$1,273 million (2016: $1,035 million) is after 
paying out $3 million (2016: $24 million) of 
acquisition-related costs, $15 million (2016: 
$62 million) of restructuring and rationalisation 
expenses and $25 million (2016: $36 million) 
relating to legal and other costs. 

Trading cash flow1 increased by $175 million 
primarily related to working capital movements.

Free cash flow1 increased by $257 million 
primarily related to working capital movements 
and lower cash outflows for acquisition-
related costs, restructuring and rationalisation 
expenses and legal and other costs. 

During the year ended 31 December 2017, 
the Group purchased a total of 3.2 million 
(2016: 24.0 million) ordinary shares at a cost 
of $52 million (2016: $368 million) as part of the 
ongoing programme to buy back an equivalent 
number of shares to those vesting as part 
of the employee share plans. 2016 share 
repurchases included a $300 million share 
buy-back programme following the disposal 
of the Gynaecology business.

DIVIDENDS
The 2016 final dividend of 18.5 US cents per 
ordinary share totalling $162 million was paid 
on 10 May 2017. The 2017 interim dividend 
of 12.3 US cents per ordinary share totalling 
$107 million was paid on 1 November 2017.

LIQUIDITY AND CAPITAL RESOURCES
The Group’s policy is to ensure that it has 
sufficient funding and facilities in place to meet 
foreseeable borrowing requirements.

The Group’s net debt decreased from 
$1,550 million at the beginning of 2017 to 
$1,281 million at the end of 2017, representing 
an overall decrease of $269 million.

At 31 December 2017, the Group held 
$155 million (2016: $38 million) in cash net of 
bank overdrafts. The Group had committed 
facilities available of $2,425 million at 
31 December 2017 of which $1,425 million was 
drawn. Smith & Nephew intends to repay the 
$13 million of bank loans due within one year 
by using available cash and drawing down on 
the longer-term facilities.

The principal variations in the Group’s 
borrowing requirements result from the 
timing of dividend payments, acquisitions 
and disposals of businesses, timing of capital 
expenditure and working capital fluctuations. 
Smith & Nephew believes that its capital 
expenditure needs and its working capital 
funding for 2017, as well as its other known 
or expected commitments or liabilities, can be 
met from its existing resources and facilities. 

The Group’s planned future contributions 
are considered adequate to cover the current 
underfunded position in the Group’s defined 
benefit plans.

RETURN ON INVESTED CAPITAL 
Return On Invested Capital1 (ROIC) is 
a measure of the return generated on 
capital invested by the Group. It provides 
a metric for long-term value creation and 
encourages compounding reinvestment 
within the business and discipline around 
acquisitions with low returns and long 
payback. ROIC increased from 11.5% in 2016 
to 14.3% in 2017 as a result of the improved 
operating profit, the lower tax rate and a stable 
asset base. 

ROIC is defined as: 

Net Operating Profit less Adjusted Taxes
(Opening Net Operating Assets +  
Closing Net Operating Assets)/2

14.3%  +280bps

Return On Invested Capital1 (ROIC)

WHY THIS KPI IS IMPORTANT
ROIC measures the return generated on 
capital invested by the Group. 

HOW WE PERFORMED 
ROIC was up 280bps year-on-year driven 
by improved operating profit, the lower tax 
rate and a stable asset base.

1  These non-IFRS financial measures are explained and reconciled to the most directly comparable financial measure prepared in accordance with IFRS on pages 178–181.

SMITH & NEPHEW ANNUAL REPORT 2017  
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OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RISK REPORT
OUR APPROACH TO RISK

OUR RISK MANAGEMENT PROCESS
Our Enterprise Risk Management process is based on a holistic approach to risk management, leveraging the best risk identification and risk 
treatments already in place throughout our Business Areas and Product Groups whilst incorporating the same risk processes into the strategic 
planning process. Our belief is that the strategic and operational benefits of managing risk are achieved when Enterprise Risk Management is 
aligned with the strategic and operational goals of the organisation and our process and governance structure firmly aligns to this approach.

In carrying out our business we face many risks and uncertainties and our Risk Management Policy and Enterprise Risk Management Manual 
ensure that our Risk Community can identify, review and report risks at every level of our business. At the very top of our structure is our Board, 
setting our risk appetite and monitoring the application of our risk framework through strategy, execution and practically through the outputs of 
regular risk ‘deep dives’ by the business and Group Risk Team. The Board cascades our risk appetite throughout our organisation through the Risk 
Committee, Risk Owner Community and our Management Group with a formal ‘bottom up’ process ensuring that risks are escalated back through 
the process to our Board and form our Principal Risks as appropriate. Providing rigour and independence across this process is our Executive 
Committee and the Group Risk Team. At the third line of defence is our Internal Audit Function, providing an annual opinion on the effectiveness 
of our Risk Management process to the Group Risk Committee chaired by the Chief Executive Officer and then to the Board and its committees.

Roles

Responsibilities

 – Responsible for regular oversight of risk management and for our annual 

strategic risk review

 – Monitors risks through Board processes (Strategy Review, Disclosures, M&A, 
Investments, Disposals) and Committees (Audit and Ethics & Compliance), 
management reports and deep dives of selected risk areas

 – Audit Committee is responsible for ensuring oversight of the process by which 
risks relating to the Company and its operations are managed and for viewing 
the operating effectiveness of the Group’s Risk Management process

 – Reviews external/internal environment for emerging risks

 – Reviews risk register updates from Business Areas

 – Identifies significant risks and assesses effectiveness of mitigating actions

 – Business Area/Product Group Risk champion provides support to ensure 

a framework is designed and implemented for alignment to the requirements 
of the Enterprise Risk Management Framework 

 – Carry out day-to-day risk management activities

 – Identify and assess risk 

 – Implement strategy and mitigating actions to treat risk within Business/

Product Risk Groups

 – Risk Champions lead regular risk register updates

 – Manage implementation of all aspects of the Group’s approach to Enterprise 
Risk Management including implementation of processes, tools and systems 
to identify, assess, measure, manage, monitor and report risks

 – Facilitates implementation and coordination through Risk Champions

 – Provides resources and training to support process

 – Prepares Board and Group Risk Committee reports based on Business Area 

and Product Group updates

Board  
of Directors and 
Board Committees

 Group  
Risk Committee

Business area/  
Product Risk Groups

Group Risk Team

Annual assessment of effectiveness –  
Internal audit and control functions

RISK

SMITH & NEPHEW ANNUAL REPORT 2017 41

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RISK REPORT continued

RISK MANAGEMENT LIFE CYCLE – OUR SEVEN-STEP PROCESS
Our risk management life cycle was refreshed and updated in 2017 to align with our new approach to include Product Groups within our risk 
portfolio. Our Risk Management Policy was launched in May with sponsorship from the Chief Executive Officer and a revised manual aligning to the 
new structure was launched shortly after. Risks continue to be managed through a ‘bottom up’ and ‘top down’ process, with monthly oversight from 
the Executive Committee and quarterly reports to the Board Committees. An overview of our ‘seven step’ process can be found below:

An overview of the Risk Management and Reporting Process

1

Risk  
Identification

IDENTIFYING risks associated  
to achievement of our objectives  
by function and product and  
at the Group level. Early and 
continuous risk identification 
including existing and 
horizon risks. 

2

Gross (inherent)  
Risk assessment

ASSESSING the level of  
inherent (gross) risk.

3 

Current Control 
identification

IDENTIFYING existing controls  
to mitigate risks. 

7

Monitoring  
and review 

MONITORING of risks and actions 
by management, the accountable 
Executive and Board. Coordinated and 
ongoing monitoring of the internal and 
external risk environment  
to respond to emerging and 
horizon risks. 

6 

Risk  
Reporting

REPORTING the status of  
our most significant risks through the 
‘bottom up’ business area processes 
and the ‘top down’ Executive 
Committee and Board process. 
Demonstrating appropriate 
management of, and response  
to, our risk profile.

5

Risk Response 
Planning

IDENTIFYING additional actions 
required to meet our expected risk 
tolerance level and ASSIGNING 
risk owners, timeframes and 
actions for ongoing management 
and reporting. 

4

Net (residual) Risk

ASSESSING the level of residual 
(net) risk after mitigation so that 
risk levels are managed within 
defined tolerance thresholds without 
being over controlled or foregoing 
desirable opportunities. 

SMITH & NEPHEW ANNUAL REPORT 2017 42

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

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REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RISK REPORT continued
2017 PRINCIPAL RISKS

We assess our Principal Risks in terms of their potential impact on our ability to deliver our Strategic Priorities. These links are highlighted across  
the following pages and further information on the Strategic Priorities is found on page 10. 

LEGAL AND COMPLIANCE RISKS 

Our global remit results in heavy regulation across multiple jurisdictions. There is increasing public scrutiny of ethics in business and ‘doing the 
right thing’ has become part of our licence to operate. National regulatory authorities enforce a complex pattern of laws and regulations that 
govern the design, development, approval, manufacture, labelling, marketing and sale of healthcare products.

Operating across this increasingly complex and dynamic legal and compliance environment, including regulations on bribery and corruption, 
with poor legal and compliance practices can lead to fines, penalties, reputational risk and competitive disadvantage. We have adopted 
a proactive, holistic approach, which guides the Company towards a culture of compliance and turns the resolution of legal and compliance 
issues into a source of competitive advantage.

Risk Tolerance
In complying with legal and compliance requirements,  
we have an extremely low tolerance.

Change from 2016

 No Change

Link to strategy
Compliance with applicable laws and regulations and 
doing the right thing is part of our licence to operate and 
underlies all our Strategic Priorities.

Oversight
Ethics & Compliance Committee

Examples of risks
 – Failure to act in an ethical manner consistent with our  

Actions taken by management
 – Ethics & Compliance Committee oversees our ethical and compliance practices.

Code of Conduct.

 – All employees are required to undertake annual training and to certify compliance 

 – Violation of anti-corruption or healthcare laws, breach by 

on an annual basis with our Code of Conduct and Business Principles.

STRATEGIC PRIORITIES PAGE 10

employee or third party representative.

 – Failure to respond adequately to changes in legislation/

regulation.

 – Misuse or loss of personal information of patients, employees, 

research subjects, consumers or customers results in 
violations of data privacy laws, including General Data 
Protection Regulations.

CYBER SECURITY

 – Group monitoring and auditing programmes in place.

 – Confidential independent reporting channels for employees and third parties 

to report concerns.

High profile incidents coupled with increasing government focus has resulted in raised awareness of the extent and potential impact of cyber 
security breaches. Our increasing business dependence on networked systems and the Internet, the design of new products, connectable 
products and embedded software and the rapidly evolving cyber security threat landscape provides us with risk exposure not experienced 
in prior years. In response to this we have undertaken an exercise to understand our threats and vulnerabilities to target cyber security 
investment in the right places. 

Risk Tolerance
In managing our cyber risk and the possible disruption and 
reputational impact we have a low to moderate tolerance for 
Cyber Security Risk.

Change from 2016

Included as ‘other risk’ in 2016

Link to strategy
Given our strategic priority ‘Innovate for value’ and an 
increasing focus on connected products we must deliver 
our technology solutions in compliance with laws and 
regulations and in a way that protects any vulnerability 
to Cyber Risk.

Oversight
Audit Committee

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Loss of Intellectual Property/major data privacy breach or 
significant impact on business operations from Malware 
or Ransomware outbreak.

 – Cyber Security is not considered in the design of new 

products with more products being connectable/having 
embedded software.

Actions taken by management
 – Security information and event management (SIEM) in place providing real-time analysis 

of security alerts generated by applications and network hardware.

 – Annual Penetration Testing, endpoint protection and Intrusion detection/prevention.

 – Annual Mandatory training and continuous awareness training for end-users.

 – Security Governance structure in place including a Cyber Security Steering Committee.

SMITH & NEPHEW ANNUAL REPORT 2017  
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FINANCIAL  
REVIEW

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GROUP AND OTHER 
INFORMATION

RISK REPORT continued

NEW PRODUCT INNOVATION, DESIGN & DEVELOPMENT INCLUDING INTELLECTUAL PROPERTY 

Our product portfolio is becoming increasingly complex, especially as we move to more innovative connected product technologies and our 
strategy of ‘owning the disease’. Our success relies on investing in safe products and platforms and aligned internal and external design and 
development innovation in order to compete effectively. The need to be nimble and considered in our approach to protecting our products, 
process and Intellectual Property is essential.

Risk Tolerance
In pursuit of our strategy to be innovative but safe in our 
product offering we have a moderate to high tolerance 
for risk.

Link to strategy
Our Strategic Priority to ‘Innovate for Value’ depends 
heavily on our ability to continue to develop new innovative 
products and bring them to market.

Oversight
Board

Change from 2016

No Change

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Insufficient long-term planning to respond to competitor 

disruptive entries into marketspace.

 – Inadequate innovation due to low R&D investment, R&D skills 

Actions taken by management
 – Newly created Global Research & Development (R&D) organisation and governance 
framework providing strategic direction for allocation of R&D investments across 
all businesses. 

gap or poor product development execution.

 – R&D charter to transform our Innovation pipeline and drive our corporate strategy to Innovate 

 – Lower value business segment investment, such as product 

for Value.

maintenance and line extension projects.

 – Strengthened Clinical Affairs programme integrated with Global Marketing. 

 – Competitors may assert patents or other intellectual property 
rights against the Company, or fail to respect the Company’s 
intellectual property rights.

 – Cross functional New Product Design and R&D processes focused on identifying new 

products and potentially disruptive technologies and solutions.

 – Monitoring of external market trends and collation of customer insights to develop 

product strategies.

 – Careful attention to intellectual property considerations.

QUALITY AND REGULATORY 

Global regulatory bodies continue to increase their expectations on manufacturers and distributors of medical devices. Our products are 
implanted into human bodies and therefore Patient Safety is of paramount importance. The European Medical Device Regulations, launch 
of ISO13485-2016, the Medical Device Single Audit Programme and the tightening of the Chinese YY standards have increased the focus on 
clinical and technical evidence, supplier controls and continual product risk reduction.

Risk Tolerance
Our response to this risk continues to be critical and our ability 
to align and exceed the standards required to ensure safe and 
compliant products is the key driver for our extremely low 
tolerance for risk in this area.

Link to strategy
Our Strategic Priority to ‘Simplify and Improve our Business 
Model’ requires us to operate effectively and efficiently and 
to produce compliant products of the highest quality to 
our customers.

Oversight
Board Ethics & 
Compliance Committee

Change from 2016

Modified Principal Risk in 2017 – formerly included as 
Operational Risk – Quality and Business Continuity

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Defects in design or manufacturing of products supplied to, 
and sold by, the Company could lead to product recalls or 
product removal or result in loss of life or major injury.

 – Significant non-compliance with policy, regulations or 

standards governing products and operations regarding 
registration, manufacturing, distribution, sales or marketing.

 – Failure to obtain proper approvals for new or changed 

technologies, products or processes.

Actions taken by management
 – Comprehensive product quality processes and controls from design to customer supply 

are in place.

 – Careful attention to intellectual property considerations.

 – Standardised monitoring and compliance with quality management practices through our 

Global Quality Assurance and Regulatory Affairs organisation.

 – Incident management teams in place to respond immediately in the event of an incident 

relating to patient safety.

 – Governance framework in place for reporting, investigating and responding to instances  

of product safety and complaints.

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PRICING AND REIMBURSEMENT  

Our success depends on our ability to sell our products profitably in spite of increasing pricing pressures from customers, and governments 
providing adequate funding to meet increasing demands arising from demographic trends. The prices we charge are therefore impacted by 
budgetary constraints and our ability to persuade customers and governments of the economic value of our products, based on clinical data, 
cost, patient outcomes and comparative effectiveness. 

We further face challenging market dynamics, such as consolidation of customers into buying groups, increasing professionalisation of 
procurement departments and the commoditisation of entire product groups, which continue to challenge prices.

Risk Tolerance
In implementing innovative pricing strategies, we have a 
moderate to high tolerance for risk and are willing to accept 
certain risks in pursuit of new business opportunities.

Change from 2016

No Change

Link to strategy
Our Strategic Priorities to ‘Build a Strong Position in 
Established Markets’ and to ‘Focus on Emerging Markets’ 
depends on our ability to sell our products profitably in 
spite of increased pricing pressures from governments.

Oversight
Board

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Reduced reimbursement levels and increasing 

pricing pressures.

Actions taken by management
 – Development of innovative economic product and service solutions for both Established and 

Emerging Markets.

 – Systemic challenge on number of elective procedures.

 – Appropriate breadth of portfolio and geographic spread to mitigate exposure to localised risks.

 – Lack of compelling health economics data to support 

 – Incorporating health economic components into the design and development of new products. 

reimbursement requests.

 – Risk of adverse trading margins due to fluctuating foreign 
currency exchange rates across our main manufacturing 
countries (US, UK, Costa Rica and China) and where our 
products are sold.

BUSINESS CONTINUITY AND BUSINESS CHANGE 

 – Emphasising value propositions tailored to specific stakeholders and geographies through 

strategic investment and marketing programmes.

 – Holding prices within acceptable ranges through global pricing corridors.

Operating with a Global Remit, increased outsourcing and more sophisticated materials and product technology has made our manufacturing 
and supply chain process far more complex, leading to a greater potential for disruptive events. Ensuring our ability to continually execute and 
operate key sites and facilities in order to develop, manufacture and sell our products within this environment is a key strategic priority of the 
organisation. In addition, the pace and scope of our business ‘change’ initiatives increases the execution risk that benefits may not be fully 
realised, costs of these changes may increase, or that our business as usual activities may not perform in line with our plans.

Risk Tolerance
In operating our business, executing our change programmes 
and in managing our suppliers and facilities we have a  
low to medium tolerance for this risk.

Change from 2016

Modified Principal Risk in 2017 – formerly included as 
Operational Risk – Quality and Business Continuity

Link to strategy
Our Strategic Priority to ‘Simplify and Improve our Business 
Model’ requires us to operate effectively and efficiently and 
to ensure continuity of supply of products and services 
to customers.

Oversight
Board

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Failure or significant performance issues experienced at 

Actions taken by management
 – Comprehensive product quality processes and controls are in place from design to 

critical/single source facilities.

customer supply.

 · Disruption to manufacturing at single or sole source facility 

 – Emergency and incident management and business recovery plans are in place at major 

(lack of manufacturing redundancy).

facilities and for key products and key suppliers.

 · Supplier failure impacts ability to meet customer demand 

 – Second source suppliers identified for critical components or products.

(single source suppliers).

 · Natural disaster impacts ability to meet customer demand.

 – Significant ‘change’ prevents our projects and programmes 
such as APEX achieving the intended benefits and disrupts 
existing business activities.

 – Undertaking risk based review programmes for critical suppliers.

 – Project Management Governance and toolkits and project Steering Committee Oversight to 
support successful execution of programme and projects. Executive Committee and Audit 
Committee oversight of Risks to change programmes. 

 – Brexit Steering Group regularly monitors the evolving impact of Brexit and oversees 

 – Political and economic ‘uncertainty’ in the countries in  

our response.

which we operate, e.g. Brexit.

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MERGERS AND ACQUISITIONS 

As the Company grows to meet the needs of our customers and patients, we recognise that we are not able to develop all the products and 
services required using internal resources and therefore need to undertake mergers and acquisitions in order to expand our offering and to 
complement our existing business. In other areas, we may divest businesses which are no longer core to our activities. It is crucial for our 
long-term success that we make the right choices around acquisitions and divestments. We have a well-defined cross-functional process for 
managing risks associated with mergers and acquisitions that is subject to scrutiny from executive management and the Board of Directors.

Risk Tolerance
In acquiring new businesses and business models, we have 
a moderate to high tolerance for commercial risk and are 
willing to accept certain risks in pursuit of new business. 

Change from 2016

No Change

Link to strategy
Our Strategic Priority to ‘Supplement Organic Growth with 
Acquisitions’ depends on our ability to identify the right 
acquisitions, to conduct thorough due diligence and to 
integrate acquisitions effectively.

Oversight
Board

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Failure to identify appropriate acquisitions or to conduct 

Actions taken by management
 – Acquisition activity is aligned with corporate strategy and prioritised towards products, 

effective acquisition due diligence.

franchises and markets identified to have the greatest long-term potential.

 – Failure to integrate newly acquired businesses 

 – Clearly defined investment appraisal process based on return on capital, in accordance with 

effectively, including Company standards, policies and 
financial controls.

Capital Allocation Framework and comprehensive post-acquisition review programme.

 – Undertaking detailed and comprehensive cross-functional due diligence prior to acquisitions.

 – Compliance risks included as part of due diligence reviews, integration plans and reporting 

for acquisitions.

TALENT MANAGEMENT

We recognise that people management, effective succession planning and the ability to attract and retain talent is of great importance to the 
success of our Company. In the current economic environment of strong competition and reduced spending, retention of top talent is a critical 
risk which requires a strong process in relation to retention and engagement. Failure to do so can result in risks in our ability to execute 
Company strategy and achieve business objectives in relevant functions and to be effective in the chosen market/discipline and leadership 
of newer workforce which may impact the Company’s future success.

Risk Tolerance
We have a moderate tolerance for this risk.

Change from 2016

Included as ‘other risk’ in 2016

Link to strategy
All our strategic priorities rely on ensuring we have the 
right talent within our organisation to deliver maximum 
efficiency in everything we do and to build strong leaders 
for the future.

Oversight
Board

STRATEGIC PRIORITIES PAGE 10

Examples of risks
 – Loss of key talent and lack of appropriate succession 
planning in context of required skill sets for future 
business needs.

Actions taken by management
 –  Formal Talent Review process where the Executive Team has accountability for 

managing talent.

 –  Identification of high performing individuals and practices to plan for the succession 

 – Loss of competitive advantage due to an inability to attract 

of key roles. 

and retain Top Talent. 

 – Loss of intellectual capital due to poor retention of talent.

 – Consistent and robust performance Management process.

 – Development of strategic skills resourcing plan by functional areas.

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COMMERCIAL EXECUTION

We continue to make good and strong progress delivering our priorities and are proud of the pace with which our strategic and operational 
decisions are quickly translated into actions. Effective communication and engagement with our customers are critical to the long-term success 
of our business. We are confident that we have the right priorities, structures and capabilities across the Group and we acknowledge that only 
strong and continued execution will keep us ahead of our competitors and best placed to serve our customers. Failure to execute our priorities 
will impact our ability to continue to grow our business and serve our customers.

Risk Tolerance
In continuing to execute our priorities in an innovative, safe, 
profitable and compliant way we have a low to moderate 
tolerance level. 

Link to strategy
All Strategic Priorities

Change from 2016

Modified Principal Risk in 2017 – 
previously incorporated into other principal risks 

STRATEGIC PRIORITIES PAGE 10

Oversight
Board

Examples of risks
 – Failure to adequately execute our strategy from high-level 
ambition to specific actions to make the ambition a reality.
 – Inability to keep pace with significant product innovation and 

Actions taken by management
 –  Strengthened our commercial platform by creating a global commercial organisation with 
a remit to drive commercial performance across the Group through sales force excellence 
and pricing discipline.

technical advances to develop commercially  
viable products.

 – Failure to appropriately adapt our priorities and execution 
when conditions change meaning that transformational 
programmes do not deliver the expected outcomes.
 – Failure to engage effectively with our key stakeholders to 
meet their evolving needs leading to loss of customers.

 –  Newly created Global Research & Development organisation and supporting 

governance framework. 

 – Improved Market Development and Launch Execution – Commitment to ‘win’ profitably 

in our target markets.

 – Strategic planning process clearly linked to business and Group Risk.
 – Global transformational programmes in place providing agile opportunities 

for efficiencies, growth and a strengthened competitive position.

DEEP DIVES COMPLETED IN THE YEAR (Group Risk Team/Board and Audit Committee Reviews)
During the year, the risks identified through the ‘bottom up’ and ‘top down’ processes were mapped against each other with the most significant 
risks forming our Principal Risks. These risks and our tolerance levels were discussed with each member of Executive Committee separately and 
collectively in August and were presented to the Board during the Strategy Review in September 2017. A further ‘bottom up’ exercise was carried 
out in November to validate that the risk profile had not significantly changed since the initial exercise in June. No changes were required to our risk 
profile as a result of this exercise, which was also formally validated by each Accountable Executive. 

Throughout 2017, a number of different risk topics were presented to the Board and its Committee and specific ‘Deep Dive’ reviews were also 
completed by the Group Risk Team as follows.

Board and Audit Committee Deep Dives

Legal, Compliance and Quality 
During the year the Ethics & Compliance Committee meetings considers 
papers from the quality and regulatory, legal and compliance teams. In 2017, 
the meetings have covered topics including preparation for General Data 
Protection Regulation (GDPR) in EU, Medical Device Regulations (MDR), FDA 
& Notified Body Inspection Activities, the Global Quality and Compliance 
Audit programme, Transactions with Compliance Risks and the outcome of 
significant Investigations. 

Strategic: Research and Development and M&A
The Board has considered a report from the R&D team covering topics/risks in 
relation to execution, driving high value Innovation Projects and investment in 
Clinical Evidence and associated strategies to manage these risks. Each Board 
meeting considers Corporate Development. For 2017, this has focused on the 
lead up to, and our acquisition of, Rotation Medical. Retrospective reviews 
have also happened during the year on previous acquisitions compared to the 
expectations in the deal models.

Manufacturing Operations 
Throughout the year, the Board has received presentations from the global 
operations team with oversight of operational matters, particularly relating to the 
manufacturing footprint and the risks associated with the current footprint and 
the proposals to mitigate these risks. 

Functional Oversight 
The Board and Audit Committee receive regular updates throughout the year 
from functions such as IT, Tax, Treasury and Financial operations. The Audit 
Committee also receives an update three times during the year on progress of 
risk management across the organisation. 

IT/Cyber 
The Audit Committee received reports on IT and Cyber security, including an 
assessment of the existing risks and benchmarking against industry standards.

HR
Annual discussion at the Board in relation to talent succession, culture 
and values. 

Group Risk Team Deep Dives

A series of planned ‘Deep Dives’ have been completed in the year across 
our Business and Product Group Risk Areas, including PICO, Total Knees and 
ALLEVYN product Groups, Compliance and Europe/Canada Business Areas. 
These reviews have been newly introduced in 2017 to supplement reports 
provided to the Board and primarily cover an ‘independent’ assessment of 
compliance to the expected Risk Management Framework and in particular the 
adequacy of stated mitigating activities. The results are reported through the 
Risk Champions and Accountable Executives to the Audit Committee and are 
tracked and monitored to resolution by the Group Risk Team.

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2018 RISK MANAGEMENT PLAN 
Our work will continue in 2018 to evolve and strengthen our approach to managing risks across the organisation, including our business areas 
and product groups. We will continue to ensure a truly collaborative approach to risk management with risk accountability sitting squarely with 
management and a proactive Group Risk Function influencing decision making through effective challenge and timely consultation. 2018 will 
see innovation further driven through a new Global Enterprise Risk Management tool, more regular and sophisticated risk reporting across the 
organisation and further embedding Risk Appetite into decision making.

2018 RISK MANAGEMENT TIMELINE

Q1 2018 
Internal Audit 

Deep dive risk reviews

Group Risk Team

 – Refresh Enterprise Risk 
management Policy 
and process

 – Monthly reports to 

Executive Committee

Q2 2018 

Q3 2018 

Q4 2018 

Q1 2019 

 – 2019 Risk Based Internal 
Audit Plan Preparation

 – Risk Management 

Effectiveness Review report 
to the next Audit Committee

 – Risk Champion/
Owner training

 – Facilitate ‘top down’ 
review process

 – Prepare 2019 Enterprise 

Risk Management Strategy

 – Report to Audit Committee

 – One to Ones with Executive 

 – Monthly reports to 

Committee and Board

 – Prepare Review of 
Principal Risks

Executive Committee

 – Monthly reports to 

 – Report to Audit Committee

Executive Committee

Business/Product Risk Areas

 – Quarterly Risk Review by 
Senior Leadership Team

 – Quarterly Risk Review by 
Senior Leadership Team

 – Quarterly Risk Review by 
Senior Leadership Team

 – Quarterly Risk Review by 
Senior Leadership Team

 – Risk Register refresh and 
submission to Group 
Risk Team

 – Risk Register refresh and 
submission to Group Risk 
Team annual certification

Executive Committee

Board

Audit Committee

 – ‘Top Down’ Review of 

 – Approve Principal Risks

Principal/Significant Risks

 – Review of significant risks

 – Review and approval 

of the Group’s 2017 Risk 
Management Process and 
Viability Statement

 – Receive report from the 
Group Risk Team and 
review Enterprise Risk 
Management process

 – Receive report from the 
Group Risk Team and 
review Enterprise Risk 
Management process

 – Review and approve 

Principal Risks

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OUR VIABILITY STATEMENT

HOW WE ASSESS OUR PROSPECTS
During the year, the Board has carried out a robust assessment of the 
Principal Risks affecting the Company, particularly those which could 
threaten the business model. These risks and the actions being taken 
to manage or mitigate them are explained in detail on pages 42–46  
of this Annual Report. 

In reaching our Viability Statement conclusion, we have undertaken  
the following process:

 – The Audit Committee reviewed the Risk Management process at 
their meetings in February, April, July and November, receiving 
presentations from the Group Risk function, explaining the processes 
followed by management in identifying and managing risk throughout 
the business.

 – In the summer, a series of detailed one-to-one discussions were held 
with each member of the Executive Committee and the Group Risk 
Team. In these discussions, the Executives were asked to consider 
the significant risks which they believed could seriously impact the 
profitability and future prospects of the Company and the principal 
risks that would threaten its business model, future performance, 
solvency or liquidity.

 – As part of the annual Strategy Review in September, the Board 

considered and discussed the principal risks which could impact 
the business model over the next three years and discussed with 
the management team how these risks were being managed 
and mitigated.

 – Throughout the year, a number of deep dives into different risks 

were conducted by the Board, the Audit Committee and the Ethics & 
Compliance Committee looking into the nature of the risks and how 
they were mitigated, as detailed on page 46 of this Annual Report.

 – Throughout the year, a number of deep dives into specific risk areas 
were conducted by the Group Risk Team, the results of which were 
presented to and discussed by the Audit Committee.

ASSESSMENT PERIOD
The Board have determined that the three-year period to December 
2020 is an appropriate period over which to provide its Viability 
Statement. This period is aligned to the Group’s Strategic Planning 
process and reflects the Board’s best estimate of the future viability  
of the business. 

2017 SCENARIOS MODELLED

Scenario 1 – Pricing

 – Pricing and reimbursement pressures or currency exchange volatility  

(Principal Risk) – leading to a major loss of revenues and profits.  
Action taken: We have modelled a 1% reduction in annual price growth/decline  
for each year from 2018. 

Scenario 2 – Operational risk

 – Execution risk – our inability to launch new products losing significant market  

share to the competition.  
Action taken: We have modelled a 1% reduction in annual volume growth rates  
each year from 2018.

 – Product liability claims – giving rise to significant claims and legal fees. 

Action taken: We have modelled a one-off significant product liability claim in 2019. 

 – Temporary loss of key production capability – resulting in our inability to 

manufacture a key product for a period of time.  
Action taken: We have modelled the loss of a factory, resulting in the loss  
of production and sales of a key product for two years from 2019.

Scenario 3 – Legal regulatory and compliance risks 

 – Regulatory measures – impacting our ability to continue to sell key products. 

Action taken: We have modelled the complete loss of revenue from a key product  
for each year from 2018.

 – Bribery and corruption claims – giving rise to significant fines.  

Action taken: We have assumed a one-off significant fine in 2019. 

Scenario 4 – Cyber security 

 – Inability to issue invoices or collect money for a period of time.  

Action taken: We have modelled one of our key regions being unable to invoice  
sales and collect cash for one month in 2019.

Other 

 – Political and economic forces – for example political upheaval, which could  

cause us to withdraw from a major market for a period of time.  
Action taken: We have modelled the loss of revenue and profits from a medium  
sized business due to withdrawal from a market from 2019.

Link to Strategy

Link to Principal Risks

 – Pricing and  

Reimbursement

 – New Product 

Innovation, Design & 
Development (including 
Intellectual property)

 – Commercial Execution

 – Legal and Compliance

 – Quality and Regulatory

 – Cyber Security

 – Business Continuity 

and Business Change

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SCENARIO TESTING
For the purpose of testing the viability of the Company, we have 
undertaken a robust scenario assessment of the principal risks  
and some other risks, which could threaten the viability or existence 
of the Company. These have been modelled as follows:

In carrying out scenario modelling of the principal and significant risks 
on the previous page we have also evaluated the impact of a severe but 
plausible combination of these risks actually occurring over the three-
year period. We have considered and discussed a report setting out the 
terms of our current financing arrangements and potential capacity for 
additional financing should this be required in the event of one of the 
scenarios modelled occurring.

We are satisfied that we have robust mitigating actions in place as 
detailed on pages 42–46 of this Annual Report. We recognise, however, 
that the long-term viability of the Company could also be impacted by 
other, as yet unforeseen, risks or that the mitigating actions we have put 
in place could turn out to be less effective than intended. 

VIABILITY STATEMENT
Having assessed the principal risks, the Board has determined that 
we have a reasonable expectation that the Company will be able to 
continue in operation and meet its liabilities as they fall due over a 
period of three years from 1 January 2018. In our long-term planning 
we consider horizons of both five and ten years. However, as most of 
our efforts are focused on the coming three years, we have chosen this 
period when considering our viability.

Our conclusion is based on our current Strategic Plan approved by 
the Board in January 2018, having regard to longer-term strategic 
intentions, yet to be formulated in detail. However, we operate in a 
changing marketplace, which might cause us to adapt our Strategic 
Plans. In responding to changing external conditions, we will continue 
to evaluate any additional risks involved which might impact the 
business model.

By order of the Board, on 22 February 2018

Susan Swabey
Company Secretary

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OUR BOARD OF DIRECTORS
A DIVERSE BOARD

ROBERTO QUARTA (68)
Chairman

OLIVIER BOHUON (59)
Chief Executive Officer 

GRAHAM BAKER (49) 
Chief Financial Officer

Joined the Board as Chief Financial Officer on 
1 March 2017 and elected by shareholders on 
6 April 2017.

Career and experience
Graham holds an MA degree in Economics from 
Cambridge University and qualified as a Chartered 
Accountant and Chartered Tax Adviser with Arthur 
Andersen. In 1995, he joined AstraZeneca PLC 
where he worked for 20 years, holding multiple 
senior roles, including Vice President Finance & 
Chief Financial Officer, North America (2008-2010), 
Vice President, Global Financial Services (2010-2013) 
and Vice President, Finance, International (2013-
2015) with responsibility for all emerging markets.  
Most recently, Graham was Chief Financial Officer  
of generic pharmaceuticals company Alvogen.

Skills and competencies
Graham has deep sector knowledge and has had 
extensive exposure to established and emerging 
markets which is extremely relevant to his role at 
Smith & Nephew. He has a strong track record 
of delivering operational excellence and has 
relevant experience across major finance roles 
and geographic markets, leading large teams 
responsible for significant budgets.

Nationality
  British

Joined the Board and was appointed Chief 
Executive Officer in April 2011. Olivier has 
announced his intention to retire by the end 
of 2018. 

Career and experience
Olivier holds a doctorate in Pharmacy from the 
University of Paris and an MBA from HEC, Paris. 
He started his career in Morocco with Roussel 
Uclaf S.A. and then, with the same company, 
held a number of positions in the Middle East 
with increasing levels of responsibility. He joined 
Abbott in Chicago as head of their anti-infective 
franchise with Abbott International before becoming 
Pharmaceutical General Manager in Spain. 
He subsequently joined GlaxoSmithKline plc, rising 
to Senior Vice President & Director for European 
Commercial Operations. He then re-joined Abbott 
as President for Europe, became President of Abbott 
International (all countries outside of the US), and 
then President of their Pharmaceutical Division. 
He joined Smith & Nephew from Pierre Fabre, where 
he was Chief Executive. 

Skills and competencies
Olivier has extensive international healthcare 
leadership experience within a number of significant 
pharmaceutical and healthcare companies. 
His global experience provides the skillset required 
to innovate a FTSE 100 company with a deep 
heritage and provide inspiring leadership. He is 
a NED of Virbac Group and Shire plc, where he is 
also a member of the Remuneration Committee 
and the Nomination & Governance Committee and 
will be appointed Senior Independent Director on 
25 April 2018. 

Nationality
  French

Joined the Board in December 2013 and 
appointed Chairman following election by 
shareholders at the 2014 Annual General 
Meeting. He was also appointed Chairman 
of the Nomination & Governance Committee 
and a Member of the Remuneration Committee 
on that day.

Career and experience
Roberto is a graduate and a former Trustee of the 
College of the Holy Cross, Worcester (MA), US. 
He started his career as a manager trainee at 
David Gessner Ltd, before moving on to Worcester 
Controls Corporation and then BTR plc, where he 
was a divisional Chief Executive. Between 1985 
and 1989 he was Executive VP of Hitchiner 
Manufacturing Co., Inc. He returned to BTR plc in 
1989 as Divisional Chief Executive, where he was 
appointed to the main board. From here he moved 
to BBA Aviation plc, as CEO and then as Chairman, 
until 2007. He has held several board positions, 
including NED of Powergen plc, Equant N.V., BAE 
Systems plc and Foster Wheeler AG. His previous 
Chairmanships include Italtel SpA, Rexel S.A., IMI 
plc and SPIE SA. He is currently Chairman of WPP 
plc. He is a partner at Clayton Dubilier & Rice and 
a former member of the Investment Committee of 
Fondo Strategico Italiano S.p.A. 

Skills and competencies
Roberto’s career in private equity brings valuable 
experience to Smith & Nephew, particularly 
when evaluating acquisitions and new business 
opportunities. He has an in-depth understanding 
of differing global governance requirements having 
served as a director and chairman of a number 
of UK and international companies. Since his 
appointment as Chairman in April 2014, he has 
conducted a comprehensive review into the 
composition of the Board and its Committees, 
and conducted the search for new Non-Executive 
Directors, resulting in the appointment of Vinita 
Bali in 2014, Erik Engstrom and Robin Freestone in 
2015, Angie Risley and Marc Owen during 2017, and 
Roland Diggelmann so far in 2018.

Nationality

  American/Italian

GOVERNANCE

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OUR BOARD OF DIRECTORS continued

VINITA BALI (62) 
Independent Non-Executive Director

IAN BARLOW (66)
Independent Non-Executive Director 

Appointed Independent Non-Executive Director 
in March 2010, Chairman (now Member) of the 
Audit Committee in May 2010, Member of the 
Ethics & Compliance Committee in October 2014 
and Senior Independent Director and Member 
of the Nomination & Governance Committee on 
6 April 2017. 

Career and experience
Ian is a Chartered Accountant with considerable 
financial experience both internationally and in 
the UK. He was a Partner at KPMG, latterly Senior 
Partner, London, until 2008. At KPMG, he was 
Head of UK tax and legal operations. Previously he 
was Chairman of WSP Group plc, and is currently 
NED and Chairman of the Audit Committees of The 
Brunner Investment Trust PLC, Foxtons Group plc 
and Urban&Civic plc.

Skills and competencies
Ian’s longstanding financial and auditing career 
and extensive board experience add value to his 
role as a member of the Audit Committee. As a 
member of the Ethics & Compliance Committee, 
he has managed to co-ordinate an oversight role 
of both Committees. This has been invaluable 
when commencing his role as Senior Independent 
Director with effect from 6 April 2017. Ian’s first 
board evaluation is discussed in the corporate 
governance statement. 

Nationality
  British

Appointed Independent Non-Executive Director in 
December 2014 and Member of the Remuneration 
Committee and Ethics & Compliance Committee.

Career and experience
Vinita holds an MBA from the Jamnalal Bajaj Institute 
of Management Studies, University of Bombay and 
a BA in Economics from the University of Delhi. 
She commenced her career in India with a Tata 
Group Company, and then joined Cadbury India, 
subsequently working with Cadbury Schweppes plc 
in the UK, Nigeria and South Africa. She has held a 
number of senior global positions in marketing and 
general management at The Coca-Cola Company 
based in the US and South America, becoming 
President of the Andean Division in 1999 and VP, 
Corporate Strategy in 2001. In 2003, she joined 
Zyman Group, LLC, a US based consultancy, as 
Managing Principal. Vinita was MD and CEO of 
Britannia Industries Limited, a leading Indian publicly 
listed food company from 2005 to 2014. Currently, 
Vinita is NED of Syngene International Limited,  
Titan Company Ltd, Bunge Limited and CRISIL India 
(a Standard & Poor Company). She is also Chair of 
the board of Global Alliance for Improved Nutrition 
and a member of the Advisory Board of PwC India.

Skills and competencies
Vinita has an impressive track record of achievement 
with blue-chip global corporations in multiple 
geographies including India, Africa, South America, 
US and UK, all key markets for Smith & Nephew. 
Additionally, her strong appreciation of customer 
service and marketing brings deep insight as we 
continue to develop innovative ways to serve our 
markets and grow our business.

Nationality
  Indian

THE RT. HON BARONESS VIRGINIA 
BOTTOMLEY OF NETTLESTONE DL (69)
Independent Non-Executive Director

Appointed Independent Non-Executive Director 
in April 2012 and Member of the Remuneration 
Committee and Nomination & Governance 
Committee in April 2014.

Career and experience
Virginia gained her MSc in Social Administration 
from the London School of Economics following her 
first degree. She was appointed a Life Peer in 2005 
following her career as a Member of Parliament 
between 1984 and 2005. She served successively 
as Secretary of State for Health and then Culture, 
Media and Sport. Virginia was formerly a Director of 
Bupa and AkzoNobel NV. She is currently a Director 
of International Resources Group Limited, member 
of the International Advisory Council of Chugai 
Pharmaceutical Co., Chancellor of University of Hull 
and Sheriff of Hull and Trustee of The Economist 
Newspaper. She is the Chair of Board & CEO 
Practice at Odgers Berndtson.

Skills and competencies
Virginia’s extensive experience within Government, 
particularly as Secretary of State for Health, brings a 
unique insight into the healthcare system both in the 
UK and globally, whilst her experience on the board 
of Bupa brings an understanding of the private 
healthcare sector and an insight into the needs of 
our customers. Her experience running the board 
practice at a search firm gives her a valuable skillset 
as a member of the Nomination & Governance 
Committee and Remuneration Committee. Her long 
association with Hull, the home of many of our UK 
employees, also brings an added perspective.

Nationality
  British

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ERIK ENGSTROM (54)
Independent Non-Executive Director

ROBIN FREESTONE (59)
Independent Non-Executive Director

MICHAEL FRIEDMAN (74)
Independent Non-Executive Director

Appointed Independent Non-Executive  
Director on 1 January 2015 and Member  
of the Audit Committee.

Career and experience
Erik is a graduate of the Stockholm School of 
Economics (BSc) and of the Royal Institute of 
Technology in Stockholm (MSc). In 1988, he 
graduated with an MBA from Harvard Business 
School as a Fulbright Scholar. Erik commenced his 
career at McKinsey & Company and then worked in 
publishing, latterly as President and COO of Random 
House Inc. and as President and CEO of Bantam 
Doubleday Dell, North America. In 2001, he moved 
on to be a partner at General Atlantic Partners, 
a private equity investment firm. Between 2004 
and 2009, he was CEO of Elsevier, the division 
specialising in scientific and medical information 
and then from 2009 CEO of RELX Group.

Skills and competencies
Erik has successfully reshaped RELX Group’s 
business in terms of portfolio and geographies. 
He brings a deep understanding of how technology 
can be used to transform a business and insight into 
the development of new commercial models that 
deliver attractive economics. His experience as a 
CEO of a global company gives him valuable insights 
as a member of our Audit Committee.

Nationality

  Swedish

Appointed Independent Non-Executive Director 
and Member of the Audit Committee and the 
Remuneration Committee on 1 September 
2015 and Chairman of the Audit Committee on 
6 April 2017. 

Career and experience
Robin graduated with a BA in Economics from The 
University of Manchester and later qualified and 
commenced his career as a Chartered Accountant 
at Deloitte. He has held a number of senior financial 
positions throughout his career, including at ICI 
plc, Henkel Ltd and at Amersham plc. Robin was 
the Deputy CFO and then later the CFO of Pearson 
plc between 2006 and August 2015, where he 
was heavily involved with the transformation and 
diversification of Pearson. He was previously NED at 
eChem Ltd, Chairman of the 100 Group and Senior 
Independent Director and Chairman of the Audit 
Committee of Cable & Wireless Communications 
plc. Robin is a NED and Chairman of the Audit 
Committee at Moneysupermarket.com Group plc 
and Michael Kors Holdings Ltd. Robin became Chair 
of the ICAEW Corporate Governance Advisory Group 
in 2017. 

Skills and competencies
Robin has been a well-regarded FTSE 100 CFO 
who has not only been heavily involved with 
transformation and diversification, but also the 
healthcare industry at Amersham, where his 
acquisition experience will be of value to Smith 
& Nephew as it continues to grow globally and in 
different markets. He brings financial expertise 
and insight as Chairman of the Audit Committee 
and an understanding of how to attract and retain 
talent in a global business as a member of the 
Remuneration Committee.

Nationality

  British

Appointed Independent Non-Executive Director 
in April 2013 and Chairman of the Ethics & 
Compliance Committee in August 2014.

Career and experience
Michael graduated with a Bachelor of Arts degree, 
magna cum laude from Tulane University and a 
Doctorate in Medicine from the University of Texas 
Southwestern Medical Center. He completed 
postdoctoral training at Stanford University and the 
National Cancer Institute, and is board certified in 
Internal Medicine and Medical Oncology. In 1983, 
he joined the Division of Cancer Treatment at the 
National Cancer Institute and went on to become 
the Associate Director of the Cancer Therapy 
Evaluation Program. Michael was most recently 
CEO of City of Hope in California, and also served 
as Director of the institution’s cancer centre and 
held the Irell & Manella Cancer Center Director’s 
Distinguished Chair. He was formerly Senior VP of 
research, medical and public policy for Pharmacia 
Corporation and also Deputy Commissioner and 
Acting Commissioner at the US Food and Drug 
Administration (FDA). He has served on a number 
of boards in a non-executive capacity, including 
Rite Aid Corporation. Currently, Michael is a NED of 
Celgene Corporation, MannKind Corporation and 
Intuitive Surgical, Inc.

Skills and competencies
Michael understands the fundamental importance 
of research, which is part of Smith & Nephew’s 
value creation process. His varied experience in 
both the public and private healthcare sectors 
have given him a deep insight and a highly 
respected career. In particular his work with the 
FDA and knowledge relating to US compliance 
provides the skillset required to Chair the Ethics & 
Compliance Committee.

Nationality

  American

JOSEPH PAPA (62)
Independent Non-Executive Director

Appointed Independent Non-Executive 
Director in August 2008 and Chairman of 
the Remuneration Committee in April 2011,  
Member of the Audit Committee and Ethics  
& Compliance Committee. 

Joe will be retiring from the Board at the 
Annual General Meeting on 12 April 2018 
and will not stand for re-election.

Career and experience
Joe graduated with a Bachelor of Science degree 
in Pharmacy from the University of Connecticut 
and MBA from Northwestern University’s Kellogg 
Graduate School of Management. In 2012, he 
received an Honorary Doctor of Science degree from 
the University of Connecticut School of Pharmacy. 
He began his career at Novartis International AG as 
an Assistant Product Manager and eventually rose 
to VP, Marketing, having held senior positions in 
both Switzerland and US. 

He moved on to hold senior positions at Searle 
Pharmaceuticals and was later President & COO 
of DuPont Pharmaceuticals and later Watson 
Pharma, Inc. He was previously Chairman and 
CEO of Cardinal Health, Inc. and Chairman and 
CEO of Perrigo Company plc from 2006 to April 
2016. Joe was appointed Chairman and CEO 
of Valeant Pharmaceuticals International, Inc. 
in May 2016. 

Nationality

  American

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MARC OWEN (58)
Independent Non-Executive Director

ANGIE RISLEY (59)
Independent Non-Executive Director

ROLAND DIGGELMANN (51)
Independent Non-Executive Director

Appointed Independent Non-Executive Director 
and Member of the Audit Committee on 1 October 
2017. To be appointed Member of the Ethics & 
Compliance Committee on 1 March 2018. 

Career and experience
Marc graduated from Oxford University with a 
BA and BCL in Law. In 1984 he was called to the 
Bar, following four years at Corpus Christi College 
Cambridge as a fellow and director of studies in law. 
He decided upon a corporate career and undertook 
an MBA at Stanford University. Marc commenced 
his healthcare and technology career at McKinsey 
& Company where he progressed to senior partner 
and eventually a founding partner of McKinsey’s 
Business Technology Office. In September 2001, 
Marc joined McKesson Corporation and served 
as Executive Vice President and member of the 
Executive Committee. He delivered strategic 
objectives and led over 40 acquisitions and 
divestments over a 10-year period. In late 2011 he 
headed Mckesson Speciality Health, which operates 
over 130 cancer centres across the US and provides 
services including market intelligence, supply 
chain services, patient access to therapy, provider 
and patient engagement and clinical trial support. 
His final executive role came in 2014 where he was 
appointed Chairman of the European Management 
Board at Celesio AG. He retired in March 2017 once 
he had improved operations, set the strategy and 
recruited his successor.

Skills and competencies
Marc is a proven leader with an astute, strategic 
vision, capable of building significant international 
healthcare businesses. He has strong commercial 
healthcare expertise which the Board values deeply 
following the pending retirement of Joseph Papa at 
the 2018 Annual General Meeting. 

Nationality
  British 

Appointed Independent Non-Executive Director 
and Chairman Elect of the Remuneration 
Committee on 18 September 2017. 

Career and experience
After graduating from Exeter University, and 
completing a 1-year personnel management 
programme, Angie joined the United Biscuits 
graduate scheme. After working in various different 
HR roles she joined Pizza Hut (UK) Ltd as Human 
Resources Director, a joint venture between 
PepsiCo and Whitbread plc. After five years she 
joined Whitbread, becoming Executive Director on 
the plc board responsible for HR and Corporate 
Social Responsibility in 2004. Between 2007–2013 
she was the Group HR Director for Lloyds Banking 
Group, joining J Sainsbury plc as Group HR Director 
in January 2013. Over the years, Angie has been 
a member of the Low Pay Commission and has 
held a number of non-executive directorships with 
Biffa plc, Arriva plc and Serco Group plc. She was a 
member of the Remuneration Committees at Arriva 
plc and Biffa plc and Chairman of the Remuneration 
Committee at Serco Group plc. She is also a NED on 
the Sainsbury’s Bank Board. 

Skills and competencies
Angie is a well-regarded FTSE 100 Human 
Resources Director, proven NED and Remuneration 
Committee Chairman. She has gained experience 
in a wide range of sectors, including a regulated 
environment. This diversity of experience is 
welcomed by the Board and the Remuneration 
Committee. Angie is also additional resource 
and sounding board for our own internal Human 
Resources function.

Nationality
  British 

To be appointed Non-Executive Director and 
Member of the Audit Committee on 1 March 2018. 

Careers and experience
Roland studied Business Administration at the 
University of Berne. In 1995, he joined Sulzer AG 
as Manager Strategic Planning and progressed 
into further senior roles over the years until his 
appointment as Executive Vice President, Sales 
Europe and Asia Pacific from 2002 to 2004 for 
Sulzer Medica (later known as Centerpulse). 
Roland joined Zimmer Group in 2004, in the role 
of Managing Director of Zimmer Japan and then 
later in 2006 as Senior Vice President, EMEA until 
2008. Roland joined Roche Diagnostics in 2008 
as president of Asia Pacific before his current 
appointment as the Chief Executive Officer of the 
Diagnostics Division of F. Hoffmann-La Roche Ltd.

Skills and experience
Having spent his whole career in medical devices, 
with 12 years at Sulzer and Zimmer, Roland brings 
an in-depth knowledge of the medical device 
industry and healthcare environment which will 
be of great value to Smith & Nephew, in particular 
following the retirement of Joseph Papa from 
the Board at the Annual General Meeting on 
12 April 2018. 

Nationality
  Swiss 

Skills and experience
Susan has over 30 years’ experience as a Company 
Secretary in a wide range of companies including 
Prudential plc, Amersham plc and RMC Group plc. 
Her work has covered board support, corporate 
governance, corporate transactions, group risk 
management, share registration, listing obligations, 
corporate social responsibility, pensions, insurance 
and employee and executive share plans. Susan is  
a member of the CBI Companies Committee and is 
a frequent speaker on corporate governance and 
related matters. She is also Chairman of the Board 
of Trustees of ShareGift, the share donation charity 
and a member of the Financial Reporting Council 
Lab Steering Group.

SUSAN SWABEY (56)
Company Secretary

Appointed Company Secretary in May 2009.

Nationality
  British

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OUR LEADERSHIP 
A STRONG TEAM

Olivier Bohuon is supported 
in the day-to-day management 
of the Group by a strong team 
of Executive Officers.

GRAHAM BAKER (49) 
Chief Financial Officer

GLENN WARNER (55)
President, US

Joined the Board as Chief Financial Officer on 
1 March 2017. Graham holds an MA degree 
in Economics from Cambridge University and 
qualified as a Chartered Accountant and 
Chartered Tax Adviser with Arthur Andersen. 
He is based in London, UK.

Skills and competencies
Graham has deep sector knowledge and has had 
extensive exposure to established and emerging 
markets which is extremely relevant to his role at 
Smith & Nephew. He has a strong track record 
of delivering operational excellence and has 
relevant experience across major finance roles 
and geographic markets, leading large teams 
responsible for significant budgets. 

Nationality
  British

Joined Smith & Nephew in June 2014 with 
responsibility for Advanced Wound Management’s 
global franchise strategy, marketing and product 
development, as well as its US commercial 
business. With effect from 1 January 2016, Glenn 
became the President of Smith & Nephew’s US 
business responsible for all the US commercial 
business. He is based in Fort Worth, US.

Skills and experience
Glenn has a broad-based background in 
pharmaceuticals and medical products including 
extensive international experience, having served 
most recently as AbbVie Vice President and 
Corporate Officer, Strategic Initiatives, where he 
was responsible for the development and execution 
of pipeline and asset management strategies. 
Prior to that he was President and Officer, Japan 
Commercial Operations in Abbott’s international 
pharmaceutical business and Executive Vice 
President, TAP Pharmaceutical Products, Inc. 

Nationality

  American

RODRIGO BIANCHI (58)
President, International Markets

BRAD CANNON (50)
Chief Marketing Officer

Joined Smith & Nephew in July 2013 with 
responsibility for Greater China, India, Russia, Asia, 
Middle East and Africa, focusing on continuing our 
strong momentum in these regions. With effect from 
1 January 2016, Rodrigo also became responsible, 
for the Latin American, Australian, New Zealand and 
Japanese markets. His role was further expanded 
in May 2017, when he became responsible for 
oversight of the markets in Europe and Canada. 
He is based in Dubai, UAE. 

Skills and experience
Rodrigo’s experience in the healthcare industry 
includes 26 years with Johnson & Johnson in 
progressively senior roles. Most recently, he was 
Regional Vice President for the Medical Devices and 
Diagnostics division in the Mediterranean region 
and prior to that President of Mitek and Ethicon, Inc. 
He started his career at Procter & Gamble Italy.

Joined Smith & Nephew in 2012 and became 
President, Europe and Canada in March 2016. 
On 1 September 2017, he became Chief Marketing 
Officer. He is based in Andover, US.

Skills and experience
Brad was most recently President, Europe and 
Canada, where he successfully led the commercial 
business in those regions. Before that, he was 
President of Global Orthopaedic Franchises, leading 
Smith & Nephew’s Reconstruction, Endoscopy, 
Trauma and Extremities businesses. Prior to Smith 
& Nephew, Brad worked in Medtronic’s Spine and 
Biologics division. From 2009, he was responsible 
for Medtronic’s Spine International division and held 
positions heading US sales and global commercial 
operations. Brad is a graduate of Washington and 
Lee University, and the Wharton School of Business 
at the University of Pennsylvania.

Nationality
  Italian 

Nationality

  American

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CATHY O’ROURKE (45)
Chief Legal Officer

MATTHEW STOBER (50)
President, Global Operations

VASANT PADMANABHAN (51) 
President of Research & Development

Joined Smith & Nephew in February 2013 
as Assistant General Counsel – Litigation & 
Investigations and became Chief Legal Officer 
in May 2017. Cathy heads up the Global Legal 
function and is based in Andover, US.

Joined Smith & Nephew in October 2015 with 
responsibility for global manufacturing, supply 
chain, distribution, quality assurance, regulatory 
affairs, direct procurement, and manufacturing IT 
optimisation. He is based in Andover, US.

Joined Smith & Nephew in August 2016 and is 
responsible for Research and Innovation, New 
Product Development, Safety Affairs, Clinical 
Affairs, Medical Device/Pharmacovigilance and 
Clinical Operations. He is based in Andover, US.

Skills and experience
Prior to joining Smith & Nephew, Cathy spent  
11 years of her career with Davis Polk & Wardwell 
LLP. Cathy earned her Juris Doctorate in Law from 
Harvard University. 

Nationality

  American

Skills and experience
Matt has more than 25 years’ experience 
in healthcare manufacturing operations for 
global companies including Merck & Co., Inc. 
and GlaxoSmithKline plc. Most recently, he served 
as Senior Vice President, Corporate Officer and 
member of the Executive Committee at Hospira 
Pharmaceuticals. As a senior pharmaceutical 
operations executive with extensive technical and 
cross functional experience in start-up and complex 
challenging environments, Matt has led global and 
multi-company development projects, new product 
launches, critical quality-related turnarounds, 
network rationalisations and organisational 
transformations. He also has extensive experience 
working directly with external regulatory bodies, 
such as the US Food and Drug Administration.

Nationality

  American

Skills and experience
Vasant brings extensive experience in R&D and 
technology. Prior to Smith & Nephew, Vasant was 
Senior Vice President of Technical Operations 
at Thoratec Corporation, a leader in mechanical 
circulatory support solutions for the treatment of 
heart failure. In this role, he provided leadership 
to a 600 member team, with responsibility for 
global R&D, Program Management, Operations 
and Quality. Prior to Thoratec, Vasant had an 
18-year career at Medtronic, starting as a Staff 
Scientist and, progressing through more senior 
roles, ultimately becoming Vice President of Product 
Development for the Implantable Defibrillator 
Business. Vasant holds a Ph.D degree in Biomedical 
Engineering from Rutgers University, USA and 
an MBA degree from the Carlson School of 
Management, Minnesota.

Nationality

  American

CYRILLE PETIT (47)
Chief Corporate Development Officer 
and President, Global Business 
Services

Joined Smith & Nephew in May 2012 and leads 
the Corporate Development function and from 
October 2015 the Global Business Services.  
He is based in London, UK.

Skills and experience
Cyrille spent the previous 15 years of his career 
with General Electric Company, where he held 
progressively senior positions beginning with GE 
Capital, GE Healthcare and ultimately as the General 
Manager, Global Business Development of the 
Transportation Division. Cyrille began his career 
in investment banking at BNP Paribas and then 
Goldman Sachs.

ELGA LOHLER (50)
Chief Human Resources Officer

Joined Smith & Nephew in January 2002 and 
became Chief Human Resources Officer in 
December 2015. Elga leads the Global Human 
Resources, Internal Communication and 
Sustainability Functions. She is based in London, UK.

Skills and experience
Prior to being appointed as Chief Human Resources 
Officer, Elga held progressively senior positions in 
Human Resources at Smith & Nephew in Wound 
Management, Operations, Corporate Functions 
and Group. Elga has more than 25 years’ Human 
Resources experience.

Nationality

  American/South African

Nationality
  French

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OVERVIEW
COMMITTED TO THE HIGHEST STANDARDS  
OF CORPORATE GOVERNANCE

We maintain these standards through a clear definition of our roles, continuing development and evaluation 
and accountability through the work of the Board Committees.

LEADERSHIP

EFFECTIVENESS

The Board sets the tone at the top of the Company 
through:
 – A clear definition of the roles of the individual members 

of the Board.

 – A comprehensive corporate governance framework.
 – Defined processes to ensure the independence of 

Directors and the management of conflicts of interest.

The Board carries out its duties through:
 – Regular meetings focusing on the oversight of strategy,  

risk (including viability) and succession planning.
 – An annual review into the effectiveness of the Board.
 – A comprehensive programme of development activities 

throughout the year.

Read more about our Board’s Leadership on pages 57–60

Read more about our Board’s Effectiveness on pages 61–65

ACCOUNTABILITY

REMUNERATION

The Board delegates some of its detailed work to the 
Board Committees:
 – Each Committee meets regularly and reports back 

to the Board on its activities.

 – The terms of reference of each Committee may be found 
on the Company’s website at www.smith-nephew.com.
 – A report from the Chairman of each Committee is included 

in this Annual Report.

The Remuneration Committee ensures that there 
is a formal and transparent process for determining 
and reporting on the pay of our Executive Directors: 
 – The Remuneration Policy was approved by shareholders 

at the 6 April 2017 Annual General Meeting.

 – The Committee ensures that: performance measures 
are linked to our strategic priorities; there is alignment 
between executive and shareholder interests; and our 
arrangements are simple to understand.

Read more about our Board’s Accountability on pages 66–78

Read more about our Board’s Remuneration on pages 79–105

The Board is committed to the highest standards of corporate governance and we comply with all the provisions of the UK Corporate 
Governance Code 2016 (the Code). The Company’s American Depositary Shares are listed on the New York Stock Exchange (NYSE) and we 
are therefore subject to the rules of the NYSE as well as to the US securities laws and the rules of the Securities Exchange Commission (SEC) 
applicable to foreign private issuers. We comply with the requirements of the NYSE and SEC and have no significant differences to report 
between the UK and US corporate governance standards. We shall explain in this Corporate Governance Statement and in the reports on the 
Audit Committee, the Nomination & Governance Committee, the Ethics & Compliance Committee and the Remuneration Committee, how we 
have applied the provisions and principles of the Financial Conduct Authority’s (FCA) Listing Rules, Disclosure & Transparency Rules (DTRs) and 
the Code throughout the year. The Code can be found at https://www.frc.org.uk/getattachment/ca7e94c4-b9a9-49e2-a824-ad76a322873c/UK-
Corporate-Governance-Code-April-2016.pdf

The Directors’ Report comprises pages 6, 16-17, 25–28, 33–39, 42–78, 107, 140-142, 158 and pages 171–193 of the Annual Report.

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COMPOSITION & ROLES

LEADERSHIP

COMPOSITION OF BOARD AS AT 31 DECEMBER 2017
We believe the Board’s composition gives us the necessary balance of diversity, skills experience, independence and knowledge to ensure we 
continue to run the business effectively and deliver sustainable growth.

Diversity

Gender

Years of service

Ethnicity

C

A

B

B

A  EXECUTIVE 

B  NON-EXECUTIVE 

C  CHAIRMAN 

A  MALE 

B  FEMALE 

2

9

1

D

E

C

A

B

A

B

A

9

3

A  LESS THAN ONE YEAR 

B  ONE TO THREE YEARS 

C  THREE TO SIX YEARS 

D  SIX TO NINE YEARS 

E  OVER NINE YEARS 

3

2

4

2

1

A  WHITE 

B  ASIAN 

11

1

The Nomination & Governance Committee uses the following matrix when considering succession planning and future Board composition 
to ensure a balanced Board:

CEO 
5 members of the Board are 
either current or recent CEOs

Financial 
5 members of the Board 
have recent and relevant 
financial experience

International 
7 members of the Board have 
international experience

Healthcare/ 
Medical Devices
5 members of the Board have 
different levels of experience 
within the Healthcare industry. 
The Board’s medical devices 
experience will be strengthened 
with the appointment of 
Roland Diggelmann

Emerging market 
2 members of the Board have 
Emerging Market experience

UK Governance 

Remuneration 

Gender

Ethnic

Other

8 members of the Board have 
considerable experience 
of working in a UK listed 
environment and 6 members of 
the Board have experience of the 
US listed environment

5 members of the Board have 
Remuneration Committee 
experience within a UK 
listed context

9 members of the Board are 
male and 3 are female

11 members of the Board are 
white and 1 is Asian ethnicity

Various Board members bring 
experiences in a variety of 
fields including customer focus, 
investment markets, government 
affairs, digital and corporate 
social responsibility

CHANGES TO THE BOARD
During the year to 31 December 2017 and since the year end, there were the following changes to the Board: 

 – Julie Brown retired from the Board as Chief Financial Officer on 11 January 2017.

 – Graham Baker joined the Board as Chief Financial Officer on 1 March 2017.

 – Brian Larcombe retired from the Board on 6 April 2017.

 – Robin Freestone was appointed Chairman of the Audit Committee, succeeding Ian Barlow on 1 March 2017.

 – Ian Barlow was appointed Senior Independent Director, succeeding Brian Larcombe on 6 April 2017.

 – Angie Risley was appointed Non-Executive Director and Member and Chairman Elect of the Remuneration Committee on 18 September 2017.

 – Marc Owen was appointed Non-Executive Director and Member of the Audit Committee on 1 October 2017. He will become a Member of the 

Ethics & Compliance Committee on 1 March 2018. 

 – Roland Diggelmann will join the Board as an additional Non-Executive Director and Member of the Audit Committee with effect from 

1 March 2018.  

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RESPONSIBILITY & ACTIVITY

LEADERSHIP

ROLE OF DIRECTORS
Whilst we all share collective responsibility for the activities of the Board, some of our roles have been defined in greater detail. In particular, the 
roles of the Chairman and the Chief Executive Officer are clearly defined.

The roles of the Chairman, Non-Executive Directors, Senior Independent Director, Chief Executive Officer, Chief Financial Officer and the Company 
Secretary are defined as follows:

Chairman
 – Building a well-balanced Board.

 – Chairing Board meetings and setting Board agendas.

 – Ensuring effectiveness of the Board and enabling the annual 

review of effectiveness.

 – Encouraging constructive challenge and facilitating effective 

communication between Board members.

 – Promoting effective Board relationships.

 – Ensuring appropriate induction and development programmes.

 – Ensuring effective two-way communication and debate with 

shareholders and stakeholders.

 – Promoting high standards of corporate governance.

 – Maintaining appropriate balance between stakeholders.

Chief Executive Officer
 – Developing and implementing Group strategy.

 – Recommending the annual budget and five-year strategic and 

financial plan.

 – Ensuring coherent leadership of the Group.

 – Managing the Group’s risk profile and establishing effective 

internal controls.

 – Regularly reviewing organisational structure, developing executive 

team and planning for succession.

 – Ensuring the Chairman and Board are kept advised and updated 

regarding key matters.

 – Maintaining relationships with shareholders and advising the 

Board accordingly.

 – Setting the tone at the top with regard to compliance and 

sustainability matters.

 – Day-to-day running of the business.

Chief Financial Officer
 – Supporting the Chief Executive Officer in developing and 

implementing the Group strategy.

 – Leading the global finance function, developing key finance talent 

and planning for succession.

 – Ensuring effective financial reporting, processes and controls are 

in place.

 – Recommending the annual budget and long-term strategic and 

financial plan.

 – Maintaining relationships with shareholders.

Non-Executive Directors
 – Providing effective challenge to management.

 – Assisting in development and approval of strategy.

 – Serving on the Board Committees.

 – Providing advice to management.

Senior Independent Director
 – Chairing meetings in the absence of the Chairman.

 – Acting as a sounding board for the Chairman on Board-

related matters.

 – Acting as an intermediary for the other Directors where necessary.

 – Available to shareholders and stakeholders on matters which 

cannot otherwise be resolved.

 – Leading the annual evaluation into the Board’s effectiveness.

 – Leading the search for a new Chairman, if necessary.

Company Secretary
 – Advising the Board on matters of corporate governance.

 – Supporting the Chairman and Non-Executive Directors.

 – Point of contact for investors on matters of corporate governance.

 – Ensuring good governance practices at Board level and throughout 

the Group.

SMITH & NEPHEW ANNUAL REPORT 2017 59

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

LEADERSHIP

CORPORATE GOVERNANCE FRAMEWORK
The Board is responsible to shareholders for approving the strategy of the Group, for overseeing the performance of the Group and evaluating 
and monitoring the management of risk. 

Each member of the Board has access, collectively and individually, to the Company Secretary and is also entitled to obtain independent 
professional advice at the Company’s expense, should they decide it is necessary in order to fulfil their responsibilities as Directors.

The Board delegates certain matters, as follows, to Board Committees, consisting of members of the Board:

BOARD

Remuneration 
Committee
Determines Remuneration 
Policy and packages for 
Executive Directors and 
Executive Officers, having 
regard to pay across 
the Group. 

Nomination & 
Governance  
Committee
Reviews size and 
composition of the 
Board, succession 
planning, diversity and 
governance matters.

Ethics &  
Compliance  
Committee
Reviews and monitors 
ethics and compliance, 
quality and regulatory 
matters across the Group.

Ad hoc  
committees
Ad hoc committees may be 
established to review and 
approve specific matters 
or projects.

Audit  
Committee
Provides independent 
assessment of the 
financial affairs of the 
Company, reviews 
financial statements 
and controls oversight 
of the risk management 
process and key risks, 
such as cyber security. 
Manages use of internal 
and external auditors. 

Read more on page 71

Read more on page 79

Read more on page 66

Read more on page 69

The Board delegates the day-to day running of the business to Olivier Bohuon, Chief Executive Officer, who is assisted in his role by the Executive 
Committee comprising the Executive Officers who are shown on pages 54–55 and certain other senior executives. The governance framework 
below outlines the Executive Committee arrangements as follows:

Recommends and implements strategy, approves budget and three-year plan, ensures liaison between commercial and corporate functions, receives regular 
reports from sub-committees, reviews major investments, divestments and capital expenditure proposals and approves business development projects.

EXECUTIVE COMMITTEE

Commercial  
Committee
Recommends and implements 
strategy for global commercial 
functions and regions, 
managing sales, marketing, 
market access and commercial 
strategy and identifying and 
executing new processes, 
systems and practices to 
improve operational efficiency 
in commercial regions.

Finance & Banking 
Committee
Approves banking and 
treasury matters, guarantees, 
Group structure changes 
relating to mergers, 
acquisitions and disposals.

Corporate Functions 
Committee
Recommends and implements 
strategy for corporate functions 
identifying and executing 
new processes, systems 
and practices to improve 
operational efficiency in 
corporate functions.

Portfolio Innovation 
Board
Defines portfolio allocation 
principles, reviewing and 
challenging current shape 
of portfolio, identifying 
gaps and opportunities and 
re-prioritising segments 
and geographies.

Regional leadership 
meetings
Regional management 
through committees to drive 
regional performance.

Functional leadership 
meetings
Functional leadership teams to 
drive functional performance.

Disclosures  
Committee
Approves release of 
communications to investors 
and Stock Exchanges.

Mergers & 
Acquisitions  
Council
Oversees Corporate 
Development Strategy, 
monitors status of transactions 
and approves various stages 
in merger, acquisition and 
disposal process.

Group Risk  
Committee
Reviews risk registers and risk 
management programme.

Group Ethics & 
Compliance 
Committee
Reviews compliance matters 
and country business unit or 
function compliance reports.

Diversity & Inclusion 
Council
Implements strategies 
to promote diversity 
and inclusion.

Global Benefits 
Committee
Oversees all policies and 
processes relating to pensions 
and employee benefit plans.

Health, Safety & 
Environment 
Committee
Oversees health, safety and 
environmental matters.

IT Governance  
Board
Oversees IT and 
cyber security.

SMITH & NEPHEW ANNUAL REPORT 2017 60

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

LEADERSHIP

INDEPENDENCE OF DIRECTORS
We require our Non-Executive Directors to remain independent from 
management so that they are able to exercise independent oversight 
and effectively challenge management. We therefore continually 
assess the independence of each of our Non-Executive Directors. 
The Executive Directors have determined that all our Non-Executive 
Directors are independent in accordance with both UK and US 
requirements. None of our Non-Executive Directors or their immediate 
families has ever had a material relationship with the Group. None of 
them receives additional remuneration apart from Directors’ fees, nor 
do they participate in the Group’s share plans or pension schemes. 
None of them serve as directors of any companies or affiliates in which 
any other Director is a director.

More importantly, each of our Non-Executive Directors are prepared 
to question and challenge management, to request more information 
and to ask the difficult questions. They insist on robust responses both 
within the Boardroom and, sometimes, between meetings. The Chief 
Executive Officer is open to challenge from the Non-Executive Directors 
and uses this positively to provide more detail and to reflect further 
on issues.

MANAGEMENT OF CONFLICTS OF INTEREST
None of our Directors or their connected persons, has any family 
relationship with any other Director or Officer, nor has a material interest 
in any contract to which the Company or any of its subsidiaries are,  
or were, a party during the year or up to 22 February 2018.

Each Director has a duty under the Companies Act 2006 to avoid a 
situation in which we have or may have a direct or indirect interest that 
conflicts or might conflict with the interests of the Company. This duty is 
in addition to the existing duty owed to the Company to disclose to the 
Board any interest in a transaction or arrangement under consideration 
by the Company. 

If any Director becomes aware of any situation which might give rise 
to a conflict of interest, they must, and do, inform the rest of the Board 
immediately and the Board is then permitted under the Company’s 
Articles of Association to authorise such conflict. This information is 
then recorded in the Company’s Register of Conflicts, together with 
the date on which authorisation was given. In addition, each Director 
certifies on an annual basis that the information contained in the 
Register of Conflicts is correct.

When the Board decides whether or not to authorise a conflict, only the 
Directors who have no interest in the matter are permitted to participate 
in the discussion and a conflict is only authorised if the Board believes 
that it would not have an impact on the Board’s ability to promote the 
success of the Company in the long term. Additionally, the Board may 
determine that certain limits or conditions must be imposed when 
giving authorisation. No actual conflicts have been identified, which 
have required approval by the Board. However, six situations have been 
identified which could potentially give rise to a conflict of interest and 
these have been duly authorised by the Board and are reviewed on an 
annual basis.

OUTSIDE DIRECTORSHIPS
We encourage our Executive Directors to serve as Non-Executive 
Directors of external companies. We believe that the work they do 
as Non-Executive Directors of other companies has benefits for their 
executive roles with the Company, giving them a fresh insight into the 
role of a Non-Executive Director. Olivier Bohuon is a Non-Executive 
Director of Shire plc and of Virbac Group. Olivier Bohuon discussed his 
external roles with the Chairman prior to accepting these appointments 
and the Chairman was satisfied that he had the capacity for the time 
commitment required.

RE-APPOINTMENT OF DIRECTORS
In accordance with the Code, all Directors offer themselves to 
shareholders for re-election annually, except those who are retiring 
immediately after the Annual General Meeting. Each Director may  
be removed at any time by the Board or the shareholders.

DIRECTOR INDEMNITY ARRANGEMENTS
Each Director is covered by appropriate directors’ and officers’ liability 
insurance and there are also Deeds of Indemnity in place between 
the Company and each Director. These Deeds of Indemnity mean that 
the Company indemnifies Directors in respect of any proceedings 
brought by third parties against them personally in their capacity as 
Directors of the Company. The Company would also fund ongoing 
costs in defending a legal action as they are incurred rather than after 
judgement has been given. In the event of an unsuccessful defence in 
an action against them, individual Directors would be liable to repay the 
Company for any damages and to repay defence costs to the extent 
funded by the Company.

LIAISON WITH SHAREHOLDERS
The Board meets with retail investors at the Annual General Meeting 
and responds to many letters and emails from shareholders throughout 
the year. 

The Executive Directors also meet regularly with institutional investors 
to discuss the Company’s business and financial performance both at 
the time of the announcement of results and at industry investor events. 
During 2017, the Executive Directors held meetings with institutional 
investors, including investors representing approximately 48% of the 
Company’s share capital. Other topics discussed included strategy, 
market trends, reimbursement and regulatory changes, relevant macro-
economic and political impacts on the business and the acquisition of 
Rotation Medical, Inc.  

SMITH & NEPHEW ANNUAL REPORT 2017 61

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

LEADERSHIP

EFFECTIVENESS

During the early part of 2017, the Chairman, Roberto Quarta, held 
17 meetings and telephone calls with investors holding approximately 
22% of the Company’s share capital. They discussed a range of topics 
including the performance of the Company during 2016, our strategic 
priorities, the structure of the Board, succession planning at Board 
and Executive level, diversity, the capital allocation framework and 
recent acquisitions.

Towards the end of 2017, Joseph Papa, the Chairman of the 
Remuneration Committee, took the opportunity of introducing Angie 
Risley, who will be succeeding him as Chairman of the Remuneration 
Committee on 12 April 2018, to eight of our key institutional shareholders 
holding around 15% of our share capital. They discussed the changes 
made to our remuneration policy, which were approved by shareholders 
at the 2017 Annual General Meeting and how the policy was being 
implemented. As well as giving shareholders the opportunity to meet 
Angie Risley, they also discussed the broad structure of remuneration 
arrangements proposed for the new Chief Executive Officer to be 
appointed following the retirement of Olivier Bohuon by the end of 2018. 
At the time of these meetings, there was no specific candidate identified 
as successor to Olivier Bohuon. They also discussed current trends and 
developments in executive remuneration.

Members of the Board are always happy to engage with investors, 
if they have matters they wish to raise with the non-executive team. 
Please contact the Company Secretary to arrange a suitable time 
to meet.

A short report on our major shareholders and any significant changes 
in their holdings since the previous meeting is reviewed at each Board 
meeting. The Chairman and Non-Executive Directors report back to the 
Board following their meetings with investors. Olivier Bohuon routinely 
reports on any concerns or issues that shareholders have raised with 
him in their meetings. Copies of the analyst reports on the Company 
and its peers are also circulated to Directors.

PURCHASE OF ORDINARY SHARES
In order to avoid shareholder dilution, shares allotted to employees 
through employee share schemes are bought back on a quarterly basis 
and subsequently cancelled as stated in Note 19.2 of the accounts on 
page 157.

RESPONSIBILITY OF THE BOARD
The work of the Board falls into the following key areas:

Strategy
 – Approving the Group strategy including major changes  

to corporate and management structure.

 – Approving acquisitions, mergers, disposals, capital transactions  

in excess of $50 million.

 – Setting priorities for capital investment across the Group.

 – Approving annual budget, financial plan, five-year business plan.

 – Approving major borrowings and finance and banking  

arrangements.

 – Approving changes to the size and structure of the Board and the 
appointment and removal of Directors and the Company Secretary.

 – Approving Group policies relating to sustainability, health 

and safety, Code of Conduct and Code of Share Dealing and 
other matters.

 – Approving the appointment and removal of key professional 

advisers.

Performance
 – Reviewing performance against strategy, budgets and financial 

and business plans.

 – Overseeing Group operations and maintaining a sound system  

of internal control.

 – Determining the dividend policy and dividend recommendations.

 – Approving the appointment and removal of the external auditor  

on the recommendation of the Audit Committee.

 – Approving significant changes to accounting policies or practices.

 – Overseeing succession planning at Board and Executive  

Officer level.

 – Approving the use of the Company’s shares in relation 

to employee and executive share incentive plans on the 
recommendation of the Remuneration Committee.

SMITH & NEPHEW ANNUAL REPORT 2017 62

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

EFFECTIVENESS

Risk
 – Overseeing the Group’s risk management programme.

 – Regularly reviewing the risk register.

 – Overseeing risk management processes (see pages 40 and 41  

for further details). 

Shareholder communications
 – Approving preliminary announcement of annual results, 

the publication of the Annual Report, the half-yearly report, 
the quarterly Trading Reports, the release of price sensitive 
announcements and any listing particulars, circulars 
or prospectuses.

APRIL

 – Received a review of recent acquisitions. 

 – Received an update on global operations. 

 – Reviewed the work of the Government Affairs function. 

 – Approved the Sustainability Report.

 – Prepared for the Annual General Meeting to be held later that day.

MAY

(via voice conference)
 – Reviewed the results for the first quarter 2017 and approved the 

Q1 Trading Report announcement.

 – Approving the Sustainability Report.

JUNE

 – Maintaining relationships and continued engagement with  

shareholders.

(via voice conference)
 – Approved the appointment of Angie Risley as Non-Executive Director.

Providing advice
 – Using experience gained within other companies and 

organisations to advise management both within and between 
Board meetings.

The Schedule of Matters Reserved to the Board describes the role and 
responsibilities of the Board more fully and can be found on our website 
at www.smith-nephew.com.

BOARD TIMETABLE 2017
FEBRUARY

Early February
Approval of Preliminary Announcement
 – Reviewed the results for the full year 2016 and the preliminary 

announcement and approved the final dividend to be recommended 
to shareholders for approval.

 – Reviewed and approved the annual risk management report.

 – Received updates on the progress of certain acquisitions over the 

past five years. 

 – Reviewed the results of the review into the effectiveness of the Board 

in 2016 and agreed action points for 2017.

 – Reviewed and accepted that fees paid to Non-Executive Directors 

should remain unchanged.

Late February (via voice conference)
Approval of Financial Statements
 – Reviewed and approved the Annual Report and Accounts for 2016, 

having determined that they were fair, balanced and understandable. 

 – Reviewed and approved the Notice of Annual General Meeting and 

related documentation.

 – Approved the Budget for 2017 and the Strategic Plan for 2017-2021.

JULY

(in Hull, UK)
 – Reviewed the results for the first half 2017 and approved the H1 

announcement, having considered management’s judgement in  
a number of areas, and approved payment of the interim dividend.

 – Received and considered a report analysing the progress in Research 

and Development. 

 – Received and discussed the annual review of Group Insurances.

 – Discussed the strategy review agenda for September 2017.

SEPTEMBER

(in Tokyo, Japan)
Strategy Review
 – Conducted review of corporate strategy for 2018-2022.

 – Reviewed the implications, risks and opportunities of the Medical 

Devices regulations. 

 – Approved the renewal of the directors’ and officers’ liability Insurance.

NOVEMBER

Early November (in Dubai, UAE)
Approval of Q3 Trading Report
 – Reviewed the results for the third quarter 2017 and approved the 

Q3 Trading Report announcement.

 – Received a follow up from Executive Officers from the Strategy Review 

in Tokyo in September. 

 – Received an update from Rodrigo Bianchi on the APAC/EM (Asia 

Pacific and Emerging Markets) business. 

 – Discussed the annual executive talent review. 

Late November
Approval of Budget
 – Reviewed the Budget for 2018.

 – Received a review of the activities of Global Business Services.

 – Received updates from Glenn Warner on the US Business.

SMITH & NEPHEW ANNUAL REPORT 2017 63

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

EFFECTIVENESS

In addition various matters were determined by written resolution, including accepting notice of the intention to retire of Olivier Bohuon as Chief 
Executive Officer and authorising the execution of certain agreements. Since the year end, we have also approved the Annual Report and Accounts 
for 2017 and have concluded that, taken as a whole, they are fair, balanced and understandable. We have approved the Notice of Annual General 
Meeting, recommended the final dividend to shareholders and have received and discussed the report on the effectiveness of the Board in 2017.
Each meeting was preceded by a meeting between the Chairman and the Non-Executive Directors without the Executive Directors and 
management in attendance. Unless otherwise stated, meetings are held in London, UK. At each meeting, we approved the minutes of the previous 
meetings, reviewed matters arising and received reports and updates from the Chief Executive Officer, the Chief Financial Officer, the Chief 
Corporate Development Officer, the Chief Legal Officer and the Company Secretary. We also received reports from the chairmen of the Board 
Committees on the activities of these Committees since the previous meeting.

BOARD AND COMMITTEE ATTENDANCE

Director

Roberto Quarta¹
Olivier Bohuon
Graham Baker²
Vinita Bali³
Ian Barlow
Virginia Bottomley

Erik Engstrom⁴
Robin Freestone
Michael Friedman
Joseph Papa
Marc Owen⁵ 
Angie Risley⁶
Brian Larcombe⁷

Audit  
Committee 
meetings  
(7 meetings)

Remuneration 
Committee 
meetings  
(7 meetings)

Nomination & 
Governance 
Committee 
meetings 
(8 meetings)

Ethics & 
Compliance 
Committee 
meetings  
(4 meetings)

Board meetings  
(9 meetings)

9/9
9/9
7/7
7/9
9/9
9/9

9/9
9/9
9/9
9/9
2/2
3/3
3/3

–
–
–
–
7/7
–

6/7
7/7
–
7/7
2/2
–
3/3

6/7
–
–
6/7
–
7/7

–
7/7
–
7/7
–
3/3
3/3

8/8
–
–
–
6/6
8/8

–
–
–
–
–
–
2/2

–
–
–
4/4
4/4
–

–
–
4/4
4/4
–
–
–

Board Member since

December 2013
April 2011
 1 March 2017
December 2014
March 2010
April 2012

 January 2015
 September 2015
April 2013
August 2008
1 October 2017
18 September 2017
March 2002

1  Roberto Quarta missed one Remuneration Committee meeting call convened on short notice. He had signified his approval of the matters being discussed to the Remuneration Committee Chairman prior to 

the meeting.

2  Graham Baker was appointed on 1 March 2017 and attended all his scheduled meetings to 31 December 2017. 

3  Vinita Bali missed one Board call and one Remuneration Committee meeting on the same day, due to a prior commitment and one Board call convened on short notice. In each case, she had signified her  

approval of the matters being discussed to the Chairman prior to the meeting. 

4  Erik Engstrom missed one Audit Committee meeting in Hull, which clashed with a RELX Board meeting, for which he is the Chief Executive Officer. 

5  Marc Owen was appointed on 1 October 2017 and attended all his scheduled meetings to 31 December 2017.

6  Angie Risley was appointed on 18 September 2017 and attended all her scheduled meetings to 31 December 2017. 

7  Brian Larcombe retired from the Board at the Annual General Meeting on 6 April 2017.

SMITH & NEPHEW ANNUAL REPORT 2017 64

OVERVIEW

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

EFFECTIVENESS

BOARD EFFECTIVENESS REVIEW
The Board Effectiveness Review in 2017 was internally facilitated by Ian Barlow, Senior Independent Director assisted by the Company Secretary. 
The 2017 review comprised a questionnaire completed by each member of the Board. This questionnaire focused on the progress made 
addressing the issues raised in previous Board Evaluations as well as looking into how the Board had handled particular topics throughout 
the year. Ian Barlow then conducted individual interviews with each Board member. He also chaired a meeting of the Non-Executive Directors 
specifically to discuss the performance of the Chairman.

In January 2018, he prepared a report, detailing his findings, which he shared with the Chairman. The report was then discussed by the full 
Board in February 2018.

In discussion, we concluded that the Board worked well with a good breadth of skills, backgrounds and experience, which has been enhanced 
with the appointments during the past year. The culture was open and collaborative; the cadence of board meetings and the administrative 
support was broadly welcomed and we covered most of the right topics across the annual cycle. We did however identify some areas for further 
improvement as follows:

 –  Some changes could be made to the Board calendar to spread our work more efficiently and effectively throughout the year, with an even 

greater focus on people issues, R&D and commercial execution.

 –  We would like to spend more time on our site visits meeting the local teams, their staff, our customers and local hospitals to give us a deeper 
understanding of our markets, our customers and our competition and to assist in assessing bench strength further down the Company.

 –  Further improvements could be made to how we monitor performance against our strategic objectives, tracking development and 

implementation of strategy and lessons learned from our successes and shortfalls.

The areas for attention identified in the 2017 review had been addressed as follows:

Actions identified

Action taken

Gaining a deeper understanding of why our competitors are enjoying 
superior growth rates compared with us so that we can help 
management identify, acquire and develop the resources they need 
to compete more effectively in our chosen markets.

Gaining a better understanding of the changing market dynamics in 
our chosen markets, focusing on identifying the different categories 
of customer and the pricing and reimbursement drivers which are 
in play, so that we can support and challenge management more 
effectively when they seek approval for projects to address these 
changing conditions.

Playing a more active role in supporting management develop robust 
succession plans for senior executive positions.

Encouraging management to develop metrics and dashboards on 
a wider range of issues beyond financial metrics, particularly in the 
areas of Human Resources and R&D and ensuring that we regularly 
monitor progress against these metrics.

During the year, as part of our site visits, the Board met with senior 
management in different territories and heard about the commercial 
challenges faced in different markets. Part of the September Strategy 
Review included a focus on the different categories of customers and 
the pricing and reimbursement drivers which affect different business 
in different parts of the world.

We positively encourage our Non-Executive Directors to spend time 
with our sales representatives in order to experience the challenges 
they face first-hand.

The Board reviews detailed succession plans on an annual basis. 
The Board also meets with potential successors to members of 
the management team during site visits and as part of Board 
presentations. During the year, Non-Executive Directors have assisted 
in the interview process for some senior management positions 
and have acted as a sounding board for the executive team, when 
considering succession plans in key areas.

Dashboards have been developed throughout the year, which are 
reviewed at each Board meeting. These dashboards track progress 
against defined metrics with both a long-term and a short-term 
focus aligned to our Strategic Priorities, covering a wide range of 
business areas, including R&D, HR, the commercial and operating 
organisations, M&A and legal and compliance.

The last externally facilitated Board Effectiveness Review was carried out in 2015 by Belinda Hudson of Independent Audit.  
The 2018 review will also be facilitated externally. 

SMITH & NEPHEW ANNUAL REPORT 2017 65

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

RESPONSIBILITY & ACTIVITY continued

EFFECTIVENESS

BOARD DEVELOPMENT PROGRAMME
Our Board Development Programme is directed to the specific needs 
and interests of our Directors. We focus the development sessions on 
facilitating a greater awareness and understanding of our business 
rather than formal training in what it is to be a Director. We value our 
visits to the different Smith & Nephew sites around the world, where 
we meet with the local managers of our businesses and see the 
daily operations in action. Meeting our local managers helps us to 
understand the challenges they face and their plans to meet those 
challenges. We also take these opportunities to look at our products 
and in particular the new products being developed by our R&D teams. 
This direct contact with the business in the locations in which we 
operate around the world helps us to make investment and strategic 
decisions. Meeting our local managers also helps us when making 
succession planning decisions below Board level.

All Non-Executive Directors are encouraged to visit our overseas 
businesses, if they happen to be travelling for other purposes. Our local 
management teams enjoy welcoming Non-Executive Directors to their 
business and it emphasises the interest the Board takes in all our 
operations. The Chairman regularly reviews the development needs  
of individual Directors and the Board as a whole. 

The following development sessions covering both the Smith & Nephew 
business and wider market issues were held during the year:

July
 – Visit to the Company’s site in Hull to take part in activities 

celebrating our 160th anniversary on the site. The Board toured the 
manufacturing and research facility and received presentations from 
members of the workforce involved in community focused activities 
as part of the Hull City of Culture 2017.

 – Presentation from our Auditor, KPMG LLP (KPMG), on External 

Reporting trends, covering changing accounting standards and 
updates on financial reporting, the SEC and corporate governance 
changes relating to Audit Committees and Auditors.

September
 – Presentations from the entire executive team as part of the Board’s 

Strategy Review, covering the whole business and including a 
discussion on Risk.

November
 – Visit to the Company’s offices in Dubai, the head office for our 

Emerging Markets businesses. The Board received presentations 
on our businesses in Saudi Arabia, India and Chile and met with the 
local General Managers in these countries.

 – Presentation on the Emerging Markets business, including deep dives 

into Brazil, China and our Mid-Tier portfolio of products.

 – Presentation on the US business discussing the opportunities and 

challenges faced by our different franchises across the US.

December
 – Opportunities for our UK based Non-Executive Directors to go on the 
road with some of our London based sales representatives and for 
Vinita Bali to meet with representatives in Bangalore.

During the course of the year, we also received updates at the Board 
and Committee meetings on external corporate governance changes 
likely to impact the Company in the future.

INDUCTION PROGRAMME FOR NEW DIRECTORS
During 2017, Graham Baker, Angie Risley and Marc Owen joined the 
Board and each received tailored induction programmes relevant to their 
skills and experiences and their roles on the Board. These induction 
programmes, which are ongoing include:

 – One-to-one meetings with senior executives to understand the roles 
played by our senior employees and specifically how we do things at 
Smith & Nephew; 

 – Visits to our sites local to the Director to get a feel of how our research 

and manufacturing operations are run;

 – Opportunities to accompany our sales representatives on the road to 

better understand the daily challenges they face; and

 – Meetings with our external advisers for example Freshfields, our 

Corporate lawyers, KPMG, our Auditor and Willis Towers Watson, our 
Remuneration Committee adviser to explain the legal and regulatory 
background to their role on our Board and how these issues are 
approached at Smith & Nephew.

By order of the Board, on 22 February 2018

 – Visit to the Company’s offices in Tokyo and meetings with our senior 
leaders in Japan, with presentations on the business and challenges 
faced in Japan.

Roberto Quarta 
Chairman

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NOMINATION &  
GOVERNANCE COMMITTEE

Member 
since

Meetings  
attended

 – Overseeing the Board Development Programme and the induction 

Membership

Roberto Quarta (Chairman)
Virginia Bottomley
Ian Barlow1
Brian Larcombe1

April 2014
April 2014
April 2017
April 2011

8/8
8/8
6/6
2/2

1 

Ian Barlow joined the Committee following the Annual General Meeting on 6 April 2017 on his 
appointment as Senior Independent Director. Ian replaced Brian Larcombe, who retired from the 
Board and the Nomination & Governance Committee following the Annual General Meeting on 
6 April 2017.  

2018 focus
 – Appointment of new Chief Executive Officer to succeed 

Olivier Bohuon. 

 – Consider how best to ensure that the Board has considered 
different stakeholders in accordance with the proposals from 
the Government and the Financial Reporting Council. 

DEAR SHAREHOLDER,
I am pleased to present the 2017 report of the Nomination 
& Governance Committee.

ROLE OF THE NOMINATION & GOVERNANCE COMMITTEE
Our work falls into the following two areas:

Board Composition
 – Reviewing the size and composition of the Board.

 – Overseeing Board succession plans.

 – Recommending the appointment of Directors.

 – Monitoring Board diversity.

Corporate Governance
 – Overseeing governance aspects of the Board and its Committees.

 – Overseeing the review into the effectiveness of the Board.

 – Considering and updating the Schedule of Matters Reserved to the 

Board and the terms of reference of the Board Committees.

 – Monitoring external corporate governance activities and keeping the 

Board updated.

process for new Directors.

 – Identifying and monitoring any conflict of interests of the Board. 

The terms of reference of the Nomination & Governance Committee 
describe our role and responsibilities more fully and can be found on 
our website www.smith-nephew.com

ACTIVITIES OF THE NOMINATION & GOVERNANCE 
COMMITTEE IN 2017 AND SINCE THE YEAR END
In 2017, we held five physical meetings and three via teleconference. 
Each meeting was attended by all members of the Committee. 
The Company Secretary, Chief Executive Officer and Chief Human 
Resources Officer also attended all or some of the meetings by invitation 
and other Non-Executive Directors were invited to join the meetings 
to discuss the search for a new Chief Executive Officer. In between 
each meeting, various discussions were held between members of the 
Nomination & Governance Committee and the external search agent. 

Our programme of work in 2017 was as follows:

Early February
Activities related to the year end
 – Considered and approved the re-appointment of Directors who had 
completed three or six years’ service and the annual appointment of 
Directors serving in excess of nine years.

 – Recommended the appointment of Ian Barlow as Senior Independent 

Director to the Board following the retirement of Brian Larcombe 
and the appointment of Robin Freestone to replace Ian Barlow as 
Chairman of the Audit Committee. 

 – Reviewed and approved the Schedule of Matters Reserved to the 

Board and the terms of reference of the Board Committees.

 – Discussed the search for two additional Non-Executive Directors. 

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April 
Activities related to the appointment of Non-Executive Directors
 – Considered candidates for the roles of Chairman Elect of the 
Remuneration Committee and a Non-Executive Director with 
Healthcare/Medical Devices experience. 

August
Appointment of new Non-Executive Director
 – Recommended to the Board that Marc Owen be appointed an 

additional Non-Executive Director.

Early September (by teleconference)
Update on search for additional Non-Executive Director
 – Received an update on potential Non-Executive Director candidates 

with Medical Devices experience. 

November (2 meetings)
Update on search for new Chief Executive Officer
 – Received an update on the search for a new Chief Executive Officer.

December (2 meetings by teleconference)
Update on search for new Chief Executive Officer
 – Discussed potential candidates for the role of Chief Executive Officer. 

In the light of the departure of Brian Larcombe and Joseph Papa, 
the Nomination & Governance Committee analysed the skills and 
experiences required by the Board going forward to provide the 
necessary support and challenge to the executive team to execute 
against our Strategic Priorities. We used a matrix (see page 57) to 
compare these required skills and experiences against those already 
held by members of the Board and determined that we need to 
focus on:

 – Increasing the diversity at Board level.

 – Finding a replacement for Joseph Papa as Chairman of the 

Remuneration Committee.

 – Replacing the investment knowledge and experience of 

Brian Larcombe.

 – Reinforcing the Board with specific healthcare and Medical 

Devices experience.

During the year, we were advised by Zygos, who prepared a longlist 
of candidates for us and then worked with us to select a shortlist of 
candidates, who were interviewed by me and a number of other Non-
Executive Directors. As a result of this process, we recommended to 
the Board that Angie Risley be appointed Non-Executive Director and 
Chairman Elect of the Remuneration Committee on 18 September 2017 
and Marc Owen be appointed Non-Executive Director and member of 
the Audit Committee on 1 October 2017.

Further matters were resolved by written resolution including noting the 
retirement of Olivier Bohuon as Chief Executive Officer.

Since the year end, we have also discussed the future structure of the 
Board and completed our year end governance processes. We’ve also 
appointed Roland Diggelmann to the Board as an additional Non-
Executive Director, who also has strong Medical Devices experience.  

Angie Risley is a well-regarded FTSE 100 Human Resources Director and 
proven Non-Executive Director and Remuneration Committee Chairman 
with experience across a wide range of sectors, including a regulated 
environment. She will bring to the Board valuable experience of leading 
a Remuneration Committee as well as providing additional resource and 
sounding for our Human Resources function.

Marc Owen is a proven leader with an astute strategic vision, and 
experience of building significant international healthcare businesses. 
He has strong commercial healthcare expertise and general business 
experience, which will be of great value to the Company.

The appointment of Roland Diggelmann on 1 March 2018 will bring 
additional Medical Devices experience to our Board. 

CHIEF EXECUTIVE OFFICER
In September 2017, Olivier Bohuon announced his intention to retire by 
the end of 2018. He chose to give us notice of this in order to give us 
time to find his successor. The Nomination & Governance Committee 
initiated a search in September 2017 advised by both Zygos and 
Russell Reynolds. Zygos does no other work for the Company other 
than advising on recruitment of Board members. Russell Reynolds also 
advises the Company on executive recruitment and appointments. 
This process is ongoing. 

The key areas of focus for us in 2017 were:

NON-EXECUTIVE DIRECTORS
Brian Larcombe retired as Senior Independent Director at the 2017 
Annual General Meeting and Ian Barlow was appointed in his 
place. Ian Barlow has served on our Board as Chairman of the Audit 
Committee since 2010. He knows the Company well and has a sound 
understanding of the governance and regulatory requirements of the 
Board. He has also met some of our shareholders in his previous role as 
Chairman of the Audit Committee.

Robin Freestone took over the role of Chairman of the Audit Committee 
from Ian Barlow with effect from 1 March 2017. Robin had served 
as a Non-Executive Director of the Board and member of the Audit 
Committee and the Remuneration Committee for a period of 18 months. 
Prior to his appointment to the Board, he was a well-regarded FTSE 100 
Chief Financial Officer who has brought relevant expertise and insight 
to the Audit Committee. His appointment as Chairman of the Audit 
Committee was designed to coincide with the appointment of Graham 
Baker to enable the Chief Financial Officer and Chairman of the Audit 
Committee to build a constructive working relationship together.

As we announced in the 2016 Annual Report, Joseph Papa will be 
retiring from the Board at the 2018 Annual General Meeting after 
more than nine years’ service, seven of which as Chairman of the 
Remuneration Committee. 

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DIVERSITY
We aim to have a Board which represents a wide range of backgrounds, 
skills and experiences. We also value a diversity of outlook, approach 
and style in our Board members. We believe that a balanced Board 
is better equipped to consider matters from a broader perspective, 
understanding the views of our stakeholders as well as our 
shareholders and therefore come to decisions that have considered 
a wider range of issues and perspectives than would be the case in a 
more homogenous Board. Diversity is not simply a matter of gender, 
ethnicity or other easily measurable characteristics. Diversity of outlook 
and approach is harder to measure than gender or ethnicity but is 
equally important. A Board needs a range of skills from technical 
adherence to governance or regulatory matters to understand the 
business in which we operate. It needs some members with a long 
corporate memory and others who bring new insights from other fields. 

There needs to be both support and challenge on the Board as 
well as a balance of gender and commercial and international 
experience. When selecting new members for the Board, we take these 
considerations into account, as well as professional background.  
A new Board member needs to fit in with their fellow Board members, 
but also needs to provide a new way of looking at things.

In 2012, we stated that our expectation would be that by 2015, 25% 
of our Board would be female and at the beginning and the end of 
2017, we met this expectation, although the various Board changes 
during the year meant that this percentage fluctuated throughout the 
year. Looking forward, we shall work towards a Board with 33% female 
representation in-line with the Hampton-Alexander Review. We will 
also look to increase ethnic diversity on the Board following the Parker 
Review as appropriate. We will continue to appoint our Directors on 
merit, valuing the unique contribution that they will bring to the Board, 
regardless of gender, ethnicity or any other diversity measure.

In order to ensure that our Board remains diverse, we analyse the skills 
and experiences we require against the skills and experiences on our 
Board using the matrix on page 57. We review this matrix regularly to 
ensure that it is refreshed to meet the changing needs of the Company.

GOVERNANCE
During the year, the Nomination & Governance Committee also 
addressed a number of governance matters. We received updates from 
the Company Secretary on new developments in corporate governance 
and reporting in the UK (and Europe). We reviewed the independence 
of our Non-Executive Directors, considered potential conflicts of interest 
and the diversity of the Board and made recommendations concerning 
these matters to the Board. 

We have reviewed the proposals in the Government’s Green Paper 
on corporate governance particularly in relation to enhancing the 
stakeholder voice. As a Board, we have identified our key stakeholders 
and during the course of 2018, we will be considering the best ways of 
ensuring that the voices of these different stakeholders are heard within 
the Boardroom.

SMITH & NEPHEW’S BROAD STAKEHOLDERS

EMPLOYEES

CUSTOMERS

GOVERNMENTS

INVESTORS

PAST

PATIENTS

REIMBURSEMENT

PAST

PRESENT

SUPPLIERS

INSURERS

PRESENT

FUTURE

SURGEONS/
NURSES

COMMUNITIES

FUTURE

PROCUREMENT

PUBLIC

NGOS

Roberto Quarta
Chairman of the Nomination & Governance Committee

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ETHICS & COMPLIANCE COMMITTEE REPORT

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ETHICS & COMPLIANCE  
COMMITTEE

Membership

Michael Friedman (Chairman)
Vinita Bali
Ian Barlow
Joseph Papa1

Member 
since

Meetings  
attended

August 2014
April 2015
October 2014
April 2008

4/4
4/4
4/4
4/4

1 

Joseph Papa will be retiring from the Board and the Committee at the Annual 
General Meeting to be held on 12 April 2018. 

2   Marc Owen will join the Committee on 1 March 2018.

2018 focus
 – Continue to monitor the impact of the EU General Data 

Protection Regulation (GDPR) and the EU Regulations for 
Medical Devices (MDR).

 – Conduct select reviews of the compliance programme 

in key markets.

 – Continue to monitor progress against key compliance 

and quality metrics. 

DEAR SHAREHOLDER,
I am pleased to present the 2017 report of the Ethics 
& Compliance Committee.

ROLE OF THE ETHICS & COMPLIANCE COMMITTEE
Our work falls into the following two general areas:

Ethics & Compliance
 – Overseeing ethics and compliance programmes, strategies 

and plans.

 – Monitoring ethics and compliance process improvements 

and enhancements. 

 – Reviewing compliance performance based on monitoring, auditing 

and internal and external investigations data.

 – Reviewing allegations of significant potential compliance issues.

 – Receiving reports from the Group’s Ethics & Compliance Committee 

meetings and from the Chief Compliance Officer and the Chief 
Legal Officer.

Quality Assurance and Regulatory Affairs (QARA)
 – Overseeing the processes by which regulatory and quality 

risks relating to the Company and its operations are identified 
and managed.

 – Receiving and considering regular functional reports and 

presentations from the President of Global Operations, SVP of  
Quality Assurance and other Officers.

The terms of reference of the Ethics & Compliance Committee describe 
our role and responsibilities more fully and can be found on our 
website: www.smith-nephew.com

ACTIVITIES OF THE ETHICS & COMPLIANCE 
COMMITTEE IN 2017 AND SINCE THE YEAR END
In 2017, we held four physical meetings. Each meeting was attended 
by all members of the Committee. The Company Secretary, the Chief 
Legal Officer, the Chief Compliance Officer, the SVP of Quality, and the 
President of Global Operations also attended all or part of the meetings 
by invitation. 

Our programme of work in 2017 included the following:

February
 – Reviewed various quality metrics including the level of complaints, 
the number and nature of field actions and the results of US Food 
and Drug Administration (FDA) inspections.

 – Noted the progress made on the Global Compliance Programme 

Plan for 2016 and noted the plan of action for 2017. 

April
 – Reviewed various quality metrics and approved the Global Quality 

Plan for 2017, noting the additional work to be done in implementing 
the EU Medical Devices Regulation (MDR).

 – Reviewed the actions taken to mitigate risk in new business ventures. 

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July (in Hull, UK)
 – Reviewed various quality metrics including the results of inspections 

by the FDA and Notified Bodies, progress on handling complaints and 
in preparing for the MDR.

 – Reviewed the progress being made to address findings identified by 

the Internal Audit function.

 – Received an update regarding the Company’s readiness for the new 

EU General Data Protection Regulation (GDPR).

November (in Dubai, UAE)
 – Reviewed various quality metrics including the results of inspections 

by the FDA and Notified Bodies, progress on handling complaints and 
preparations for the implementation of the MDR.

 – Reviewed the progress against the 2017 Compliance Plan of Action 
and the follow up actions to findings identified in compliance audits.

At each meeting we noted and considered the activities of compliance 
and enforcement agencies and investigation of possible improprieties. 
At every meeting a report on the Quality Assurance Regulatory 
Assurance (QARA) function was provided along with updates of product 
complaint trends regularly discussed in 2017. We also reviewed a report 
on the activities of the Group’s Ethics & Compliance Committee and 
reviewed the progress of the Global Compliance Programme. 

OVERSIGHT OF QUALITY & REGULATORY 
Product safety is at the heart of our business. Regulatory authorities 
across the world enforce a complex series of laws and regulations that 
govern the design, development, approval, manufacture, labelling, 
marketing and sale of healthcare products. During the year, we oversaw 
the quality and regulatory activities of our business. At each meeting, 
we received a report on quality and regulatory matters from the SVP 
Quality and the President of Global Operations.

We reviewed the results of inspections carried out by the FDA and other 
regulators and monitored the progress of improvements following some 
of these inspections, using a dashboard, which highlighted progress 
being made. We also monitored the work being undertaken to help our 
manufacturing sites to prepare for future inspections.

We requested an in-depth report from management into our complaint 
handling process. This report explained our approach to complaint 
handling including, how we categorised different complaints, how 
we trained our staff to recognise and escalate complaints received 
by the business appropriately, and our planned and ongoing 
process enhancements.

We reviewed the results of quality audits undertaken during the year, 
approved follow up actions and monitored progress made to address 
these actions.

OVERSIGHT OF ETHICS & COMPLIANCE
‘Doing the right thing’ is part of our licence to operate. 
Business practices in the healthcare industry are subject to increasing 
scrutiny by government authorities in many countries. During the year, 
we oversaw the ethics and compliance activities of our business. 
At each meeting we received a report on ethics and compliance matters 
from the Chief Compliance Officer and a legal update on these matters 
from the Chief Legal Officer.

We regularly review our compliance programme as it relates to 
healthcare professionals and third party sellers (such as distributors 
and sales agents), particularly in higher risk markets. For healthcare 
professionals, this includes policies, training and certification, as well 
as pre-approval of consulting services and grants and fellowships. 
For third parties, our programme includes due diligence, contracts 
with compliance terms, compliance training and certification, and site 
assessments to check compliance controls and monitoring visits to 
review books and records. 

We ensure that comprehensive due diligence is carried out prior to an 
acquisition and we ensure that following acquisitions new businesses 
are integrated rapidly into the Smith & Nephew compliance programme. 
During the year, we received a report from management on the ethics 
and compliance lessons learned from our mergers and acquisitions 
process over the last five years.

We oversee the employee compliance training programme, ensuring 
that all new employees are trained on our Code of Conduct, which 
sets out our basic legal and ethical principles for conducting business. 
We are updated on significant calls made to our whistle-blower line, 
which enables employees and members of the public to contact us 
anonymously through an independent provider (where allowed by 
local law) and are updated on allegations of potentially significant 
improprieties and the Company’s response. 

Michael Friedman
Chairman of the Ethics & Compliance Committee

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AUDIT  
COMMITTEE

Membership

Member 
since

Meetings  
attended

Robin Freestone (Chairman)1,2
Ian Barlow 1,2 
Erik Engstrom3
Brian Larcombe4
Marc Owen5
Joseph Papa6

September 2015
May 2010
January 2015
January 2003
October 2017
February 2011

7/7
7/7
6/7
3/3
2/2
7/7

1  Robin Freestone was appointed Chairman of the Audit Committee on 1 March 2017, succeeding 
Ian Barlow, who remained as a member of the Committee and became the Senior Independent 
Director with effect from 6 April 2017. 

2  Designated financial experts under the SEC Regulations or recent and relevant financial 

experience under the UK Corporate Governance Code.

3  Erik Engstrom missed one Audit Committee meeting in Hull, which clashed with a RELX board 

meeting for which he is the Chief Executive Officer. 

4  Brian Larcombe retired from the Board and Audit Committee at the Annual General Meeting on 

6 April 2017.

5  Marc Owen was appointed to the Board and the Audit Committee with effect from 1 October 2017.

6   Joseph Papa will retire from the Board and the Audit Committee at the Annual General Meeting  

to be held on 12 April 2018. 

7  Roland Diggelmann will join the Audit Committee on 1 March 2018. 

2018 focus
 – To provide assurance over the next phase of the Group’s 

NAPO system (our SAP Enterprise Resource Planning (ERP) 
implementation in North America).

 – To extend the breadth of the assurance activities to include 
other risk areas such as product risk linking into the Group’s 
top risk items. 

 – Monitoring the progress made on cyber security, one of our 

principal risks identified in 2017. 

 – To provide assurance over the Accelerating Performance 
and Execution (APEX) programme, which will streamline 
manufacturing, warehouse and distribution, use systems to 
provide general administration more efficiently and increase  
sales force effectiveness whilst maintaining customer focus. 

DEAR SHAREHOLDER,
I’m pleased to write to you for the first time as your new Chairman of 
the Audit Committee. I must take this opportunity to thank Ian Barlow 
for his excellent chairmanship over the past seven years and wish him 
well in his new role as Senior Independent Director, whilst retaining 
his invaluable experience and expertise as he remains a member 
of the Audit Committee. I’d also like to thank Brian Larcombe, who 
stepped down on 6 April 2017, for his many years of wise counsel on 
this Committee.

Your Audit Committee has had another busy year, meeting seven times. 
Of course, the usual matters we expect to cover every year were dealt 
with, but as with all years there were other matters as well. Indeed there 
have been a number of personnel changes directly or indirectly 
affecting the Committee this year which I should reference: 

We welcomed Graham Baker as our new Chief Financial Officer, with 
effect from 1 March 2017. Graham’s profile can be read in the section 
about Directors on page 50 and he is an excellent appointment to 
the Board, including strong executive oversight of the Company’s 
controls framework. 

Marc Owen has also joined the Audit Committee. His background 
in healthcare, based in the US and European markets, provides the 
experience which will be missed by the anticipated retirement of Joe 
Papa in 2018. I’d like to welcome Marc to the Committee and look 
forward to working with him. 

We welcomed Steve Humphries, our new SVP Internal Audit. 
Steve comes from a rich industry background. He was previously Chief 
Internal Auditor for SABMiller plc, another manufacturing firm, and 
brings strong insight. He has previously held positions at Wolseley plc, 
Avery Dennison Inc. and Néstle UK Ltd.

Finally, we welcomed our new Chief Information Officer, Chris Bayley, 
who has a strong background in cyber security from TUI plc. The work 
he has commenced has given the Committee the opportunity to review 
and challenge the IT architecture in the Company and its future-proofing 
to the ever present threat of cyber attack. 

Moving onto our auditor, KPMG. They have completed their third year’s 
audit and continue to provide robust challenge and suggest areas of 
improvement within our internal control framework. We have negotiated 
fees that will continue to be reviewed for good market practice. 
KPMG and the SVP Internal Audit‘s team continued to highlight areas 
where improvements are required. Further detail of the work undertaken 
can be found in the report below. 

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The main non-routine matters we dealt with during the year were:

 – Monitoring the improvements made in our risk management; led 
by Susan Swabey, Company Secretary, who is responsible for our 
risk management assessment. Susan has worked closely with our 
Senior Director of Internal Audit to develop our processes for risk 
management, our approach to risk appetite and improving alignment 
between the Board’s assessment of risk and the underlying risk 
registers generated by management. This work accelerated in 2017 
with deep dives to examine risk through the lens of our products and 
also considering risks from a cross-functional perspective. 

 – Monitoring the Company’s Minimum Acceptable Practices (MAPs) for 
internal controls. We have set a goal of 97% compliance with these 
practices (currently 95% as self-assessed by management) and 
expect this to be achieved during 2018. 

 – Updates from our SVP Treasury, Tax and Finance Operations 

Functions. The SVP Tax reported on US tax reform. 

 – Monitoring the Finance Transformation project, which is planned to 
deliver significant cost savings and improvements to internal control 
and update on the service provided by our outsourced finance facility.

 – Monitoring the progress of the implementation of our NAPO system 

(our SAP ERP implementation in North America). 

 – Assessing new accounting standards IFRS 9, 15 and 16. 

 – Update from Smith & Nephew’s Chief Information Officer including 
cyber risk, IT risk as a whole and incident management reporting. 

Robin Freestone
Chairman of the Audit Committee

ROLE OF THE AUDIT COMMITTEE
Our work falls into the following six areas:

Financial reporting
 – Reviewing significant financial reporting judgements and accounting 

policies and compliance with accounting standards.

 – Ensuring the integrity of the financial statements and their compliance 

with UK and US statutory requirements.

 – Ensuring the Annual Report and Accounts are fair, balanced and 
understandable and recommending their adoption by the Board.

 – Monitoring announcements relating to the Group’s financial  

performance.

Internal controls
 – Monitoring the effectiveness of internal controls and compliance with 
the UK Corporate Governance Code 2016 and the Sarbanes-Oxley 
Act, specifically sections 302 and 404.

 – Reviewing the operation of the Group’s risk mitigation processes and 

the control environment over financial risks.

Risk management
 – On behalf of the Board, reviewing and ensuring oversight of the 

processes by which risks are managed, through regular functional 
reports and presentations, and reporting any issues arising out of 
such reviews to the Board.

 – Reviewing the process undertaken and deep-dive work required to 
complete the Viability Statement and recommending its adoption to 
the Board.

 – Reviewing the impact of risk management and internal controls and 

working closely with the Ethics & Compliance Committee. 

Fraud and whistle-blowing
 – Receiving reports on the processes in place to prevent fraud and to 

enable whistle-blowing.

 – If significant, receive and review reports of potential fraud or whistle-

blowing incidents. 

Internal audit
 – Agreeing Internal Audit plans and reviewing reports of Internal 

Audit work.

 – Monitoring the effectiveness of the Internal Audit function.

 – Reviewing the control observations made by the Internal Auditor, the 
adequacy of management’s response to recommendations and the 
status of any unremediated actions.

External audit
 – Overseeing the Board’s relationship with the external auditor.

 – Monitoring and reviewing the independence and performance of the 

external auditor and evaluating their effectiveness.

 – Making recommendations to the Board for the appointment or  

re-appointment of the external auditor.

 – Monitoring and approving the external auditor’s fees. 

The terms of reference of the Audit Committee describe our role 
and responsibilities more fully and can be found on our website, 
www.smith-nephew.com, where further information can be found for 
permitted non-audit services.

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ACTIVITIES OF THE AUDIT COMMITTEE IN 2017 
AND SINCE THE YEAR END
In 2017, we held five physical meetings and two meetings via voice 
conference. All except one meeting were attended by all appointed 
members of the Audit Committee. The Chairman, the Chief Executive 
Officer, the Chief Financial Officer, the SVP Internal Audit, the external 
auditor, and key members of the finance function, the Company 
Secretary and Deputy Company Secretary also attended by invitation. 
We also met with the external auditor and the SVP Internal Audit without 
management present. Our programme of work in 2017 was as follows:

Early February
Approval of Preliminary Announcement
 – Reviewed the results for the full year 2016 and the preliminary 

July (in Hull, UK)
Approval of H1 Results
 – Reviewed the results for the first half 2017 and approved the 

H1 announcement.

 – KPMG reviewed and provided findings on H1 2017. 

 – Reviewed and approved the external auditor’s Integrated Audit Plan 

for 2017.

 – Received a progress report from the SVP Internal Audit. 

 – Received a report from the Group Treasurer, including an update on 

pension matters. 

 – Approved the definitions for trading/non-trading for annual 

reporting purposes.

announcement and recommended them for adoption by the Board.

 – Received an update regarding the implementation of IFRS 9, 15 

 – Reviewed a draft of the 2016 Annual Report. 

and 16.

 – Reviewed the effectiveness of financial controls and of the Risk 

Management process and identified areas for improvement in 2017.

 – Received a progress report from the SVP Internal Audit and approved 

the Internal Audit Plan for 2017.

 – Received the Quality Assurance Report and approved the Quality 

Assurance work programme for 2017.

 – Received the Viability Statement and confirmed that the Company is  

a viable entity for the assessed forthcoming three-year period.

 – Confirmed the independence of KPMG as external auditor. 

 – Held private meetings with external auditor, KPMG and the SVP 

Internal Audit. 

Early November (in Dubai, UAE)
Approval of Q3 Trading Report
 – Reviewed the Q3 2017 Trading Report and approved the 

Q3 announcement.

 – Reviewed the progress reports from the external auditor on Q3 2017 

and from Internal Audit on their work. 

 – Received an update on new reporting, regulatory and 

 – Held a private meeting with external auditor, KPMG. 

governance requirements.

Late February (via voice conference)
Approval of Financial Statements
 – Reviewed and approved the Annual Report and Accounts for 2016, 
having agreed that they were fair balanced and understandable,  
and recommended them for adoption by the Board.

 – Considered the effectiveness and independence of the external auditor 
and concluded that their work had been effective and independent.

April
 – Reviewed the control themes and observations of the external auditor 

 – Received an update on Sarbanes-Oxley (SOx) and MAPs progress. 

 – Received a progress report from the SVP Internal Audit, focusing 

on fraud. 

 – Held a private meeting with the external auditor, KPMG.

Late November
Review of Functional Reports
 – Received a report from the SVP Internal Audit focusing on the 2018 

Internal Audit plan. 

 – Reviewed and approved the layout and design of the Annual 

and concluded that they had met expectations. 

Report 2017.

 – Received a progress report from the SVP Internal Audit. 

 – Considered and approved critical accounting policies and 

 – Approved the Sustainability Report and its verification process. 

judgements in advance of the 2017 year end.

 – Received a corporate governance update for 2018 

corporate reporting.

 – Reviewed the annual report process and recommended 

improvements for 2017. 

 – Risk management update, including heat maps from the Company 

Secretary and Senior Director of Internal Audit. 

 – Held a private meeting with the external auditor, KPMG.

May (via voice conference)
Approval of Q1 Trading Report
 – Reviewed the Q1 2017 Trading Report and approved the 

Q1 announcement.

 – Approved the Company’s policy and report on Conflict Minerals 

for submission to the NYSE.

 – Received an update from KPMG on the external audit and preliminary 

SOx control findings.

 – Received and discussed reports on Tax, Risk Management, Finance 

Transformation and Cyber Risk.

 – Held private meetings with external auditor, KPMG and the SVP 

Internal Audit. 

Since the year end, we have also reviewed the results for the full year 
2017, the preliminary announcement, Annual Report and Accounts for 
2017 and have concluded that taken as a whole, they are fair, balanced 
and understandable and have advised the full Board accordingly. 
In coming to this conclusion, we have considered the description of the 
Group’s strategy and key risks, the key elements of the business model, 
which is set out on pages 8–9, risks and the key performance indicators 
and their link to the strategy.

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AUDIT COMMITTEE REPORT continued

ACCOUNTABILITY

SIGNIFICANT MATTERS RELATED  
TO THE FINANCIAL STATEMENTS
We considered the following key areas of judgement in relation to the 
2017 accounts and at each half-year and quarterly trading report, which 
we discussed in all cases with management and the external auditor:

Valuation of inventories
A feature of the Orthopaedic Reconstruction and Trauma & 
Extremities franchises (whose finished goods inventory makes up 
approximately 60% of the Group total finished goods inventory) is the 
high level of product inventory required, some of which is located at 
customer premises and is available for customers’ immediate use. 
Complete sets of products, including large and small sizes, have to 
be made available in this way. These sizes are used less frequently 
than standard sizes and towards the end of the product life cycle 
are inevitably in excess of requirements. Adjustments to carrying 
value are therefore required to be made to orthopaedic inventory 
to anticipate this situation. These adjustments are calculated in 
accordance with a formula based on levels of inventory compared 
with historical usage. This formula is applied on an individual product 
line basis and is first applied when a product group has been on 
the market for two years. This method of calculation is considered 
appropriate based on experience, but it does involve management 
estimation of customer demand, effectiveness of inventory 
deployment, length of product lives, phase-out of old products and 
efficiency of manufacturing planning systems. 

Our action
At each quarter end, we received reports from, and discussed with, 
management the level of provisioning and material areas at risk. 
The provisioning level was 19% at 31 December 2017 (20% as at 
31 December 2016). We challenged the basis of the provisions and 
concluded that the proposed levels were appropriate and have been 
consistently estimated.

Liability provisioning
The recognition of provisions for legal disputes is subject to 
a significant degree of estimation. Provision is made for loss 
contingencies when it is considered probable that an adverse 
outcome will occur and the amount of the loss can be reasonably 
estimated. In making its estimates, management takes into 
account the advice of internal and external legal counsel and uses 
third party actuarial modelling where appropriate. Provisions are 
reviewed regularly and amounts updated where necessary to 
reflect developments in the disputes. The ultimate liability may 
differ from the amount provided depending on the outcome of court 
proceedings and settlement negotiations or if investigations bring to 
light new facts. 

Our action
As members of the Board, we receive regular updates from the 
Chief Legal Officer. These updates form the basis for the level of 
provisioning. The Group carries a provision relating to potential 
liabilities arising on its portfolio of modular metal-on-metal hip 
products of $157 million as of 31 December 2017. We received 
detailed reports from management on this position, including the 
actuarial model used to estimate the provision, and challenged the 
key assumptions, including the number of claimants and projected 
value of each settlement. The legal judgements have decreased 
by $35 million during the year, primarily due to settlements of a 
number of metal-on-metal matters that were provided for within the 
actuarially determined provision. There have been some smaller 
movements from cases having been resolved and some new 
matters arising. We have determined that the proposed levels of 
provisioning at year end of $190 million included within ‘provisions’ 
in Note 17.1 in 2017 ($225 million in 2016) were appropriate in 
the circumstances.

Impairment
In carrying out impairment reviews of acquisition intangible assets 
a number of significant assumptions have to be made when 
preparing cash flow projections. These include the future rate of 
market growth, discount rates, the market demand for the products 
acquired, the future profitability of acquired businesses or products, 
levels of reimbursement and success in obtaining regulatory 
approvals. If actual results should differ or changes in expectations 
arise, impairment charges may be required, which would adversely 
impact operating results. 

Our action
We reviewed management’s reports on the key assumptions 
with respect to acquisition intangible assets – particularly the 
forecast future cash flows and discount rates used to make these 
calculations. We noted the reduction in headroom relating to the 
coblation technology asset acquired with ArthroCare in 2014 and 
challenged the assumptions used for future revenue growth of 
products using this technology. We concluded that the carrying value 
of this asset is appropriately supported by the cash flow projections. 
We have also considered the disclosure surrounding these reviews, 
and concluded that the review and disclosure were appropriate.

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ACCOUNTABILITY

Taxation
The Group operates in numerous tax jurisdictions around the 
world. Although it is Group policy to submit its tax returns to the 
relevant tax authorities as promptly as possible, at any given time 
the Group has unagreed years outstanding and is involved in 
disputes and tax audits. Significant issues may take several years to 
resolve. In estimating the probability and amount of any tax charge, 
management takes into account the views of internal and external 
advisers and updates the amount of provision whenever necessary. 
The ultimate tax liability may differ from the amount provided 
depending on interpretations of tax law, settlement negotiations  
or changes in legislation. 

Our action
We annually review our processes and approve the principles 
for management of tax risks. We review quarterly reports from 
management evaluating existing risks and tax provisions, which 
has included a detailed impact assessment of US tax reforms in the 
year end report from management. Based on a thorough report from 
management of tax liabilities and our challenge of the basis of any 
tax provisions recorded, we concluded that the levels of provisions 
and disclosures were appropriate.

OTHER MATTERS RELATED TO THE FINANCIAL STATEMENTS
As well as the identified significant matters, other matters that the Audit 
Committee considered during 2017 were:

Business combinations
During 2017, we acquired Rotation Medical, Inc. We received a report 
from management setting out the significant assets and liabilities 
acquired, details of the provisional fair value adjustments applied, an 
analysis of the intangible assets acquired, the assumptions behind the 
valuation of these acquired intangible assets and the proposed useful 
economic life of the intangible asset acquired. During 2017, we also 
considered and concurred with management that there had been no 
changes to the provisional fair values recognised in the 2016 acquisition 
of Blue Belt Technologies, Inc.

Post Retirement Benefit Pensions
The Group has post retirement defined benefit pension schemes, which 
require estimation in setting the assumptions. We received a report from 
management setting out their proposed assumptions for the UK and 
US schemes and concurred with management that these assumptions 
were appropriate.

EXTERNAL AUDITOR
Independence of External Auditor
Following a competitive tender in 2014, KPMG was appointed external 
auditor of the Company in 2015. We are satisfied that KPMG are fully 
independent from the Company’s management and free from conflicts 
of interest. Our Auditor Independence Policy, which ensures that this 
independence is maintained, is available on the Company’s website. 

We believe that the implementation of this policy helps ensure that 
auditor objectivity and independence is safeguarded. The policy also 
governs our approach when we require our external auditor to carry 
out non-audit services, and all such services are strictly governed by 
this policy. 

The Auditor Independence Policy also governs the policy regarding 
audit partner rotation with the expectation that the audit partner will 
rotate at least every five years. Stephen Oxley has been in tenure 
for three years as our Audit Partner. The Audit Committee confirms 
it has complied with the provision of the Competition and Markets 
Authority Order. 

Effectiveness of external auditor(s)
We conducted a review into the effectiveness of the external audit as 
part of the 2017 year end process, in line with previous years. We sought 
the views of key members of the finance management team, considered 
the feedback from this process and shared it with management.

During the year, we also considered the inspection reports from the 
Audit Oversight Boards in the UK and US and determined that we were 
satisfied with the audit quality provided by KPMG.

The Audit Committee regularly receives feedback from KPMG, including 
at each meeting where management present their summary of critical 
accounting estimates as at each quarter end.  

Overall therefore, we concluded that KPMG had carried out their audit 
for 2017 effectively. 

The Audit Committee continues to review not only the effectiveness  
of the external auditor, KPMG but also its market competitiveness. 

Appointment of External Auditor at Annual General Meeting
Resolutions will be put to the Annual General Meeting to be held on 
12 April 2018 proposing the re-appointment of KPMG as the Company’s 
auditor and authorising the Board to determine its remuneration,  
on the recommendation of the Audit Committee in accordance with  
the Competition and Markets Authority (CMA) Order 2014.

Disclosure of Information to the Auditor
In accordance with Section 418 of the Companies Act 2006, the 
Directors serving at the time of approving the Directors’ Report confirm 
that, to the best of their knowledge and belief, there is no relevant audit 
information of which the Auditor, KPMG, is unaware and the Directors 
also confirm that they have taken reasonable steps to be aware of any 
relevant audit information and, accordingly, to establish that the Auditor 
is aware of such information.

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AUDIT COMMITTEE REPORT continued

ACCOUNTABILITY

Non-Audit Fees Paid to the Auditor
Non-audit fees are subject to approval in-line with the Auditor 
Independence Policy which is reviewed annually and forms part  
of the terms of reference of the Audit Committee.

The Audit Committee recognise the importance of the independence 
of the external auditor and ensures that the Auditor’s independence 
should not be breached. The Audit Committee ensures that the Auditor 
does not receive a fee from the Company or its subsidiaries that would 
be deemed large enough to impact its independence or be deemed 
a contingent fee. The total fees for permitted non-audit services shall 
be no more than 70% of the average of the fees paid in the last three 
consecutive financial years for the statutory audits of the Company 
and its subsidiaries. In light of the Financial Reporting Council’s revised 
Ethical Standards and SEC Regulations, we have revised our Auditor 
Independence Policy.

Any pre-approved aggregate, individual amounts up to $25,000 may 
be authorised by the Senior Vice-President Tax and Senior Vice-
President Group Finance respectively and amounts up to $50,000 by 
the Chief Financial Officer. Any individual amount over $50,000 must be 
pre-approved by the Chairman of the Audit Committee. If unforeseen 
additional permitted services are required, or any which exceed the 
amounts approved, again pre-approval by the Chairman of the Audit 
Committee is required.

The following reflects the non-audit fees incurred with KPMG in 2017, 
which were approved by the Chairman of the Audit Committee:

Assistance with tax compliance
in Singapore only. 

Tax fees and 
compliance  
services
Pension advice Advice on the impact of changes

to pension benefits for the UK 
defined benefit scheme.

2017
$ million 

2016 
$ million

0.1

0.1

–

0.5

Tax compliance services conducted by KPMG in 2017 only took place 
in countries where it is required by law for the auditor to conduct 
these services.

The ratio of non-audit fees to audit fees for the year ended 31 December 
2016 was 0.15. The ratio of non-audit fees to audit fees for the year 
ended 31 December 2017 is 0.02.

Full details are shown in Note 3.2 of the Notes to the Group accounts.

Audit Fees paid to the Auditor
Fees for professional services provided by KPMG, the Group’s 
independent auditor in each of the last two fiscal years, in each of the 
following categories were:

Audit fees
Audit-related fees
Total

2017  
$ million

2016  
$ million

4.4
–
4.4

4.0
–
4.0

INTERNAL AUDIT
The Internal Audit team, which reports functionally to the Audit 
Committee, carries out risk-based reviews across the Group. 
These reviews examine the management of risks and controls over 
financial, operational, IT and transformation programme activities. 
The audit team, led by the SVP Internal Audit, consists of appropriately 
qualified and experienced employees. Third parties may be engaged to 
support audit work as appropriate. 

The SVP Internal Audit has direct access to, and has regular meetings 
with, the Audit Committee Chair and prepares formal reports for 
Audit Committee meetings on the activities and key findings of the 
function, together with the status of management’s implementation of 
recommendations. The Audit Committee has unrestricted access to all 
internal audit reports, should it wish to review them.

During the year, the team completed over 40 audits and reviews across 
the Group. These included reviews of: the roll-out of SAP across the 
North America business; IT operations including cyber status; inventory, 
financial reporting and credit management processes across multiple 
markets; Treasury operations; Manufacturing operations in China and 
Costa Rica; Shared Services operations in China, India and Poland; 
ERM effectiveness; and readiness for complying with e-commerce with 
key customers (GS1-GDSN) and Global Data Protection Requirements 
(GDPR). 

A periodic review of the Internal Audit function is undertaken, most 
recently in 2014, by an independent external consultant in accordance 
with the guidelines of the Institute of Internal Auditors. In addition 
a structured questionnaire was introduced this year, allowing Non-
Executive and Executive and senior management, plus the external 
auditor, to comment on key aspects of the function’s performance. 
The Audit Committee, which re-approved the function’s charter in 
November 2017, has satisfied itself that adequate, objective internal 
audit standards and procedures exist within the Group and that the 
Internal Audit function is effective.

RISK MANAGEMENT PROGRAMME
Whilst the Board is responsible for ensuring oversight of strategic 
risks relating to the Company, determining an appropriate level of 
risk appetite, and monitoring risks through a range of Board and 
Board Committee processes, the Audit Committee is responsible for 
ensuring oversight of the processes by which operational risks, relating 
to the Company and its operations are managed and for reviewing 
financial risks and the operating effectiveness of the Group’s Risk 
Management process. 

During the year, we reviewed our Risk Management processes 
and progress was discussed at our meetings in February, April and 
November. We approved the Risk Management Programme for 2017 
and monitored performance against that plan specifically reviewing the 
work undertaken by the risk champions across the Group, identifying 
the risks which could impact their areas of our business. 

During May and June, a new risk management policy and manual 
was rolled out with one-to-one training provided to risk champions. 
From May 2017, this allowed risk reporting to commence in-line with the 
strategy of a bottom up approach. This was revisited again in November. 
The Enterprise Risk Management (ERM) approach commenced and 
included interviewing individual members of senior management and 
the Board throughout Q3 2017, to discuss principal risks and concerns 
they had. These interviews were also used to understand the individual 
Board members’ risk tolerance. 

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ACCOUNTABILITY

Later in July, the ERM structure was aligned with that of the Internal Audit 
function to assess the mitigating actions in place for our key products. 

In November, it was reported that deep dives had concluded for 
ALLEVYN, Total Knees, Compliance EUCAN (Europe and Canada) and 
PICO, with key themes noted by the Committee. The 2017 Annual Report 
disclosure was also discussed. 

Since the year end, we have reviewed a report from the SVP Internal 
Audit into the effectiveness of the Risk Management Programme 
throughout the year. We considered the principal risks, the actions 
taken by management to review those risks and the Board risk appetite 
in respect of each risk. 

We concluded that the Risk Management process during 2017 and up 
to the date of approval of this Annual Report was effective. Work will 
continue in 2018 and beyond to continue to enhance the process. 

See pages 40–49 for further information on our Risk 
Management Process. 

VIABILITY STATEMENT
We also reviewed management’s work in conducting a robust 
assessment of those risks which would threaten our business model 
and the future performance or liquidity of the Company, including its 
resilience to the threats of viability posed by those risks in severe but 
plausible scenarios. This assessment included stress and sensitivity 
analyses of these risks to enable us to evaluate the impact of a severe 
but plausible combination of risks. We then considered whether 
additional financing would be required in such eventualities. Based on 
this analysis, we recommended to the Board that it could approve and 
make the Viability Statement on pages 48–49.

GOING CONCERN
The Group’s business activities, together with the factors likely to 
affect its future development, performance and position are set out 
in the ‘Financial review and principal risks’ section on pages 36–49. 
The financial position of the Group, its cash flows, liquidity position and 
borrowing facilities are described on pages 38–39.

In addition, the Notes to the Group accounts include the Group’s 
objectives, policies and processes for managing its capital; its financial 
risk management objectives; details of its financial instruments and 
hedging activities; and its exposure to credit risk and liquidity risk.

The Group has considerable financial resources and its customers 
and suppliers are diversified across different geographic areas. As a 
consequence, the Directors believe that the Group is well placed to 
manage its business risk successfully despite the ongoing uncertain 
economic outlook.

The Directors have a reasonable expectation that the Group has 
adequate resources to continue in operational existence for the 
foreseeable future. Thus they continue to adopt the going concern basis 
for accounting in preparing the annual financial statements.

Management also believes that the Group has sufficient working capital 
for its present requirements.

EVALUATION OF INTERNAL CONTROLS
Management is responsible for establishing and maintaining adequate 
internal control over financial reporting as defined in Rule 13a–15(f) and 
15d–15(f) under the US Securities Exchange Act of 1934.

There is an established system of internal control throughout the Group 
and our country business units. The main elements of the internal 
control framework are:

 – The management of each country is responsible for the establishment 
and review of effective financial controls within their business unit.

 – The Group’s IT organisation is responsible for the establishment of 

effective IT controls within the core financial systems and underlying 
IT infrastructure. The responsibility for the review of the effectiveness 
of such controls is split between the IT organisation and the Financial 
Controls & Compliance Group.

 –  The Group Finance Manual sets out financial and accounting policies. 

The Group’s Minimum Acceptable Practices (MAPs) have been 
enhanced by simplifying and clarifying the requirements as well as 
broadening their scope. The business is required to self-assess their 
level of compliance with the MAPs twice a year and remediate any 
gaps. MAPs compliance is validated through spot checks conducted 
by the Financial Controls and Compliance function and during both 
Internal Audit and external audit visits.

 –  There are clearly defined lines of accountability and delegations 

of authority.

 –  During the year, there has been further progress in standardising and 
simplifying our core financial controls. In 2018, there will be a focus on 
standardising the controls globally, merging the core financial controls 
with the MAPs and evaluating technology solutions to operating and 
testing controls.

 –  The Internal Audit function executes a risk-based annual work plan, 

as approved by the Audit Committee.

 –  The Audit Committee reviews reports from Internal Audit on their 
findings on internal financial controls, including compliance with 
MAPs and from the SVP Group Finance and the heads of the 
Financial Controls and Compliance, Taxation and Treasury functions.

 –  The Audit Committee reviews regular reports from the Financial 
Controls and Compliance function with regard to compliance 
with the Sarbanes-Oxley Act including the scope and results of 
management’s testing and progress regarding any remediation, as 
well as the aggregated results of MAPs self-assessments performed 
by the business.

 –  Business continuity planning, including preventative and contingency 

measures, back-up capabilities and the purchase of insurance.

 –  Risk management policies and procedures including segregation of 

duties, transaction authorisation, monitoring, financial and managerial 
review and comprehensive reporting and analysis against approved 
standards and budgets.

 –  A treasury operating framework and Group treasury team, 

accountable for all treasury activities, which establishes policies and 
manages liquidity and financial risks, including foreign exchange, 
interest rate and counterparty exposures. Treasury policies, risk 
limits and monitoring procedures are reviewed regularly by the Audit 
Committee on behalf of the Board.

 –  Our published Group tax strategy which details our approach to tax 
risk management and governance, tax compliance, tax planning, the 
level of tax risk we are prepared to accept and how we deal with tax 
authorities, which was reviewed by the Audit Committee on behalf of 
the Board. 

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AUDIT COMMITTEE REPORT continued

ACCOUNTABILITY

 –  The Audit Committee reviews the Group whistle-blower procedures. 

 – Having received the report from management, the Audit Committee 

reports to the Board on the effectiveness of controls.

 – KPMG, an independent registered public accounting firm issued an 
audit report on the Group’s internal control over financial reporting  
as at 31 December 2017.

CODE OF ETHICS FOR SENIOR FINANCIAL OFFICERS
We have adopted a Code of Ethics for Senior Financial Officers, which 
applies to the Chief Executive Officer, the Chief Financial Officer, the 
SVP Group Finance and the Group’s senior financial officers. There have 
been no waivers to any of the Code’s provisions nor have there been 
any amendments to the Code during 2017 or up until 22 February 2018. 
A copy of the Code of Ethics for Senior Financial Officers can be found 
on our website at www.smith-nephew.com

In addition, every individual in the finance function certifies to the 
Chief Financial Officer that they have complied with the Finance Code 
of Conduct.

EVALUATION OF COMPOSITION, PERFORMANCE AND 
EFFECTIVENESS OF THE AUDIT COMMITTEE
The composition, performance and effectiveness of the Audit 
Committee was evaluated this year in accordance with the EU Audit 
Reform. Its effectiveness is also reviewed in conjunction with the annual 
Board evaluation, which this year was conducted by Ian Barlow, in his 
first year as Senior Independent Director.

The review by the Audit Committee found the following and the below 
action will be taken during 2018: 

Finding

Composition

The composition of the Audit Committee with at 
least one financial expert and a mix of UK and 
global experience in the healthcare sector was 
deemed appropriate.

Performance

The Committee was considered to have performed 
effectively with an appropriate balance between 
challenge and constructive support. 

Effectiveness

The Committee was considered to be effective with a 
thorough agenda and good papers, which were well 
presented and debated. 

Action 

None

None

None

 –  The Audit Committee received and reviewed a report on the progress 
of the Finance Transformation during 2017 and the mitigation of the 
associated risks.

This system of internal control has been designed to manage rather 
than eliminate material risks to the achievement of our strategic 
and business objectives and can provide only reasonable, and not 
absolute, assurance against material misstatement or loss. Because of 
inherent limitation, our internal controls over financial reporting may not 
prevent or detect all misstatements. In addition, our projections of any 
evaluation of effectiveness in future periods are subject to the risk that 
controls may become inadequate because of changes in conditions, 
or that the degree of compliance with the policies or procedures may 
deteriorate. Entities where the Company does not hold a controlling 
interest have their own processes of internal controls similar to those  
of the Company.

We have reviewed the system of internal financial control and satisfied 
ourselves that we are meeting the required standards both for the year 
ended 31 December 2017 and up to the date of approval of this Annual 
Report. No concerns were raised with us in 2017 regarding possible 
improprieties in matters of financial reporting. 

This process complies with the Financial Reporting Council’s ‘Guidance 
on Risk Management, Internal Control and Related Financial and 
Business Reporting’ on the UK Corporate Governance Code and 
additionally contributes to our compliance with the obligations under  
the Sarbanes-Oxley Act and other internal assurance activities. 
There has been no change during the period covered by this Annual 
Report that has materially affected, or is reasonably likely to materially 
affect, the Group’s internal control over financial reporting.

The Board is responsible overall for reviewing and approving the 
adequacy and effectiveness of the risk management framework and 
the system of internal controls over financial, operational (including 
quality management and ethical compliance) processes operated by 
the Group. The Board has delegated responsibility for this review to 
the Audit Committee. The Audit Committee, through the Internal Audit 
function, reviews the adequacy and effectiveness of internal control 
procedures and identifies any weaknesses and ensures these are 
remediated within agreed timelines. The latest review covered the 
financial year to 31 December 2017 and included the period up to the 
approval of this Annual Report. 

The main elements of this annual review are as follows:

 – The Chief Executive Officer and the Chief Financial Officer evaluated 

the effectiveness of the design and operation of the Group’s 
disclosure controls and procedures as at 31 December 2017. 
Based upon this evaluation, the Chief Executive Officer and Chief 
Financial Officer concluded on 22 February 2018 that the disclosure 
controls and procedures were effective as at 31 December 2017.

 – Management is responsible for establishing and maintaining 

adequate internal control over financial reporting. 
Management assessed the effectiveness of the Group’s internal 
control over financial reporting as at 31 December 2017 in accordance 
with the requirements in the US under section 404 of the Sarbanes-
Oxley Act. In making that assessment, they used the criteria set 
forth by the Committee of Sponsoring Organisations of the Treadway 
Commission in Internal Control-Integrated Framework (2013). 
Based on their assessment, management concluded and reported 
that, as at 31 December 2017, the Group’s internal control over 
financial reporting was effective based on those criteria.

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DIRECTORS’ REMUNERATION REPORT

REMUNERATION

DEAR SHAREHOLDER,

This will be the final time I write to you as your Chairman of the Smith 
& Nephew plc Remuneration Committee. I have been a member of the 
Board since 2008 and Chairman of the Remuneration Committee since 
April 2011. With that longevity in mind, I will retire as Chairman of the 
Remuneration Committee and as a Director of the Company at the 
2018 Annual General Meeting, where I will not stand for re-election. 
Much of my time during 2017 has been assisting our Chairman to 
find my replacement and assisting the new Remuneration Committee 
Chair in settling into her new role. I am very pleased to introduce 
Angie Risley to you as our Chairman Elect. Angie has vast experience 
of Human Resources, including remuneration and importantly was 
an effective member of the Remuneration Committee in her previous 
non-executive director roles, most recently as Chairman of the 
Remuneration Committee at Serco plc. Her experience in a wide 
variety of different sectors will add real value to what is becoming an 
expanded role for the Remuneration Committee. Proposed Corporate 
Governance changes indicate that increased employee engagement 
and oversight of employee remuneration generally will fall under the 
remit of the Remuneration Committee. 

REVIEW OF 2017 PERFORMANCE
During the year, the Group delivered underlying revenue growth of 
3% and a 20bps improvement in trading profit margin, in-line with 
guidance. Highlights included strong growth from Knee Implants and 
in the Emerging Markets. Trading cash flow improved year-on-year, at  
$940 million, as did the trading profit to cash conversion ratio of 90%. 
The tax rate on trading results reduced by 670bps to 17.1%, including 
a benefit from a one-off US tax settlement. Adjusted earnings 
per share (EPSA) were up 14%. Our Return On Invested Capital 
also improved, up 280bps to 14.3%. 

These non-IFRS financial measures are explained and reconciled 
to the most directly comparable financial measure prepared in 
accordance with IFRS on pages 178–181.

As a result of the financial performance in 2017 and over the three-
year period ending 31 December 2017, our Executive Directors 
received the following awards:

Cash bonus  
(as % of salary)

91%
104%

Equity Incentive 
Award  
(as % of salary 
at date of grant)

Performance Share 
Award vesting  
(as % of salary 
at date of grant)

50%
55%

102.6%
N/A

Olivier Bohuon
Graham Baker

The total remuneration paid to Olivier Bohuon and Graham Baker 
in 2017 is detailed further on page 83. As Graham Baker joined the 
Company on 1 March 2017, there are no comparative figures for him. 

The single total remuneration figure for Mr Bohuon for 2017 increased  
to $5,032,925 from $3,332,850 in 2016. This was directly related to 
the stronger Company performance in 2017 and in particular above 
target performance for trading cash flow and trading profit margin, 
which collectively led to an increase of $616,009 for the Cash Incentive 
Plan. Our cumulative free cash flow and Emerging Market results over 
the three year performance period for our Performance Share Plan 
also contributed to a total vesting of these awards at 108% of target 
compared to 16% in 2016.

RETIREMENT OF OLIVIER BOHUON
You will see from the meetings the Remuneration Committee has 
conducted, 2017 was a busy year relating to Executive Director 
remuneration. Our Chairman, Roberto Quarta, has already touched 
on the retirement of Olivier Bohuon as Chief Executive Officer. 
The Committee has met to approve his retirement arrangements, 
which are in-line with the Remuneration Policy approved by our 
shareholders at the 2017 Annual General Meeting.

In summary, Olivier Bohuon will support the transition to the new 
Chief Executive Officer, when appointed and will continue to receive 
the same salary and benefits as in 2017. He will participate in the 
Annual Incentive Plan for the period worked in 2018, but will not 
receive a 2018 award under the Performance Share Plan. As a good 
leaver, his Equity Incentive Awards will vest on his leaving date, and 
his Performance Share Awards will be pro-rated for length of time 
served since the date of award and will vest subject to the original 
performance conditions on their original vesting dates in 2019 and 
2020. Additionally, his 2017 award will remain subject to a two-year 
post vesting holding period. 

I’d also like to personally thank Olivier for his leadership and 
improvements achieved during his tenure, and wish him the best 
for the future.   

2017 ANNUAL GENERAL MEETING (AGM)
We were pleased that following the vote against our Remuneration 
Report (excluding the policy) in 2016, that both our Remuneration 
Policy and Remuneration Report received over 98% of votes in favour 
at the 2017 Smith & Nephew plc AGM. This demonstrates the strong 
support from our shareholders for our remuneration arrangements. 
We do not plan to make any changes to our remuneration 
arrangements in 2018.

I’d like to thank those shareholders who engaged with us during 
2017 and met with Angie Risley. These shareholders covered nearly 
15% of our shares. We welcome your feedback on our remuneration 
policy and arrangements and actively consider your views in 
our discussions. 

LOOKING FORWARD
The Remuneration Committee will continue to be guided by the 
principles we have followed in the past:

 –  Performance measures linked to our strategic priorities;

 –  Alignment of executive and shareholder interests; and

 –  Simplicity.

We will ensure that pay remains aligned with performance. 

We will also continue to monitor external corporate governance 
developments and respond accordingly, in particular those relating 
to expanding the remit of the Remuneration Committee to take 
greater account of the employee voice.

Joseph Papa
Chairman of the Remuneration Committee

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REMUNERATION

MEASURES IN OUR VARIABLE PAY PLANS

Financial measures in Annual Incentive Plan

Revenue (35%)

Revenue is a key driver of profit growth.

Trading Profit Margin (25%)

Trading Cash Flow (15%)

Trading profit margin is a critical measure both for the business and our shareholders and 
delivering margin improvements is a core commitment under our strategy. 

Cash flow from our Established Markets is necessary in order to fund growth in Emerging 
Markets, innovation, organic growth and acquisitions.

Business objectives in Annual Incentive Plan

Business Process (8.3%)

People (8.3%)

Customer (8.3%)

We need to release resources from the businesses through improved structures, efficiencies 
and business processes in order to re-invest in our higher growth areas, including Emerging 
Markets, innovation, organic growth and acquisitions.

We need to attract and retain the right people to achieve our strategy through improving our 
operating model and drive the right behaviours for all of our people globally.

Our mission is to deliver advanced medical technologies that help healthcare professionals, 
our customers and improve the quality of life of their patients.

Performance measures in our Performance Share Plan

Relative TSR (25%)

Cumulative Cash Flow (25%)

If we execute our strategy successfully, this will lead to an increased return for our 
shareholders, whether you invest in the healthcare sector or in the FTSE.

Cash flow from our Established Markets is necessary in order to fund growth in Emerging 
Markets, innovation, organic growth and acquisitions.

Sales Growth (25%)

Sales growth is a key driver of profit growth.

Return on Invested Capital (25%)

Detailed further on pages 97–101.

Return on invested capital is a high priority for our shareholders which will drive better 
financial discipline and enhanced operating performance.

Compliance statement

We have prepared this Directors’ Remuneration Report (the Report) in accordance with The Enterprise and Regulatory Reform Act 2012-2013 (clauses 81-84) and 
The Large and Medium-Sized Companies and Groups (Accounts and Reports) (Amendment) Regulations 2013 (the Regulations). The Report also meets the relevant 
requirements of the Financial Conduct Authority (FCA) Listing Rules.

The first part of the Report (pages 81–96) is the annual report on remuneration (the Implementation Report). The Implementation Report will be put to shareholders for 
approval as an advisory vote at the Annual General Meeting on 12 April 2018. The Implementation Report explains how the Remuneration Policy was implemented 
during 2017 and also how it is currently being implemented in 2018. 

The second part of the Report (pages 97–105) is the Directors’ Remuneration Policy Report (the Policy Report) which was approved by shareholders at the Annual 
General Meeting held in April 2017. The Policy Report describes our Remuneration Policy as it relates to the Directors of the Company. All payments we make to 
any Director of the Company will be in accordance with this Remuneration Policy. This Policy remains unchanged in 2018 and it is intended that it will next be put to 
shareholder vote at the Annual General Meeting to be held in 2020.

The financial tables on pages 83–92, the Directors’ interests table on page 93 and the tables on pages 94–96 have been audited by KPMG LLP.

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REMUNERATION

REMUNERATION  
COMMITTEE

Membership

The Remuneration Committee presents the Annual Report on 
remuneration (the Implementation Report), which will be put to 
shareholders for an advisory vote at the Annual General Meeting 
to be held on 12 April 2018.

ROLE OF THE REMUNERATION COMMITTEE
Our work falls into the following three areas:

Determination of Remuneration Policy and Packages
 – Determination of Remuneration Policy for Executive Directors and 

senior executives.

 – Approval of individual remuneration packages for Executive Directors 
and Executive Officers, at least annually, and any major changes to 
individual packages throughout the year.

 – Consideration of remuneration policies and practices across 

the Group.

 – Approval of appropriate performance measures for short-

term and long-term incentive plans for Executive Directors and 
senior executives.

Member 
since

Meetings  
attended

 – Determination of pay-outs under short-term and long-term incentive 

plans for Executive Directors and senior executives.

Joseph Papa (Chairman)
Angie Risley1 (Chairman Elect)
Vinita Bali2
Virginia Bottomley
Robin Freestone
Brian Larcombe3
Roberto Quarta4

April 2011
September 2017
April 2015
April 2014
September 2015
September 2010
April 2014

7/7
3/3
6/7
7/7
7/7
3/3
6/7

1  Angie Risley was appointed to the Board on 18 September 2017 and will be appointed Chairman of 

the Committee with effect from 12 April 2018, subject to her re-election.  

2   Vinita Bali was unable to attend one meeting due to a prior commitment. She had signified her 
approval of the matters being discussed to the Remuneration Committee Chairman prior to 
the meeting.  

3  Brian Larcombe retired from the Board at the Annual General Meeting on 6 April 2017.

4   Roberto Quarta was unable to attend one meeting due to its short notice. He had signified 

his approval of the matter being discussed to the Remuneration Committee Chairman prior to 
the meeting.   

2018 focus
 – Evaluate remuneration package for a new Chief Executive Officer.

 – Review gender pay reports and approve the implementation of 

a programme designed to reduce the gender pay gap.  

 – Consider possible response to BEIS Green Paper on Corporate 
Governance and how best to engage with our employees on 
remuneration matters.

 – Consider the implications of US tax reform.  

Oversight of all Company Share Plans
 – Determination of the use of long-term incentive plans and overseeing 

the use of shares in executive and all-employee plans.

Reporting and Engagement with shareholders 
on Remuneration Matters
 – Approval of the Directors’ Remuneration Report ensuring compliance 

with related governance provisions.

 – Continuation of constructive engagement on remuneration matters 

with shareholders.

The terms of reference of the Remuneration Committee describe our 
role and responsibilities more fully and can be found on our website: 
www.smith-nephew.com

ACTIVITIES OF THE REMUNERATION COMMITTEE 
IN 2017 AND SINCE THE YEAR END
In 2017, we held seven meetings and determined six matters by 
written resolution. Each meeting was attended by all members of the 
Committee (except Vinita Bali and Roberto Quarta who each missed 
one meeting this year). The Chief Executive Officer, the Chief Human 
Resources Officer and the SVP Global Reward, key members of the 
finance function and the Company Secretary also attended all or part 
of some of the meetings, except when their own remuneration was 
being discussed. We also met with the independent Remuneration 
Consultants, Willis Towers Watson, without management present. 
Our programme of work in 2017 can be found in the report below.

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REMUNERATION

Early February
Approval of salaries, awards and payouts in 2017
 – Agreed the targets for the short-term and long-term incentive plans 
for 2017. Introduced global revenue growth and ROIC as long-term 
performance measurements (defined on page 89). Approved the 
remuneration strategy for 2017 against the proposed business plan. 

 – Approved the quantum of cash payments to Executive Directors 

and Executive Officers under the Annual Incentive Plan and awards 
under the Equity Incentive Programme and the Performance Share 
Programme, having considered the 2016 financial results against the 
performance targets, that were set. 

 – The Audit Committee joined the Remuneration Committee for both of 
the above agenda items to answer any questions regarding audited 
numbers and provide assurance.

 – Reviewed the salaries of the Board, Executive Directors and Officers 

and Chairman. 

 – Approved the text of the Remuneration Report.

Mid February 
Review of Remuneration (via voice conference)
 – Discussed the payout under the Annual Incentive Plan and decided 

to use downwards discretion to adjust outcomes following the 
performance of the Company in 2016. 

Late February 
Final approval of the Remuneration Report (via voice conference)
 – Approved the final targets for the short-term and long-term incentive 

plans for 2017.

 – Approved the final text of the Remuneration Report. 

July (in Hull, UK)
Mid-year Review of Remuneration Arrangements
 – Reviewed the shareholder response to the Remuneration Report at 
the Annual General Meeting and noted shareholders’ feedback that 
would be addressed in this report. 

 – Reviewed the performance of long-term awards granted in 2015, 2016 

and 2017.

 – Discussed and planned a programme of engagement with 

institutional investors on remuneration.

 – Considered termination arrangements for Executive Directors and 

Executive Officers. 

 – Reviewed adherence to shareholding guidelines by Executive 

Directors, Executive Officers and senior executives.

 – Monitored dilution limits and the number of shares available for use 

in respect of executive and all-employee share plans.

 – Approved amendments to the Smith & Nephew ShareSave Plan 2012 

rules to reflect regulatory changes. 

October  
 – Approved retirement package for Olivier Bohuon, 

Chief Executive Officer. 

Early November (in Dubai, UAE)
 – Prepared for meetings with shareholders to solicit viewpoints and 

introduce Angie Risley. 

 – Reviewed first draft of the Remuneration Report for 2017.

Late November 
Review of Remuneration Strategy
 – Received a report from the Chairman of the Remuneration Committee 

on recent engagement with shareholders.

 – Reviewed and considered the principles for determining payouts 

under the long-term plans due to vest in 2018.

 – Approved the final Remuneration Strategy for 2018.

 – Reviewed market data for the Executive Directors and Executive 
Officers prepared in accordance with the agreed methodology. 

Six written resolutions were approved during the year relating to the 
approval of remuneration arrangements for various Executive Officers.  

Since year end, we have also reviewed the financial results for 2017 
against the targets under the short-term and long-term incentive 
arrangements jointly with the Audit Committee, and have agreed the 
targets for the short-term and long-term incentive plans for 2018. 
We have also approved increases to the salaries of Executive Directors 
and Executive Officers and determined cash payments under the 
Annual Incentive Plan, awards under the Equity Incentive Programme 
and the Performance Share Programme, and the vesting of awards 
under the Performance Share Programme granted in 2015. Finally, we 
approved the wording of this Directors’ Remuneration Report.

During the year, the Remuneration Committee received information 
and advice from Willis Towers Watson, an independent executive 
remuneration consultancy firm appointed by the Remuneration 
Committee in 2011 following a full tender process. They provided 
advice on market trends and remuneration issues in general, attended 
Remuneration Committee meetings, assisted in the review of the 
Directors’ Remuneration Report, provided market benchmark data on 
compensation design and levels, undertook calculations relating to 
the TSR performance conditions, assisted in matters relating to the 
Chief Executive Officer’s retirement, and advised on investor views 
and engagement. In addition, the Committee received independent 
advice from Mercer relating to the use of discretion downwards when 
determining the level of payout in respect of the 2016 annual cash 
incentive plan. The fees paid to Willis Towers Watson for Remuneration 
Committee advice during 2017, charged on a time and expense basis, 
were £98,000 and the fee paid to Mercer was £4,350. Willis Towers 
Watson also provided other human resources and compensation advice 
to the Company for the level below the Board. Mercer also provided 
insurance broking, market data, actuarial and investment consulting 
services both at a global and local level. Both Willis Towers Watson 
and Mercer comply with the Code of Conduct in relation to Executive 
Remuneration Consulting in the United Kingdom and the Remuneration 
Committee is satisfied that their advice is objective and independent.

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REMUNERATION IMPLEMENTATION REPORT

SINGLE TOTAL FIGURE ON REMUNERATION
The amounts for 2017 have been converted into US$ for ease of comparability using the exchange rates of £ to US$1.2877 and € to US$1.1279 
(2016: £ to US$1.349 and € to US$1.106). 

Olivier Bohuon
Appointed 1 April 2011

Graham Baker
Appointed 1 March 2017

2017

2016

2017

Julie Brown
Appointed 4 February 2013
(resigned with effect from 11 January 2017)

2017

2016

Fixed pay

Base salary

Payment in lieu of pension

Taxable benefits

Annual variable pay

Annual Incentive  
Plan – cash

Hybrid

Annual Incentive  
Plan – equity

Long-term variable pay

$1,330,347

$1,295,017

$399,104

$177,433

$388,505

$166,465

$547,273

$164,182

$22,308

$1,208,911

$592,902

$683,797

$665,173

$652,258

$361,200

Performance Share Plan

$1,251,957

$237,703

–

$21,606

$6,482

$637

$730,257

$219,078

$30,007

–

–

–

–

–

–

Total

$5,032,925

$3,332,850

$1,778,760

$28,725

$979,342

Olivier Bohuon

Graham Baker

Julie Brown

2017

2016

$5,032,925

2017

$3,322,850

N/A
2016

$1,778,760

2017

2016

$28,725

$979,342

Base salary

the actual salary receivable for the year.

Payment in lieu of pension the value of the salary supplement paid by the Company in lieu of a pension.

Taxable benefits

the gross value of all taxable benefits (or benefits that would be taxable in the UK) received in the year.  

Annual Incentive  
Plan – cash

Annual Incentive  
Plan – equity

Performance Share Plan

the value of the cash incentive payable for performance in respect of the relevant financial year.

the value of the equity element awarded in respect of performance in the relevant financial year, but subject to an ongoing 
performance test as described on pages 87–88 of this report.

the value of shares vesting that were subject to performance over the three-year period ending on 31 December in the 
relevant financial year. For awards vesting in early 2018 this is based on an estimated share price of 1,352.140p per share, 
which was the average price of a share over the last quarter of 2017. The value of the 2014 share awards that vested in 2017 
have now been restated with the share price on the date of actual vesting being 1,221.625p per share on 7 March 2017. 

Total

the sum of the above elements.

All data is presented in our reporting currency of US$. Amounts for Olivier Bohuon have been converted from EURO and amounts for Julie Brown 
and Graham Baker from GBP using average exchange rates. Given currency volatility in 2017, this may give the impression of changes that are 
misleading. Data is presented in local currency in the subsequent sections in the interests of full transparency. 

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REMUNERATION IMPLEMENTATION REPORT

Retirement of Olivier Bohuon 
On 9 October 2017, we announced that Olivier Bohuon intended to retire as Chief Executive Officer by the end of 2018.

Up until the date of his retirement, Olivier Bohuon will continue to be paid his salary, pension and benefits and will participate on a pro-rata basis 
in the 2018 Annual Incentive Plan, which will be delivered entirely as cash. He will not receive a Performance Share Plan in respect of 2018. In-line 
with good leaver provisions in the Plan Rules and Remuneration Policy, the awards granted under the Performance Share Plan in 2016 and 2017 
(as detailed in this report) will be pro-rated for length of time held and will, subject to the performance conditions being satisfactorily met, vest on 
the original vesting dates on the third anniversary of the respective dates of grant. The 2017 award will remain subject to a two-year post-vesting 
holding period. 

FIXED PAY

Base salary 

In February 2017, it was agreed that with effect from 1 April 2017, Executive Directors would be paid the following base salaries.

Olivier Bohuon
Graham Baker 

2017

2016

€1,179,490
£510,000

€1,179,490 
–

In February 2018, we reviewed the base salaries of the Executive Directors, having considered general economic conditions and average salary 
increases across the rest of the Group, which have averaged at 2% in the UK and the US; 2.6% globally. The Remuneration Committee has agreed 
that there will be no increase to the base salary of Olivier Bohuon and that Graham Baker’s salary will be increased by 2% to £520,200.

Payment in lieu of pension 

In 2017, Olivier Bohuon, Graham Baker and Julie Brown until her resignation on 11 January 2017 received a salary supplement of 30% of their basic 
salary to apply towards their retirement savings, in lieu of membership of one of the Company’s pension schemes.  

Benefits

In 2017, Olivier Bohuon, Graham Baker and Julie Brown until her resignation on 11 January 2017 received death in service cover of seven-times basic 
salary, of which four-times salary is payable as a lump sum, with the balance used to provide for any spouse and dependent persons. They also 
received health cover for themselves and their families, a car allowance and financial consultancy advice. Olivier Bohuon also received assistance 
with travel costs between London and Paris. The same arrangements will apply in 2018 for Olivier Bohuon and for Graham Baker. The following table 
summarises the value of benefits on an element-by-element basis in respect of 2016 and 2017. Julie Brown received these benefits until she retired 
from the Board on 11 January 2017. 

Health cover
Car and fuel allowance
Financial consultancy advice 

Travel costs
Subscriptions

2017

£17,807
£15,000
£34,204
€37,736
£33,703
£4,023

Olivier Bohuon

2016

£15,672
€18,292
£66,572
–
£23,814
£2,344

2017

£1,217
£14,182
£1,925
–
–
–

Graham Baker

2016

–
–
–
–
–
–

2017

£44
£451
–
–
–
–

Julie Brown

2016

£1,440
£14,640
£6,614
–
–
–

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REMUNERATION IMPLEMENTATION REPORT

ANNUAL VARIABLE PAY

Annual Incentive Plan 2017

Cash Element
During 2016, the Remuneration Committee reviewed the operation of the Annual Incentive Plan and the performance measures and weightings 
which would apply to the cash element of the Annual Incentive Plan. These changes placed a greater emphasis on financial goals reflecting the 
importance we place on achievement of financial measures. The financial measures comprise 75% of the total award and are split between revenue 
(35%), trading profit margin (25%), and trading cash flow (15%). These measures were selected because revenue and trading profit margin constitute 
the key drivers of profit growth, and trading cash flow was a key measure of how efficiently we turn our assets into cash. Trading profit margin is a 
critical measure both for the business and our investors and delivering margin improvements is a core commitment under our strategy. 

The remaining 25% of the total award are individual business objectives, similar to previous years, tied to our strategic priorities. As in previous 
years, these business objectives fell into the categories of Business Process, People and Customer.

The weighting of the performance measures for 2017 can be summarised as follows:

Financial objectives 
  Revenue
  Trading profit margin
  Trading cash flow
Business objectives
  Business process
  People
  Customer

75%

25%

35%
25%
15%

8.33%
8.33%
8.33%

The figures for threshold, target and maximum relating to the financial objectives of the cash element of the 2017 Annual Incentive Plan are 
shown below: 

Revenue
Trading profit margin
Trading cash flow² 

1  At constant exchange rates. See page 182.

Threshold

$4,578m
21.8%
$801m

Target

Maximum

$4,720m
22.3%
$890m

$4,861m
22.7%
$979m

Actual
$4,654m1
22.3%1
$940m

2  During the year, the trading cash flow target was adjusted upwards to reflect the change regarding the cash funding of closed post-retirement benefit schemes (see pages 150–155).  

‘Target’ was set and approved by the Board in the 2017 Budget. ‘Threshold’ and ‘Maximum’ are set at +/-3% from the target for revenue, at +/-45bps 
for the trading profit margin measure and at +/-10% for the trading cash flow from target.

This resulted in a bonus achievement of 73% of salary in respect of the financial objectives.

Revenue
Trading profit margin 
Trading cash flow 

Weight

Achieved % of target

Award % of salary 

35%
25%
15%

77%
107%
128%

26.9%
26.8%
19.2%

Accordingly, the following amounts have been earned by Olivier Bohuon and Graham Baker under the cash element of the Annual Incentive Plan in 
respect of their financial objectives.

Olivier Bohuon
Graham Baker

€859,517
£371,647

The same measures and weightings will apply to the financial measurements of the cash element of the Annual Incentive Plan 2018. For reasons 
of commercial sensitivity, we are unable to disclose the precise targets now, but they will be disclosed in the 2018 Remuneration Report at the time 
of vesting.

Business Objectives
When setting business objectives for the upcoming year, the Board looks not only at the expected financial performance for the year, but also 
at the actions it expects the Executive Director to carry out in the year to build a solid foundation for financial performance over the longer term. 
In reviewing performance against these objectives at the end of the year, the Board is mindful that there is not always a necessary correlation 
between financial performance and the achievement of business objectives. 

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REMUNERATION IMPLEMENTATION REPORT

The table below sets out how Olivier Bohuon and Graham Baker have performed against the business objectives of People, Business Process 
and Customers.

Olivier Bohuon

People

Graham Baker

 – Delivered 50bps improvement in Group Great Place to Work Trust Index, 

 – Delivered 30bps improvement Finance function Great Place to Work Trust 

meeting target of 67%.

Index, meeting target of 67%.

 – Further five countries awarded Great Place to Work Accreditation, ahead 

 – Met target to upgrade Finance leadership team through combination of 

internal moves and external hires. Exceeded targets to retain and develop 
top Finance talent (80% of critical roles filled internally vs 50% target). 
Exceeded target on Finance leadership retention, with minimal loss of 
top-talent against target of less than 10%.

of target of two new countries, with nine countries in total now recognised.

 – Made progress against targets for 50% of critical roles filled by top talent 

(48% achieved); met target to identify internal successors for 50% of critical 
roles. Target to reduce voluntary turnover of top talent missed (12% against 
target of less than 10%).

 – Clear communication of strategy and implementation plans across 

the Group through direct and indirect channels to drive alignment and 
increase engagement. 

 – Target of delivering $5 million incremental revenue from commercial excellence 

programme not met with remediation action initiated.

 – Achieved target of all employees and third party sellers completing more than 

95% of global compliance on time.

Business Process

 – Achieved target of new global R&D model fully operational by first quarter 
of 2017, including Portfolio Innovation Board to drive strategy and prioritise 
projects. More than 80% of programme milestones met tracking towards best-
in-class standard of 90%, and programme to develop further clinical evidence 
progressing to plan. 

 – Maintaining an effective financial control environment.  
 – Met target to hold employees accountable for Finance policies and 

procedures, with 95% compliance on Minimum Acceptable Practices (MAPs) 
and deeper checking across all Group countries.  

 – Finance Transformation plan built, including integrating some back-office 

services into Global Business Services. 

 – First phase of new IT finance system successfully implemented in 

North America on time and within budget.

 – Established relationships with investors and analysts supporting Group IR 

programme, receiving excellent feedback from external stakeholders.

Customers

 – Met target to continue to develop new business models including mid-tier 

 – Met target to provide robust financial modelling to improve business 

portfolio in the Emerging Markets and eCAP in the US.

 – Roadmap for mid-tier product development completed in-line with target, with 
notable successes including ANTHEM Knee and ATLAS HF Nail in Emerging 
Markets. Mid-tier portfolio revenue growth tracked behind target.

decision-making processes, including improved visibility of R&D portfolio 
value and completion of acquisition of Rotation Medical, Inc.

 – Delivered leadership with Chief Executive Officer in developing APEX 

programme to improve competitiveness of Smith & Nephew. 

 – Met tax targets with tax on trading reduced from 23.8% in 2016 to 17.1% in 2017 
reflecting one-off benefit following the conclusion of a US tax audit, further 
progress in improving our tax rate, tax provision releases following expiry of 
statute of limitations and a beneficial geographical mix of profits on trading. 

This resulted in a bonus achievement of 18% of salary in respect of the 
business objectives.

This resulted in a bonus achievement of 31% of salary in respect of the 
business objectives.

People
Business Process
Customers 

Weight

8.33%
8.33%
8.33%

Achieved % of 
target

Award % of 
salary 

72%
100%
50%

6%
8%
4%

People
Business Process
Customers

Weight

8.33%
8.33%
8.33%

Achieved % of 
target

Award % of 
salary 

120%
132%
120%

10%
11%
10%

Accordingly, the following amount has been earned by Olivier Bohuon 
under the cash element of the Annual Incentive Plan in respect of his 
business objectives.

Accordingly, the following amount has been earned by Graham Baker 
under the cash element of the Annual Incentive Plan in respect of his 
business objectives.

Olivier Bohuon

€212,308

Graham Baker

£159,375

The same measures and weightings will apply to the business objectives of the cash element of the Annual Incentive Plan in 2018. 

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REMUNERATION IMPLEMENTATION REPORT

HYBRID

Equity Incentive Award

The individual performance of all employees in the Group is assessed on two bases. The first looks at what has been achieved, namely the extent 
to which the employee has performed against the financial and business objectives set at the beginning of the year. The second looks at how this 
performance has been achieved, reflecting the right culture and values in accordance with our critical enablers. Against each, the employee is rated 
as having performed below, in-line or above expectations.

Assessment of what has been achieved

Below expectations

No Award

No Award

No Award

Assessment of how Executive Directors have achieved

Below expectations

In-line with expectations

Above expectations

In-line with expectations

No Award

Above expectations

No Award

Award of  
50% of Salary
Award of  
55% of Salary

Award of  
55% of Salary
Award of  
65% of Salary

The Remuneration Committee has considered the performance of Olivier Bohuon and Graham Baker in exactly the same way as other employees 
in the Group when determining the level of Equity Incentive Award to be made to them. In assessing their performance against the same financial 
and business objectives used to determine the level of their cash award, the Remuneration Committee has determined that on the first criterion 
(assessing what they have achieved) Olivier Bohuon and Graham Baker have both performed in-line with expectations throughout the year. On the 
second criterion (assessing how they have achieved), the Remuneration Committee has determined that Olivier Bohuon has performed in-line with 
expectations and Graham Baker has performed above expectations. These ratings result in an Equity Incentive Award of 50% of salary for Olivier 
Bohuon and 55% of salary for Graham Baker.

In summary, as a result of the financial performance described on page 85 and the performance described in the table on page 86, the 
Remuneration Committee determined that the following awards be made under the Annual Incentive Plan in respect of performance in 2017:

Executive Director

Olivier Bohuon
Graham Baker

Cash Component 

Equity Component 

% of salary

Amount

% of salary

Amount

91% €1,071,825
£531,022

104%

50%
55%

€589,745
£280,500

These figures are converted into dollars and included under Annual Incentive Plan (cash) and (equity) in the single figure table on page 83.

As a result of the 2017 performance assessment for Olivier Bohuon, the first tranche of the Equity Incentive Award made in 2017, the second tranche 
of the Equity Incentive Award made in 2016 and the third tranche of the Equity Incentive Award made in 2015 will vest. Both the grant and vesting of 
these awards are subject to Olivier’s performance discussed on page 86. Graham Baker was not employed during 2016 and therefore received no 
Equity Incentive award in 2017.

Director

Olivier Bohuon

Date of Grant

7 March 2017 – 1st tranche
7 March 2016 – 2nd tranche
9 March 2015 – 3rd tranche

Number of shares under  
award vesting

Number of shares to vest  
from each grant subject  
to performance

13,886
16,717
12,849

27,779
16,725
0

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Details of awards made under the Equity Incentive Programme during 2017
Details of conditional awards over shares, granted as part of the Annual Equity Incentive Programme to Executive Directors under the rules of the 
Global Share Plan 2010 for their 2016 performance (awarded in 2017) are shown below. The performance conditions and performance periods 
applying to these awards are detailed above.

Date granted

Olivier Bohuon
7 March 2017

Number of shares under award

Date vesting

41,665

1/3 on 7 March 2018
1/3 on 7 March 2019
1/3 on 7 March 2020

The precise awards granted in 2018 to Olivier Bohuon and Graham Baker in respect of service in 2017 will be announced when the awards are 
made and will be disclosed in the 2018 Annual Report. 

Olivier Bohuon has announced his intention to retire by the end of 2018 and will therefore not be entitled to receive an Equity Incentive Award in 
2019 after ceasing to be an employee. He will therefore receive a cash amount equivalent to the Equity Incentive Award he would have received, 
if any, had he remained employed. This will be disclosed in full in the 2018 Remuneration Report.

The Equity Incentive Award element will operate in 2018 in exactly the same way as in 2017 and previous years. The Remuneration Committee will 
assess what has been achieved by the Executive Directors against the same financial and business objectives used to determine the level of their 
cash awards. The Remuneration Committee will assess how the Executive Directors have achieved their objectives by considering the role played 
by the Executive Directors in establishing an appropriate culture and set of values throughout the organisation. The level of Equity Incentive Award 
to be made will be determined according to the matrix on page 87. 

LONG-TERM VARIABLE PAY

Performance Share Plan

Performance Share Programme – 2017 grants
Performance share awards granted in 2017 were made to Executive Directors under the Global Share Plan 2010 to a maximum value of 190% 
of salary (95% for target performance). During 2016, the Remuneration Committee reviewed the operation of the Performance Share Programme 
and made changes to the performance measures and weightings which were included with the Remuneration Policy and approved at the Annual 
General Meeting on 6 April 2017. The four equally weighted performance measures are relative TSR, return on invested capital, sales growth and 
cumulative free cash flow. These measures are aligned with our financial priorities and strategies. Performance will be measured over the three 
financial years from 1 January 2017 and awards will vest subject to performance and continued employment in 2020. Sufficient shares will be sold 
to cover taxation obligations and the Executive Directors will be required to hold the net shares for a further period of two years. 

The two equally weighted peer groups against which the Company’s TSR performance will be measured are defined at the start of each 
performance period based on constituents of the following:

 – A sector-based peer group based on those companies classified as the S&P 1200 Global Healthcare subset comprising Medical Devices, 

equipment and supplies companies (official industry classifications of ‘Health Care Equipment and Supplies, Life Sciences Tools & Services and 
Health Care Technology’). This is a broader sector-based peer group than in previous years, so that we maintain a focus on outperforming our 
broad sector without being impacted by the volatility of a smaller group. 

 – FTSE 100 constituents excluding financial services and commodities companies. This is in response to shareholders who assess our 

performance not based on sector, but instead based on the index we operate in.

The Group’s TSR performance and its performance relative to the comparator group is independently monitored and reported to the Remuneration 
Committee by Willis Towers Watson.

Total Shareholder Return (TSR) performance is relative to two separate indices as follows: 

Relative TSR ranking

Below median
Median
Upper quartile or above 

Award vesting as % of salary at date of grant 

Sector Based Peer Group

FTSE100 Peer Group

Nil   
5.9375%
23.75%

Nil
5.9375% 
23.75%

Awards will vest on a straight-line basis between these points. If the Company’s TSR performance is below median, none of this part  
of the award will vest.

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Return on invested capital (ROIC), adds focus on enhancing operating performance and reducing the under-performing asset base. 25% of the 
award will vest subject to ROIC:

ROIC will be defined as:

Net Operating Profit1 less Adjusted Taxes2
(Opening Net Operating Assets + Closing Net Operating Assets3)/2

ROIC will be measured each year of the three-year performance period and a simple average of the three years will be compared to the targets 
below (precise numbers will be included in the Remuneration Report prospectively). The Remuneration Committee will have the discretion to adjust 
ROIC targets in the case of significant events such as material mergers, acquisitions and disposals and that such adjustment will be consistent with 
the deal model and approved by the Board at the time of the transaction. 

1  Operating profit is as disclosed in the Group income statement in the Annual Report. 

2  Adjusted taxes represents our taxation charge per the Group income statement adjusted for the impact of tax on items not included in Operating Profit notably interest income and expense, other finance costs  

and share of results of associates. 

3  Net Operating Assets comprises net assets from the Group balance sheet (Total assets less Total liabilities) excluding the following items: Investments, Investments in associates, Retirement benefit assets  

and liabilities, Long-term borrowings, Bank overdrafts and loans, and Cash at bank. 

The awards subject to ROIC will vest as follows: 

Return on Invested Capital 

Below Threshold 11.1%
Threshold 11.1% (-1.9% of target)
Target 13% (as derived from the Strategic Plan)
Maximum or above 14.9% (+1.9% of target)

Award vesting as % of salary

Nil
11.875%
23.75%
47.5%

Awards will vest on a straight-line basis between these points. 

Sales growth focuses on growth in both Established Markets and Emerging Markets. 25% of the award will be subject to sales growth and will vest 
as follows:

Sales growth over three-year period commencing 1 January 2017

Award vesting as % of salary

Below Threshold
Threshold (-3% of target)
Target
Maximum or above (+3% of target)

Nil
11.875%
23.75%
47.5%

It is not possible to disclose precise targets for sales growth as this will give commercially sensitive information to our competitors concerning our 
growth plans and is potentially price sensitive information. This target however will be disclosed in the 2019 Annual Report, when the Committee will 
discuss performance against the target.

Cumulative free cash flow is defined as net cash inflow from operating activities, less capital expenditure, less the cash flow input of certain 
adjusted items. Free cash flow is the most appropriate measure of cash flow performance because it relates to cash generated to finance additional 
investments in business opportunities, debt repayments and distribution to shareholders. This measure includes significant elements of operational 
financial performance and helps to align Executive Director awards with shareholder value creation.

It is important as it is derived from increased revenues and healthy trading profits. Having a healthy cash flow will enable us to continue to grow and 
invest. 25% of the award will be subject to cumulative free cash flow performance and will vest as follows:

Cumulative free cash flow

Below $1,482m
$1,482m (-13% of target)
$1,703m
$1,924m or more (+13% of target)

Award vesting as % of salary

Nil
11.875%
23.75%
47.5%

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Performance Share Programme 2018
A performance share award will be made in 2018 to Graham Baker under the Global Share Plan 2010 to a maximum value of 190% of salary (95% for 
target performance). No performance share award will be made to Olivier Bohuon in 2018.

Performance will be measured over the three financial years commencing 1 January 2018 against the same four equally weighted performance 
measures as in 2017: relative TSR, return on invested capital, sales growth and cumulative free cash flow. On vesting, sufficient shares will be sold to 
cover taxation obligations and Graham Baker will be required to hold the net shares for a further period of two years.  

TSR performance will be measured in the same way as in 2017 as described on page 88 against the same two peer groups.

Return on invested capital (ROIC) will be measured in the same way as in 2017, as described on page 89. The targets will be as follows:

Return on Invested Capital

Below Threshold 11.6%
Threshold 11.6% (-1.25% of target)
Target 12.9% (as derived from the Strategic Plan)
Maximum or above 14.1% (+1.25% of target)

Award vesting as % of salary

Nil
11.875%
23.75%
47.5%

Awards will vest on a straight-line basis between these points. 

Sales growth will be measured in the same way as in 2017, as described on page 89. The targets will be as follows:

Sales growth over three-year period commencing 1 January 2018

Award vesting as % of salary

Below Threshold
Threshold (-2.7% of target)
Target
Maximum or above (+2.7% of target)

Nil
11.875%
23.75%
47.5%

It is not possible to disclose precise targets for sales growth as this will give commercially sensitive information to our competitors concerning our 
growth plans and is potentially price sensitive information. This target however will be disclosed in the 2020 Annual Report, when the Committee 
will discuss performance against the target.

Cumulative free cash flow will be measured in the same way as in 2017, as described on page 89. The targets will be as follows:

Cumulative free cash flow

Below $1,575m
$1,575m (-13% of target)

$1,810m
$2,046m or more (+13% of target)

Award vesting as % of salary

   Nil
11.875%

23.75%
47.5%

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VESTING OF AWARDS MADE IN 2015
Performance Share Programme 2015
Since the end of the year, the Remuneration Committee has reviewed the vesting of conditional awards made to Executive Directors under the 
Global Share Plan 2010 in 2015. Vesting of the conditional awards made in 2015 was subject to performance conditions based on TSR, revenue in 
Emerging Markets and cumulative free cash flow measured over a three-year period commencing 1 January 2015.

25% of the award was based on the Company’s TSR relative to a bespoke group of 12 Medical Devices companies. This group comprised of the 
following companies: Baxter, Becton Dickinson, Boston Scientific, Coloplast, Conmed, Edwards Life Sciences, Medtronic, NuVasive, Orthofix, Stryker, 
Wright Medical and Zimmer. The following companies delisted during the period and were therefore removed: Covidien, C R Bard, Nobel Biocare 
and St Jude Medical. Against this peer group, the Company’s TSR performance ranked below median meaning that this part of the award therefore 
vested at 0%.

25% of the award was based on revenues in Emerging Markets. The threshold set in 2015 was $2,395 million with a target of $2,818 million. 
Over the three-year period, the adjusted revenues in Emerging Markets were $2,411 million. These adjustments include translational foreign 
exchange and Board-approved M&A. This part of the award therefore vested at 13% out of the 25% target.

50% of the award was based on cumulative free cash flow performance. Over the three-year period, the adjusted cumulative free cash flow was 
$2,024 million which is between target and maximum. These adjustments include items such as Board-approved M&A, including the acquisition of 
BlueBelt and Board-approved Business Plans such as the metal-on-metal settlements. This part of the award therefore vested at 95%.

TSR
Emerging Markets Sales
Cumulative Free Cash Flow

Threshold

Target

Maximum

Actual 

 Median
    $2,395m
   $1,578m

 –
  $2,818m
  $1,814m

Upper Quartile    Below Median
   $2,411m
      $2,024m

   $3,240m
   $2,050m

Percentage 
Vesting

0%
13%
95%

Overall therefore, the conditional awards made in 2015 will vest at 54% of maximum (108% of target) on 9 March 2018 as follows:

Director

Olivier Bohuon

Date of grant

9 March 2015

Number of shares under  
award at maximum

133,156

Number vesting

71,904

DETAILS OF OUTSTANDING AWARDS MADE UNDER THE PERFORMANCE SHARE PROGRAMME
Details of conditional awards over shares granted to Executive Directors subject to performance conditions are shown below. These awards 
were granted under the Global Share Plan 2010. The performance conditions and performance periods applying to these awards are detailed 
on pages 88 and 89.  

Olivier Bohuon

Graham Baker

Date granted

9 March 2015
7 March 2016
7 March 2017
7 March 2017

Number of ordinary shares  
under award at maximum
133,1561
146,620
158,328
79,166

Date of vesting

9 March 2018
7 March 2019
7 March 2020
7 March 2020

1  On 6 February 2018, 46% of the award granted at maximum to Olivier Bohuon lapsed following completion of the performance period.

SUMMARY OF SCHEME INTERESTS AWARDED DURING THE FINANCIAL YEAR

Annual Equity Incentive Award (see page 87)
Performance Share Award at maximum (see page 91)

41,665
158,328

€589,745
€2,241,030

–
79,166

1  Annual Equity Incentive Awards for 2017 were based on performance for 2016, hence Graham Baker received no award.

Number of shares

Face value

Number of shares

Olivier Bohuon

Graham Baker1

Face value

–
£969,000

Please see Policy Table on pages 99 and 100 for details of how the above plans operate. The number of shares is calculated using the closing share 
price on the day before the grant, which for the awards granted on 7 March 2017 was 1,224p.

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SINGLE TOTAL FIGURE ON REMUNERATION 
Chairman and Non-Executive Directors

Director

Roberto Quarta
Vinita Bali2

Ian Barlow
Virginia Bottomley
Erik Engstrom
Robin Freestone
Michael Friedman
Brian Larcombe3
Marc Owen4 
Joseph Papa
Angie Risley5

Basic annual fee1

Committee Chairman / 
Senior Independent 
Director fee

Intercontinental travel fee

2017

2016

2017

2016

2017

2016

2017

 £412,000
 £36,750
 $59,780
£68,135
£68,135
£68,135
£68,135
$129,780
 £20,750
$30,000
$129,780
£18,173

£409,750
£63,000
$9,780
£68,135
£68,135
£68,135
£68,135
$129,780
£68,135
–
$129,780
–

–
–
 –
£20,000
–
–
£16,667
$35,000
 £1,277
–
$35,000
–

–
–
 –
£18,750 
–
–
–
$33,000
£18,750
–
$33,000
–

£7,000
£7,000
 $21,000
£7,000
£7,000
£7,000
£7,000
$42,000
–
$14,000
$35,000
£7,000

£3,500
£21,000
– 
£3,500
£3,500
£3,500
£3,500
$35,000
£3,500
– 
$35,000
– 

£419,000
£43,750
$80,780 
£95,135 
£75,135
£75,135
 £91,802
 $206,780
£22,027 
$44,000
$199,780
£25,173

Total

2016

£413,250
£84,000 
$9,780 
£90,385
£71,635
£71,635
£71,635
$197,780
£90,385
– 
$197,780
– 

1  The basic annual fee includes shares purchased for the Chairman and Non-Executive Directors in lieu of part of the annual fee, details of which can be found on the table on page 104.

2  Vinita Bali elected to receive the payment of her fee in US$ in August 2017 having previously been in GBP. 

3  Brian Larcombe retired from the Board with effect from 6 April 2017. 

4  Marc Owen was appointed to the Board with effect from 1 October 2017.  

5  Angie Risley was appointed to the Board with effect from 18 September 2017.

Chairman and Non-Executive Director Fees
In February 2018, the Remuneration Committee reviewed the fees paid to the Chairman and determined that with effect from 1 April 2018 the fees 
paid would increase by 2%. The Board reviewed the fees paid to the Non-Executive Directors and determined that with effect from 1 April 2018, the 
fees paid in GBP would be increased by 2% and the fees paid in US$ would remain unchanged as follows:

Annual fee paid to the Chairman
Annual fee paid to Non-Executive Directors

Intercontinental travel fee (per meeting)
Fee for Senior Independent Director and Committee Chairman

£420,240 of which £105,060 paid in shares 
£69,500 of which £6,500 paid in shares  
Or $129,780 of which $9,780 paid in shares 
£3,500 or $7,000 
£20,000 or $35,000

Chief Executive Officer’s remuneration compared to employees generally
The percentage change in the remuneration of the Chief Executive Officer between 2016 and 2017 compared to that of employees generally is 
as follows:

Chief Executive Officer
Average for all employees

Base salary % 
change 2017

Benefits % 
change 2017

0%
3.3%

6.6%
N/A

Annual cash 
bonus % 
change 2017

103.9%
N/A

The average cost of wages and salaries for employees generally decreased by 10% in 2017 (see Note 3.1 to the Group accounts). Figures for annual 
cash bonuses are included in the numbers. 

The Committee is mindful that the Government now requires quoted companies to publish their Chief Executive Officer’s pay in relation to its 
workforce. The Committee awaits the Government’s advice on the exact method of calculation, but aims to publish this information in the 2018 
Annual Report.

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Payments made to past Directors
No payments were made to former Directors in the year, other than base payments made to Julie Brown for the 11 days worked in January 2017, as 
disclosed on page 83. 

Payments for loss of office
No payments were made in respect of a Director’s loss of office in 2017.

Service contracts
Executive Directors are employed on rolling service contracts with notice periods of up to 12 months from the Company and six months from the 
Executive Director. Further information can be found on page 102 of the Policy Report. 

Outside directorships
Olivier Bohuon is a Non-Executive Director of Virbac SA and received €21,000 in respect of this appointment. He is also a Non-Executive Director 
of Shire Plc and received €107,466 in cash and £24,053 in shares in respect of this appointment. Julie Brown is a Non-Executive Director of Roche 
Holding Ltd and received a fee of CHF10,849 until 11 January 2017.

Directors’ interests in ordinary shares
Beneficial interests of the Executive Directors in the ordinary shares of the Company are as follows:

Ordinary shares
Share options
Performance share awards5
Equity Incentive awards
Other awards

Olivier Bohuon 

Graham Baker

1 January  
2017

31 December  
2017

424,288
– 
460,080
96,417
– 

467,811
– 
423,680
87,956
– 

16 February
20181
467,8114
– 
362,428
87,956
– 

1 March 
20172

31 December  
2017

– 
– 
– 
– 
– 

– 
– 
79,166
– 
– 

16 February
20181
–4
– 
79,166
– 
– 

1 January 
2017

90,040
2,400
273,598
50,649
– 

Julie Brown

11 January 
20173

90,040
– 
– 
– 
– 

1  The latest practicable date for this Annual Report.

2  Graham Baker was appointed to the Board from 1 March 2017. 

3  Julie Brown retired from the Board on 11 January 2017.  

4  The ordinary shares held by Olivier Bohuon on 16 February 2018 represent 571.6% of his base annual salary and for Graham Baker 0% of his base salary. 

5  These share awards are subject to further performance conditions before they may vest, as detailed on pages 88–90.

The beneficial interest of each Executive Director is less than 1% of the ordinary share capital of the Company. In addition, Olivier Bohuon holds 
50,000 deferred shares. Following the redenomination of ordinary shares into US$ on 23 January 2006, the Company issued 50,000 deferred 
shares. These shares are normally held by the Chief Executive Officer and are not listed on any stock exchange and have extremely limited rights 
attached to them.

Beneficial interests of the Chairman and Non-Executive Directors in the ordinary shares of the Company are as follows:

Director
Roberto Quarta3 
Vinita Bali4
Ian Barlow
Virginia Bottomley
Erik Engstrom
Robin Freestone
Michael Friedman4
Brian Larcombe⁵
Marc Owen 
Joseph Papa4
Angie Risley

1 January 2017 (or date of 
appointment if later)

31 December 2017 (or date 
of retirement if earlier)

16 February 20181

Shareholding as % 
of annual fee2

24,156
6,522
18,786
18,473
15,350
15,310
9,476
40,718
–
13,547
–

28,261
6,836
19,009
18,714
15,547
15,525
9,910
40,718
–
13,860
–

28,261
6,836
19,009
18,714
15,547
15,525
9,910
N/A
7,000
13,860
1,601

87.8
130.7
357
351.4
292
291.5
139.4
N/A
98.5
195
30.1

1  The latest practicable date for this Annual Report.

2  Calculated using the closing share price of 1,279.50p per ordinary share and $36.54 per ADS on 16 February 2018, and an exchange rate of £1/$1.4027.

3  All Non-Executive Directors in office since 1 January 2017 held the required shareholding during the year except the Chairman.

4  Vinita Bali, Michael Friedman and Joseph Papa hold some of their shares in the form of ADS.

5  Brian Larcombe retired from the Board on 6 April 2017.

The beneficial interest of each Non-Executive Director is less than 1% of the ordinary share capital of the Company.

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Relative importance of spend on pay
The following table sets out the total amounts spent in 2017 and 2016 on remuneration, the attributable profit for each year and the dividends 
declared and paid in each year.

Attributable profit for the year
Dividends paid during the year
Share buyback
Total Group spend on remuneration

For the year to  
31 December 2017

For the year to  
31 December 2016

$767m
$269m
$52m¹
$1,157m

$784m 
$279m 
$368m² 
$1,227m 

% change

-2%
-4%
-86%
-6%

1  Shares are bought in the market in respect of shares issued as part of the executive and employee share plans. 

2  Following the disposal of the Gynaecology business in August 2016, the Company commenced a $300m share buy-back programme which completed during 2016. See Note 19.2 for further information. 

Total Shareholder Return
A graph of the Company’s TSR performance compared to that of the FTSE 100 index is shown below in accordance with Schedule 8 to 
the Regulations.

Nine-year Total Shareholder Return 
(measured in UK Sterling, based on monthly spot values)

275

250

225

200

175

150

125

100

75

50

25

0

-25

Dec 2008
Source: DataStream

Dec 2009

Dec 2010

Dec 2011

Dec 2012

Dec 2013

Dec 2014

Dec 2015

Dec 2016

Dec 2017

Smith & Nephew

FTSE 100

However, as we compare the Company’s performance to a tailored sector peer group of medical devices companies (see page 88), when 
considering TSR performance in the context of the Global Share Plan 2010, we feel that the following graph showing the TSR performance of this 
peer group is also of interest.

Nine-year Total Shareholder Return 
(measured in US Dollars, based on monthly spot values)

250

225

200

175

150

125

100

75

50

25

0

-25

Dec 2009

Dec 2008
Source: DataStream
Medical Devices comparators that are still trading for awards made since 2012

Dec 2010

Dec 2011

Dec 2012

Smith & Nephew

Medical Devices – Median

Dec 2013

Dec 2014

Dec 2015

Dec 2016

Dec 2017

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INFORMATION

DIRECTORS’ REMUNERATION REPORT continued

REMUNERATION IMPLEMENTATION REPORT

Table of historic data
The following table details information about the pay of the Chief Executive Officer in the previous nine years:

Year

2017
2016
2015
2014
2013
2012
2011
2011
2010

Chief Executive Officer

Olivier Bohuon
Olivier Bohuon
Olivier Bohuon
Olivier Bohuon
Olivier Bohuon
Olivier Bohuon
Olivier Bohuon1,2
David Illingworth3
David Illingworth

Single figure of total 
remuneration $

Annual Cash Incentive 
payout against maximum %

Performance shares %

Options %

Long-term incentive vesting rates against maximum opportunity

$5,032,925
$3,332,850⁴
$5,342,377
$6,785,121
$4,692,858
$4,956,771
$7,442,191
$3,595,787
$4,060,707

60.67⁵
30
75
43
84
84
68
37
57

54
8
33.5
57
0
N/A
N/A
27
70

– 
– 
– 
– 
– 
– 
– 
27
61

1  Appointed Chief Executive Officer on 1 April 2011.

2 

Includes recruitment award of €1,400,000 cash and a share award over 200,000 ordinary shares with a value of €1,410,000 on grant.

3  Resigned as Chief Executive Officer on 1 April 2011.

4  Prior years are restated to reflect amounts not known at the date of signing the previous Annual Report.

5  Calculated as 91% (actual payout) disclosed on page 87 divided by the maximum potential payout of 150%.

Statement of voting at Annual General Meeting held in 2017
At the Annual General Meeting held on 6 April 2017, votes cast by proxy and at the meeting and votes withheld in respect of the votes on the 
Directors’ Remuneration Report were as follows:

Resolution

Approval of the Directors’ 
Remuneration Policy
Approval of the Directors’ 
Remuneration Report

Votes for

578,383,031

581,873,387

% for

98.30

98.85

Votes against

10,003,885

6,787,211

% against

Total votes validly cast

Votes withheld

1.70

1.15

588,386,916

1,422,700

588,660,598

1,149,020

The Remuneration Committee is mindful of the Government’s new requirements to engage more with employee stakeholders on all matters of 
remuneration. The Committee is currently reviewing how best to implement this and will communicate with employees accordingly. Gender pay 
is also a 2018 focus for the Committee, a programme to ensure women are fully supported in their careers at Smith & Nephew will be part of the 
Committee’s agenda during this time of improvement as we look to the future. 

Senior management remuneration
The Group’s administrative, supervisory and management body (senior management) is comprised for US reporting purposes, of Executive 
Directors and Executive Officers. Details of the current Executive Directors and Executive Officers are given on pages 50 and 54–55. 

Compensation paid to senior management in respect of 2015, 2016 and 2017 was as follows:

Total compensation (excluding pension emoluments, but including cash payments 
under the performance-related incentive plans)
Total compensation for loss of office
Aggregate increase in accrued pension scheme benefits
Aggregate amounts provided for under supplementary schemes

2017

2016

2015

$13,573,000

$12,874,000

$13,971,000

$2,711,000 
– 
$872,00

– 
– 
$1,112,000

– 
– 
$698,000

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REMUNERATION IMPLEMENTATION REPORT

As at 16 February 2018, senior management owned 720,897 shares and 3,015 ADSs, constituting less than 0.1% of the share capital of the Company. 
Details of share awards granted during the year and held as at 16 February 2018 by members of senior management are as follows:

Equity Incentive awards
Performance Share awards at maximum
Conditional share awards under the Global Share Plan 2010
Options under Employee ShareSave plans
Options under the Global Share Plan 2010

Share awards granted 
during the year 

Total share awards held 
as at 16 February 2018

306,903
617,156
190,464
0
0

319,377
1,033,315
197,510
4,559
0

Dilution headroom
The Remuneration Committee ensures that at all times the number of new shares which may be issued under any share-based plans, including 
all-employee plans, does not exceed 10% of the Company’s issued share capital over any rolling 10-year period (of which up to 5% may be issued to 
satisfy awards under the Company’s discretionary plans). The Company monitors headroom closely when granting awards over shares taking into 
account the number of options or shares that might be expected to lapse or be forfeited before vesting or exercise. In the event that insufficient new 
shares are available, there are processes in place to purchase shares in the market to satisfy vesting awards and to net-settle option exercises.

Over the previous 10 years (2008 to 2017), the number of new shares issued under our share plans has been as follows:

 7,275,468 (0.83% of issued share capital as at 16 February 2018)
33,119,507 (3.79% of issued share capital as at 16 February 2018)

All-employee share plans
Discretionary share plans

By order of the Board, on 22 February 2018

Joseph Papa
Chairman of the Remuneration Committee

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REMUNERATION THE POLICY REPORT

FUTURE POLICY TABLE – EXECUTIVE DIRECTORS 
The following table and accompanying notes explain the different elements of remuneration we pay to our Executive Directors. It was approved by 
shareholders at the 2017 Annual General Meeting on 6 April 2017. 

BASE SALARY AND BENEFITS
Base salary

We are a FTSE 50 listed company, operating in over 100 countries around the world. Our strategy to generate cash from Established Markets 
in order to invest for growth in higher growth geographies and franchises means that we are competing for international talent and our base 
salaries therefore need to reflect what our Executive Directors would receive if they were to work in another international company of a similar size, 
complexity and geographical scope.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

Performance in the prior year is one of the factors 
taken into account and poor performance is likely 
to lead to a zero salary increase.

Salaries are normally reviewed annually, 
with any increase applying from 1 April.

The base salary of the Executive Directors 
with effect from 1 April 2017 will be as follows:

Salary levels and increases take account of:

 – Market movements within a peer group 
of similarly sized UK listed companies;

 – Scope and responsibility of the position;

 – Skill/experience and performance of the 

individual Director;

 – General economic conditions in the 
relevant geographic market; and

 – Average increases awarded across 

the Company, with particular regard to 
increases in the market in which the 
Executive is based.

 – Olivier Bohuon €1,179,490.

 – Graham Baker £510,000.

The factors noted in the previous column 
will be taken into consideration when making 
increases to base salary and when appointing 
a new Director.

In normal circumstances, base salary 
increases for Executive Directors will relate 
to the geographic market and peer group. 
In addition, the average increases for 
employees across the Group will be taken into 
account. The Remuneration Committee retains 
the right to approve higher increases when 
there is a substantial change in the scope of 
the Executive Director’s role. A full explanation 
will be provided in the Implementation Report 
should higher increases be approved in 
exceptional cases.

Payment in lieu of pension

In order to attract and retain Executive Directors with the capability of driving our corporate strategy, we need to provide market-competitive 
retirement benefits similar to the benefits they would receive if they were to work for one of our competitors. 

At the same time, we seek to avoid exposing the Company to defined benefit pension risks, and where possible will make payments in lieu of 
providing a pension.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

Current Executive Directors receive 
an allowance in lieu of membership 
of a Company-run pension scheme.

Base salary is the only component 
of remuneration which is pensionable.

Up to 30% of base salary.

The level of payment in lieu of a pension 
paid to Executive Directors is not dependent 
on performance.

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REMUNERATION THE POLICY REPORT

Benefits

In order to attract and retain Executive Directors with the capability of driving our corporate strategy, we need to provide a range of market-
competitive benefits similar to the benefits they would receive if they were to work for one of our competitors.

It is important that our Executive Directors are free to focus on the Company’s business without being diverted by concerns about medical 
provision, risk benefit cover or, if required, relocation issues.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

The level and cost of benefits provided to 
Executive Directors is not dependent on 
performance but on the package of benefits 
provided to comparable roles within the 
relevant location.

A wide range of benefits may be provided 
depending on the benefits provided 
for comparable roles in the location in 
which the Executive Director is based. 
These benefits will include, as a minimum, 
healthcare cover, life assurance, long-term 
disability, annual medical examinations, 
company car or car allowance. 
The Committee retains the discretion 
to provide additional benefits where 
necessary or relevant in the context of the 
Executive’s location.

Where applicable, relocation costs may 
be provided in-line with Company’s 
relocation policy for employees, which 
may include removal costs, assistance 
with accommodation, living expenses for 
self and family and financial consultancy 
advice. In some cases such payments may 
be grossed up. 

The policy is framed by the nature of the 
benefits that the Remuneration Committee 
is willing to provide to Executive Directors. 
The maximum amount payable will 
depend on the cost of providing such 
benefits to an employee in the location 
at which the Executive Director is based. 
Shareholders should note that the cost of 
providing comparable benefits in different 
jurisdictions may vary widely.

As an indication, the cost of such benefits 
provided in 2016 was as follows:

 – Olivier Bohuon €150,511.

 – Julie Brown £22,244.

The maximum amount payable in benefits 
to an Executive Director, in normal 
circumstances, will not be significantly more 
than amounts paid in 2016 (or equivalent in 
local currency). The Remuneration Committee 
retains the right to pay more than this should 
the cost of providing the same underlying 
benefits increase or in the event of a 
relocation. A full explanation will be provided 
in the Implementation Report should the cost 
of benefits provided be significantly higher.

ALL-EMPLOYEE ARRANGEMENTS
All-employee share plans

To enable Executive Directors to participate in all-employee share plans on the same basis as other employees.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

ShareSave Plans are operated in the UK 
and 31 other countries internationally. In the 
US, an Employee Stock Purchase Plan is 
operated. These plans enable employees 
to save on a regular basis and then buy 
shares in the Company. Executive Directors 
are able to participate in such plans 
on a similar basis to other employees, 
depending on where they are located.

Executive Directors may currently invest up 
to £500 per month in the UK ShareSave 
Plan. The Remuneration Committee may 
exercise its discretion to increase this amount 
up to the maximum permitted by the HM 
Revenue & Customs. Similar limits will apply in 
different locations.

The potential gains from all-employee plans 
are not based on performance but are linked 
to growth in the share price.

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REMUNERATION THE POLICY REPORT

ANNUAL INCENTIVES
Annual Incentive Plan – Cash Incentive

To motivate and reward the achievement of specific annual financial and business objectives related to the Company’s strategy and sustained 
through a clawback mechanism explained more fully in the notes.

The objectives which determine the payment of the annual cash incentive and the level of the annual equity award are linked closely to the 
Group strategy.

The financial measures of Revenue, Trading Profit Margin and Trading Cash Flow underline our strategy for growth. 

The business objectives are also linked to the Group strategy. These change from year to year to reflect the evolving strategy, but will typically be 
linked to the Strategic Priorities set out in this Annual Report. The Implementation Report each year will explain how each objective is linked to a 
specific strategic priority.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

The Annual Incentive Plan comprises 
a cash and an equity component, both 
based on the achievement of financial 
and business objectives set at the start of 
the year.

The cash component is paid in full after the 
end of the performance year.

At the end of the year, the Remuneration 
Committee determines the extent to which 
performance against these has been 
achieved and sets the award level.

The total maximum payable under the Annual 
Incentive Plan is 215% of base salary (150% 
Cash Incentive and 65% Equity Incentive).

The cash and share awards are subject to malus 
and clawback as detailed in the notes following 
this table. 

In respect of the Cash Incentive:

 – 150% salary awarded for 
maximum performance.

 – 100% salary awarded for 

target performance.

 – 50% salary awarded for 
threshold performance.

 – Performance assessed against individual 
objectives and Group financial targets.

75% of the cash component is based on financial 
performance measures, which currently include 
Revenue (35%), Trading Profit Margin (25%) and 
Trading Cash Flow (15%). 

25% of the cash component is based on 
other business goals linked to the Company’s 
strategy, which could include financial and non-
financial measures.

The Remuneration Committee retains the 
discretion to adjust the relative weightings of 
the financial and business components, and to 
adopt any performance measure that is relevant 
to the Company.

Annual Incentive Plan – Equity Incentive

To drive share ownership and encourage sustained high standards through the application of a ‘malus’ provision over three years, explained more 
fully in the notes.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

The equity award component comprises 
conditional share awards (made at the time 
of the cash award), with vesting phased 
over the following three years.

In respect of the Equity Incentive:

 – Performance is assessed against individual 
performance, which includes an element of 
Group financial targets.

The equity component vests 1⁄3, 1⁄3, 1⁄3 
on successive award anniversaries, only 
if performance remains satisfactory over 
each of these three years; otherwise the 
award will lapse.

Participants will receive an additional 
number of shares equivalent to the amount 
of dividend payable per vested share 
during the relevant performance period.

 – 65% of salary awarded for 
maximum performance.

 – 50% of salary awarded for 

target performance.

 – 0% of salary awarded for performance 

assessed to be below target.

The Remuneration Committee will use its 
judgement of the individual’s performance based 
both on what has been achieved during the year 
and how it has been achieved in determining the 
level of equity award that may be awarded within 
the range of 0% to 65% of salary.

The equity component will vest in three equal 
tranches over a three-year period, provided that 
satisfactory performance is sustained.

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REMUNERATION THE POLICY REPORT

LONG-TERM INCENTIVES (AWARDS ACTIVELY BEING MADE)
Performance Share Programme

To motivate and reward longer-term performance linked to the long-term strategy and share price of the Company.

The performance measures which determine the level of vesting of the Performance Share Awards are linked to our corporate strategy.

How the component operates

Maximum levels of payment

Framework in which performance is assessed

The Performance Share Programme 
comprises conditional share awards 
which vest after three years, subject to the 
achievement of stretching performance 
targets linked to the Company’s strategy.

Awards may be subject to clawback in the 
event of material financial misstatement 
or misconduct.

Participants will receive an additional 
number of shares equivalent to the amount 
of dividend payable per vested share 
during the relevant performance period.

On vesting, a number of shares are sold 
to cover the tax liability. The remaining 
shares are required to be held by the 
Executive Director for a further two-year 
holding period.

Annual awards:

Currently:

 – 190% of salary for maximum performance.

 – 95% of salary for target performance.

 – 47.5% of salary for threshold performance.

 – 25% of the award vests on achievement of a 
three-year cumulative free cash flow target.

 – 25% of the award vests subject to three-year 
Total Shareholder Return (TSR) at median 
performance relative to Global Healthcare 
companies and to FTSE 100 companies.

 – 25% of the award vests subject to the 
achievement of return on invested 
capital targets.

 – 25% of the award vests subject to total 

sales growth.

 – These measures, the targets and performance 
against them are described more fully in the 
Implementation Report.

 – The Performance Share Award will vest on 
the third anniversary of the date of grant, 
depending on the extent to which the 
performance conditions are met over the 
three-year period commencing in the year the 
award was made.

 – The Remuneration Committee retains the 

discretion to change the measures and their 
respective weightings to ensure continuing 
alignment with the Company’s strategy.

 – The cash and share awards are subject to 

malus and clawback as detailed in the notes 
following this table.

Awards made prior to 2017 were subject to 
TSR against a sector peer group, cash flow and 
revenue in Emerging Markets targets.

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REMUNERATION THE POLICY REPORT

ILLUSTRATIONS OF THE APPLICATION OF THE 
REMUNERATION POLICY 2017
The following charts show the potential split between the different 
elements of the Executive Directors’ remuneration under three different 
performance scenarios.

Figures as at salary levels in 2017, when the Policy Report 
was approved by shareholders

Chief Executive Officer

I

I

I

I

M
M
N
N
M
M
U
U
M
M

€1,683,848
€1,683,848

T
A
T
A
R
R
G
G
E
T
E
T

€4,573,599
€4,573,599

I

M
M
A
A
X
X
M
M
U
U
M
M

I

Chief Financial Officer

I

I

I

I

M
M
N
N
M
M
U
U
M
M

£685,244
£685,244

T
A
T
A
R
R
G
G
E
T
E
T

£1,934,744
£1,934,744

I

M
M
A
A
X
X
M
M
U
U
M
M

I

£2,750,744
£2,750,744

  Benefits 

  Payment in lieu of pension 

  Salary 
  Annual Incentive (Cash) 
  Performance Share Programme

  Annual Incentive (Equity) 

Total Remuneration by Performance Scenario  
for 2017 Financial Year (percentage split)

Chief Executive Officer 

Chief Financial Officer

4
2

3
1

6
2

7
3

0
0
1

5
3

2
1

7
2

6
2

5
2

3
1

6
2

6
3

0
0
1

5
3

2
1

8
2

5
2

MINIMUM %

TARGET %

MAXIMUM %

MINIMUM %

TARGET %

MAXIMUM %

  Fixed pay 
  Annual Incentive (Cash) 
  Long-term Incentives

  Annual Incentive (Equity) 

Data for the Chief Executive Officer assumes an exchange rate of €1 = £0.820.

MALUS AND CLAWBACK
The Remuneration Committee may determine that an unvested 
award or part of an award may not vest (regardless of whether or not 
the performance conditions have been met) or may determine that 
any cash bonus, vested shares, or their equivalent value in cash be 
returned to the Company in the event that any of the following matters 
is discovered:

 – A material misstatement of the Company’s financial results; or

 – A material error in determining the extent to which any performance 

condition has been satisfied; or

 – A significant adverse change in the financial performance of the 
Company, or a significant loss at a general level or at the country 
business unit or function in which a participant worked; or

 – Inappropriate conduct (for example reputational issues), capability 
or performance by a participant, or within a team business area or 
profit centre.

€6,460,783
€6,460,783

These provisions apply to share awards under the Global Share Plan 
2010 and cash amounts under the Annual Cash Incentive Plan.

POLICY ON RECRUITMENT ARRANGEMENTS
Our policy on the recruitment of Executive Directors is to pay a 
fair remuneration package for the role being undertaken and the 
experience of the Executive Director appointed. In terms of base 
salary, we will seek to pay a salary comparable, in the opinion of the 
Committee, to that which would be paid for an equivalent position 
elsewhere. The Remuneration Committee will determine a base salary 
in-line with the policy and having regard to the parameters set out on 
in the future policy table. Incoming Executive Directors will be entitled 
to pension, benefit and incentive arrangements which are the same as 
provided to existing Executive Directors. On that basis, incentive awards 
would not exceed 405% of base salary.

We recognise that in the event that we require a new Executive Director 
to relocate to take up a position with the Company, we will also pay 
relocation and related costs as described in the future policy table, 
which is in-line with the relocation arrangements we operate across 
the Group.

We also recognise that in many cases, an external appointee may forfeit 
sizeable cash bonuses and share awards if they choose to leave their 
former employer and join us. The Remuneration Committee therefore 
believes that we need the ability to compensate new hires for incentive 
awards they give up on joining us. The Committee will use its judgement 
in determining any such compensation, which will be decided on a 
case-by-case basis. We will only provide compensation which is no 
more beneficial than that given up by the new appointee and we will 
seek evidence from the previous employer to confirm the full details of 
bonus or share awards being forfeited. As far as possible, we will seek 
to replicate forfeited share awards using Smith & Nephew incentive 
plans or through reliance on Rule 9.4.2 in the Listing Rules, whilst at the 
same time aiming for simplicity. 

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REMUNERATION THE POLICY REPORT

If we appoint an existing employee as an Executive Director of the 
Company, pre-existing obligations with respect to remuneration, such 
as pension, benefits and legacy share awards, will be honoured. 
Should these differ materially from current arrangements, these will be 
disclosed in the next Implementation Report. 

We will supply details via an announcement to the London Stock 
Exchange of an incoming Executive Director’s remuneration 
arrangements at the time of their appointment.

SERVICE CONTRACTS
We employ Executive Directors on rolling service contracts with notice 
periods of up to 12 months from the Company and six months from 
the Executive Director. On termination of the contract, we may require 
the Executive Director not to work their notice period and pay them an 
amount equivalent to the base salary and payment in lieu of pension 
and benefits they would have received if they had been required to 
work their notice period. 

Under the terms of the Executive Director’s service contract, Executive 
Directors are restricted for a period of 12 months after leaving the 
employment of the Company from working for a competitor, soliciting 
orders from customers and offering employment to employees of Smith 
& Nephew. The Company retains the right to waive these provisions 
in certain circumstances. In the event that these provisions are waived 
or the former Executive Director commences employment earlier than 
at the end of the notice period, no further payments shall be made in 
respect of the portion of notice period not worked. Directors’ service 
contracts are available for inspection at the Company’s registered office: 
15 Adam Street, London WC2N 6LA.

POLICY ON PAYMENT FOR LOSS OF OFFICE
Our policy regarding termination payments to departing Executive 
Directors is to limit severance payments to pre-established contractual 
arrangements. In the event that the employment of an Executive 
Director is terminated, any compensation payable will be determined 
in accordance with the terms of the service contract between the 
Company and the Executive Director, as well as the rules of any 
incentive plans.

Under normal circumstances (excluding termination for gross 
misconduct) all leavers are entitled to receive termination payments 
in lieu of notice equal to base salary, payment in lieu of pension, and 
benefits. In some circumstances additional benefits may become 
payable to cover reimbursement of untaken holiday leave, repatriation 
and outplacement fees, legal and financial advice. 

In addition, we may also in exceptional circumstances exercise our 
discretion to pay the Executive Director a proportion of the annual cash 
incentive they would have received had they been required to work 
their notice period. Any entitlement or discretionary payment may be 
reduced in-line with the Executive Director’s duty to mitigate losses, 
subject to applying our non-compete clause.

We will supply details via an announcement to the London Stock 
Exchange of a departing Executive Director’s termination arrangements 
at the time of departure.

In the case of a change of control which results in the termination of 
an Executive Director or a material alteration to their responsibilities 
or duties, within 12 months of the event, the Executive Director would 
be entitled to receive 12 months’ base salary plus payment in lieu of 
pension and benefits. In addition, the Remuneration Committee has 
discretion to pay an Executive Director in these circumstances an 
annual cash incentive. For Directors appointed prior to 1 November 
2012, an automatic annual cash incentive is payable at target.

In the event that an Executive Director leaves for reasons of ill-health, 
death, redundancy or retirement in agreement with the Company, 
then the vesting of any outstanding annual cash incentive and 
equity incentive awards will generally depend on the Remuneration 
Committee’s assessment of performance to date. Performance share 
awards will be pro-rated for the time worked during the relevant 
performance period, and will remain subject to performance over the 
full performance period.

For all other leavers, the annual cash incentive will generally be forfeited 
and outstanding equity incentive awards and performance share 
awards will lapse.

One-off awards granted on appointment will normally lapse on 
leaving except in cases of death, retirement, redundancy, or ill-health. 
The Remuneration Committee has discretion to permit such awards to 
vest in other circumstances and will be subject to satisfactorily meeting 
performance conditions if applicable.

The Remuneration Committee retains discretion to alter these provisions 
on a case-by-case basis following a review of circumstances and to 
ensure fairness for both shareholders and Executive Directors.

We will supply details via an announcement to the London Stock 
Exchange of an out-going Executive Director’s remuneration 
arrangements around the time of leaving.

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REMUNERATION THE POLICY REPORT

CHANGES TO POLICY
The 2017 Remuneration Policy makes the following changes to the 
2014 Remuneration policy:

 – Introduction of a two-year holding period for vested 

Performance shares;

 – Flexibility to change measures;

 – Increased emphasis on financial objectives in the Annual Incentive 

Plan, increases from 70% to 75%; and

 – Increased shareholding requirement to 300% of salary for the 

Chief Executive Officer.

Further details can be found in the letter from the Chairman of the 
Remuneration Committee on pages 79–80 of the 2017 Annual Report. 

POLICY ON SHAREHOLDING REQUIREMENTS
The Remuneration Committee believes that one of the best ways our 
Executive Directors can have a greater alignment with shareholders 
is for them to hold a significant number of shares in the Company. 
The Chief Executive Officer is therefore expected to build up a holding 
of Smith & Nephew shares worth three times their base salary and the 
Chief Financial Officer is expected to build up a holding of two times 
their basic salary. In order to reinforce this expectation, we require them 
to retain 50% of the shares (after tax) vesting under the equity incentive 
programmes until this holding has been met, recognising that differing 
international tax regimes affect the pace at which an Executive Director 
may fulfil the shareholding requirement. When calculating whether or 
not this requirement has been met, we will include ordinary shares 
or ADRs held by the Executive Director and their immediate family. 
Ordinarily, we would expect this required shareholding to have been 
built up within a period of five years from the date of appointment.

Furthermore, from awards made in 2017, we require our Executive 
Directors to retain all the shares (after tax) vesting under the 
Performance Share Programme for a period of two years after vesting.

STATEMENT OF CONSIDERATION OF EMPLOYMENT 
CONDITIONS ELSEWHERE IN THE COMPANY AND 
DIFFERENCES TO THE EXECUTIVE DIRECTOR POLICY
All employees across the Group have performance-based pay linked 
to objectives derived from the strategic priorities, which underpin the 
performance metrics in the Executive Director Incentive Plans.

Executive Director base salaries will generally increase at a rate in-line 
with the average salary increases awarded across the Company. 
Given the diverse geographic markets within which the Company 
operates, the Committee will generally be informed by the average 
salary increase in both the market local to the Executive and the UK, 
recognising the Company’s place of listing, and will also consider market 
data periodically.

A range of different pension arrangements operate across the Group 
depending on location and/or length of service. Executive Directors and 
Executive Officers either participate in the legacy pension arrangements 
relevant to their local market or receive a cash payment of 30% of salary 
in lieu of a pension. Senior executives who do not participate in a local 
Company pension plan receive a cash payment of 20% of salary in lieu 
of pension. Differing amounts apply for lower levels within the Company.

The Company has established a benefits framework under which the 
nature of benefits varies by geography. Executive Directors participate in 
benefit arrangements similar to those applied for employees within the 
applicable location.

All employees are set objectives at the beginning of each year, 
which link through to the objectives set for the Executive Directors. 
Annual cash incentives payable to employees across the Company 
depend on the satisfactory completion of these objectives as well as 
performance against relevant Group and country business unit financial 
targets relating to revenue, trading profit and trading cash, similar to the 
financial targets set for the Executive Directors.

Executive Officers and senior executives (61 as at 2017) participate 
in the annual Equity Incentive Programme and the Performance 
Share Programme. The maximum amounts payable are lower, but 
the performance conditions are the same as those that apply to the 
Executive Directors.

No specific consultation with employees has been undertaken  
relating to Director remuneration. However, regular employee surveys 
are conducted across the Group, which cover a wide range of issues 
relating to local employment conditions and an understanding of 
Group-wide strategic matters. As at 2017, around 5,000 employees 
in 63 countries participate in one or more of our global share plans. 

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

DIRECTORS’ REMUNERATION REPORT continued

REMUNERATION THE POLICY REPORT

FUTURE POLICY TABLE – CHAIRMAN AND NON-EXECUTIVE DIRECTORS
The following table and accompanying notes explain the different elements of remuneration we pay to our Chairman and Non-Executive Directors. 
No element of their remuneration is subject to performance. All payments made to the Chairman are determined by the Remuneration Committee, 
whilst payments made to the Non-Executive Directors are determined by the Directors who are not themselves Non-Executive Directors, currently 
the Chairman, the Chief Executive Officer and the Chief Financial Officer.

Annual fees

Basic annual fee

To attract and retain Directors by setting fees at rates comparable to what would be paid in an equivalent position elsewhere.

A proportion of the fees are paid in shares in the third quarter of each year in order to align Non-Executive Directors’ fees with the interests 
of shareholders.

How the component operates

Maximum levels of payment

Fees will be reviewed periodically. In future, any increase will be paid in 
shares until 25% of the total fee is paid in shares.

Fees are set in-line with market practice for fees paid by similarly sized 
UK listed companies. 

Annual fees are set and paid in UK Sterling or US Dollars depending on 
the location of the Non-Executive Director. If appropriate, fees may be 
set and paid in alternative currencies.

Annual fees are currently as follows:

 – £63,000 in cash plus £5,135 in shares; or

 – $120,000 in cash plus $9,780 in shares.

Chairman fee:

 – £309,000 plus £103,000 in shares.

Whilst it is not expected to increase the fees paid to the Non-Executive 
Directors and the Chairman by more than the increases paid to 
employees generally, in exceptional circumstances higher fees might 
become payable.

The total maximum aggregate fees payable to the Non-Executive 
Directors will not exceed £1.5 million as set out in the Company’s 
Articles of Association.

Fee for Senior Independent Director and Committee Chairmen

To compensate Non-Executive Directors for the additional time spent as Committee Chairmen or as the Senior Independent Director.

How the component operates

Maximum levels of payment

A fixed fee is paid, which is reviewed periodically.

 – £20,000 in cash; or

 – $35,000 in cash.

Whilst it is not expected that the fees paid to the Senior Independent 
Director or Committee Chairmen will exceed the increases paid to 
employees generally, in exceptional circumstances, higher fees might 
become payable.

Intercontinental travel 

To compensate Non-Executive Directors for the time spent travelling to attend meetings in another continent.

How the component operates

Maximum levels of payment

A fixed fee is paid, which is reviewed periodically.

 – £3,500 in cash; or

 – $7,000 in cash.

Whilst it is not expected to increase these fees by more than the 
increases paid to employees generally, in exceptional circumstances, 
higher fees might become payable.

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

DIRECTORS’ REMUNERATION REPORT continued

REMUNERATION THE POLICY REPORT

NOTES TO FUTURE POLICY TABLE  
– NON-EXECUTIVE DIRECTORS
Changes to Remuneration Policy
There have been no changes to our Remuneration Policy as it applies 
to Non-Executive Directors, since the Policy was initially approved by 
shareholders in April 2014.

Additional duties undertaken by Non-Executive Directors
In the event that the Chairman or a Non-Executive Director is required 
to undertake significant additional executive duties in order to support 
the Executive Directors during a period of absence due to illness or a 
gap prior to the appointment of a permanent Executive Director, the 
Remuneration Committee is authorised to determine an appropriate 
level of fees which shall be payable. These fees will not exceed the 
amounts which would normally be paid to a permanent Executive 
Director undertaking such duties and shall not include participation  
in short- or long-term incentive arrangements or benefit plans.

Policy on recruitment arrangements
Any new Non-Executive Director shall be paid in accordance with the 
current fee levels on appointment, in line with the Policy set out above. 
With respect to the appointment of a new Chairman, fee levels will take 
into account market rates, the individual’s profile and experience, the 
time required to undertake the role and general business conditions. 
In addition, the Remuneration Committee retains the right to authorise 
the payment of relocation assistance or an accommodation allowance in 
the event of the appointment of a Chairman not based within the UK.

Letters of appointment
The Chairman and Non-Executive Directors have letters of appointment 
which set out the terms under which they provide their services to the 
Company and are available for inspection at the Company’s registered 
office: 15 Adam Street, London WC2N 6LA. The appointment of Non-
Executive Directors is not subject to a notice period, nor is there any 
compensation payable on loss of office, for example, should they not 
be re-elected at an Annual General Meeting. The appointment of the 
Chairman is subject to a notice period of six months.

The Chairman and Non-Executive Directors are required to acquire 
a shareholding in the Company equivalent in value to one times their 
basic fee within two years of their appointment to the Board.

STATEMENT OF CONSIDERATION OF SHAREHOLDER VIEWS
The broad outline of our remuneration arrangements have remained 
largely unchanged since 2012. As our strategy has evolved, we 
have altered some of the measures we use in our short- and long-
term incentive plans, but the overall structure of our remuneration 
arrangements has remained the same. Shareholders formally approved 
the Remuneration Policy in respect of our Executive Directors at the 
Annual General Meeting in 2014. Joseph Papa, Chairman of the 
Remuneration Committee, has met with shareholders before the policy 
was approved and every year since, in order to ascertain shareholder 
views on our remuneration arrangements. 

Ahead of the Annual General Meeting in 2016, Mr Papa held meetings 
and calls with 28 shareholders holding approximately 33% of the 
Company’s Share Capital. Although the holders of 53% of our shares 
voted against the Remuneration Report in 2016, our engagement ahead 
of the 2016 Annual General Meeting had shown us that shareholders 
were broadly supportive of our Remuneration Policy and those who 
opposed the Remuneration Report were primarily voting against the use 
of discretion rather than any aspect of the Remuneration Policy.

During 2016, following the Annual General Meeting, Mr Papa continued 
to engage extensively with shareholders. In Autumn 2016, he met with 
or held telephone calls with 28 shareholders holding around 41% of the 
Company’s shares. The shareholders he met ranged from some of our 
top 20 shareholders down to smaller active and engaged shareholders 
holding fewer than one million shares. He discussed our proposals 
to continue with the same overall remuneration arrangements, whilst 
altering the performance measures used in the short- and long-term 
incentive plans. We found the discussions with shareholders at this time 
useful in helping to understand the measures and targets which were 
important to our shareholders, and those which shareholders did not 
support. As a result of these discussions, some updated performance 
measures have been incorporated into our incentive plans for 2017 and 
a two-year holding period will now apply on the vesting of performance 
shares for our Executive Directors.

SMITH & NEPHEW ANNUAL REPORT 2017 106

OVERVIEW

CONTENTS

OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

NOTE 14 

TRADE AND OTHER PAYABLES

NOTE 15 

CASH AND BORROWINGS

NOTE 16 

FINANCIAL INSTRUMENTS  
AND RISK MANAGEMENT

NOTE 17 

PROVISIONS AND CONTINGENCIES

NOTE 18 

RETIREMENT BENEFIT OBLIGATIONS

NOTE 19 

EQUITY

NOTE 20  CASH FLOW STATEMENT

NOTE 21  ACQUISITIONS AND DISPOSALS

NOTE 22  OPERATING LEASES

NOTE 23.1  SHARE-BASED PAYMENTS

NOTE 23.2  RELATED PARTY TRANSACTIONS

NOTE 24 

POST BALANCE SHEET EVENTS

COMPANY FINANCIAL STATEMENTS  
AND ASSOCIATED NOTES

GROUP AND OTHER INFORMATION

GROUP INFORMATION

OTHER FINANCIAL INFORMATION

INFORMATION FOR SHAREHOLDERS

139

140

143

148

150

156

158

159

161

162

162

162

163

171

176

184

STATEMENT OF DIRECTORS’ RESPONSIBILITIES

INDEPENDENT AUDITOR’S REPORT

CRITICAL JUDGEMENTS AND ESTIMATES

GROUP FINANCIAL STATEMENTS

GROUP INCOME STATEMENT

GROUP STATEMENT OF  
COMPREHENSIVE INCOME

GROUP BALANCE SHEET

GROUP CASH FLOW STATEMENT

GROUP STATEMENT OF CHANGES IN EQUITY

NOTES TO THE GROUP ACCOUNTS

NOTE 1 

 BASIS OF PREPARATION

NOTE 2 

BUSINESS SEGMENT INFORMATION

NOTE 3 

OPERATING PROFIT

NOTE 4 

INTEREST AND OTHER FINANCE COSTS

NOTE 5 

TAXATION

NOTE 6 

EARNINGS PER ORDINARY SHARE

NOTE 7 

PROPERTY, PLANT AND EQUIPMENT

NOTE 8 

GOODWILL

NOTE 9 

INTANGIBLE ASSETS

NOTE 10 

INVESTMENTS

NOTE 11 

INVESTMENTS IN ASSOCIATES

NOTE 12 

INVENTORIES

NOTE 13 

TRADE AND OTHER RECEIVABLES

107

108

114

115

115

116

117

118

119

121

125

126

127

130

131

133

134

136

136

137

138

ACCOUNTS

SMITH & NEPHEW ANNUAL REPORT 2017  
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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

GROUP FINANCIAL STATEMENTS
STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN RESPECT  
OF THE ANNUAL REPORT AND THE FINANCIAL STATEMENTS

The Directors are responsible for preparing the Annual Report and Form 20-F and the Group and Parent Company financial statements in 
accordance with applicable law and regulations.  

Company law requires the Directors to prepare Group and Parent Company financial statements for each financial year. Under that law they are 
required to prepare the Group financial statements in accordance with International Financial Reporting Standards as issued by the International 
Accounting Standards Board (IASB) and as adopted by the European Union (IFRSs as adopted by the EU) and applicable law and have elected to 
prepare the Parent Company financial statements in accordance with UK accounting standards, including FRS 101 Reduced Disclosure Framework.  

Under company law the Directors must not approve the financial statements unless they are satisfied that they give a true and fair view of the state 
of affairs of the Group and Parent Company and of their profit or loss for that period. In preparing each of the Group and Parent Company financial 
statements, the Directors are required to:

 – select suitable accounting policies and then apply them consistently; 
 – make judgements and estimates that are reasonable, relevant, reliable and prudent; 
 – for the Group financial statements, state whether they have been prepared in accordance with IFRSs, as issued by the IASB and adopted by 

the EU; 

 – for the Parent Company financial statements, state whether applicable UK Accounting Standards have been followed, subject to any material 

departures disclosed and explained in the Parent Company financial statements; 

 – assess the Group and Parent Company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern; and 
 – use the going concern basis of accounting unless they either intend to liquidate the Group or the Parent Company or to cease operations, or have 

no realistic alternative but to do so.

The Directors are responsible for keeping adequate accounting records that are sufficient to show and explain the Parent Company’s transactions 
and disclose with reasonable accuracy at any time the financial position of the Parent Company and enable them to ensure that its financial 
statements comply with the Companies Act 2006. They are responsible for such internal control as they determine is necessary to enable the 
preparation of financial statements that are free from material misstatement, whether due to fraud or error, and have general responsibility for taking 
such steps as are reasonably open to them to safeguard the assets of the Group and to prevent and detect fraud and other irregularities.  

Under applicable law and regulations, the Directors are also responsible for preparing a Strategic Report, Directors’ Report, Directors’ Remuneration 
Report and Corporate Governance Statement that complies with that law and those regulations.  

The Directors are responsible for the maintenance and integrity of the corporate and financial information included on the Company’s website.  
Legislation in the UK governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions. 

RESPONSIBILITY STATEMENT OF THE DIRECTORS IN RESPECT OF THE ANNUAL REPORT
We confirm that to the best of our knowledge:

 – the financial statements, prepared in accordance with the applicable set of accounting standards, give a true and fair view of the assets, liabilities, 

financial position and profit or loss of the Company and the undertakings included in the consolidation taken as a whole; and

 – the Strategic Report and Directors’ Report include a fair review of the development and performance of the business and the position of the 

issuer and the undertakings included in the consolidation taken as a whole, together with a description of the principal risks and uncertainties 
that they face.

The Strategic Report, which has been prepared in accordance with the requirements of the Companies Act 2006, comprises the following sections:

 – Overview (pages 2–7);
 – Our Business and Marketplace (pages 8–17);
 – Operational Review (pages 18–35);
 – Financial Review (pages 38–39);
 – Risk (pages 40–49).

The Directors’ Report has also been prepared in accordance with the Companies Act 2006 and The Small Companies and Groups (Accounts and 
Directors’ Report) Regulations 2008 comprising of pages 6, 16–17, 25–28, 33–39, 42–78, 107, 140–142, 158 and pages 171–192 of the Annual Report. 

And has been approved and signed on behalf of the Board.

We consider the Annual Report and financial statements, taken as a whole, are fair, balanced and understandable and provide the information 
necessary for shareholders to assess the Group’s position and performance, business model and strategy. 

By order of the Board, on 22 February 2018

Susan Swabey 
Company Secretary

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

GROUP FINANCIAL STATEMENTS
INDEPENDENT AUDITOR’S UK REPORT

AUDITOR’S REPORTS ON THE FINANCIAL STATEMENTS AND ON INTERNAL CONTROL OVER FINANCIAL REPORTING  
(SARBANES-OXLEY ACT SECTION 404)
The report set out below is provided in compliance with International Standards on Auditing (UK and Ireland). KPMG LLP has also issued reports in 
accordance with standards of the Public Company Accounting Oversight Board in the US, which will be included in the Annual Report on Form 20-F 
to be filed with the US Securities and Exchange Commission. Those reports are unqualified and include opinions on the Group Financial Statements 
and on the effectiveness of internal control over financial reporting as at 31 December 2017 (Sarbanes-Oxley Act Section 404).

The Directors’ statement on internal control over financial reporting is set out on pages 77–78. 

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF SMITH & NEPHEW PLC ONLY 
OPINIONS AND CONCLUSIONS ARISING FROM OUR AUDIT
1. Our opinion is unmodified
We have audited the financial statements of Smith & Nephew Plc (“the Company”) for the year ended 31 December 2017 which comprise the Group 
Income Statement, Group Statement of Comprehensive Income, Group Balance Sheet, Group Cash Flow Statement, Group Statement of Changes in 
Equity, Company Balance Sheet, Company Statement of Changes in Equity, and the related notes which include the accounting policies.  

In our opinion: 
 – The financial statements give a true and fair view of the state of the Group’s and of the parent Company’s affairs as at 31 December 2017 and of 

the Group’s profit for the year then ended; 

 – The Group financial statements have been properly prepared in accordance with International Financial Reporting Standards as adopted by the 

European Union; 

 – The parent Company financial statements have been properly prepared in accordance with UK accounting standards, including FRS 101 Reduced 

Disclosure Framework; and 

 – The financial statements have been prepared in accordance with the requirements of the Companies Act 2006 and, as regards the Group 

financial statements, Article 4 of the IAS Regulation.

Additional opinion in relation to IFRSs as issued by the IASB 
As explained in the accounting policies set out in the Group financial statements, the Group, in addition to complying with its legal obligation to 
apply IFRS as adopted by the EU, has also applied IFRS as issued by the IASB. In our opinion, the Group financial statements have been properly 
prepared in accordance with IFRS as issued by the IASB.

Basis for opinion 
We conducted our audit in accordance with International Standards on Auditing (UK) (“ISAs (UK)”) and applicable law. Our responsibilities are 
described below. We believe that the audit evidence we have obtained is a sufficient and appropriate basis for our opinion. Our audit opinion is 
consistent with our report to the audit committee. 

We were appointed as auditor by the shareholders on 9 April 2015. The period of total uninterrupted engagement is for the 3 financial years ended 
31 December 2017. We have fulfilled our ethical responsibilities under, and we remain independent of the Group in accordance with, UK ethical 
requirements including the FRC Ethical Standard as applied to listed public interest entities. No non-audit services prohibited by that standard 
were provided.

OVERVIEW
Materiality: Group financial statements as a whole

Coverage
Risks of material misstatement 

$42m (2016: $44m)
4.8% (2016: 5.3%) of group normalised profit before tax
87% (2016: 91%) of group profit before tax
Recurring risks

vs 2016

Recognition and measurement of provisions for uncertain tax provisions 

Liability provisioning for metal-on-metal hip products

Advanced Wound Care, Bioactives and Devices revenue related rebates 

Excess and obsolescence (E&O) provision for Orthopaedics Inventory

.

SMITH & NEPHEW ANNUAL REPORT 2017 109

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

GROUP FINANCIAL STATEMENTS
INDEPENDENT AUDITOR’S UK REPORT continued

2. Key audit matters: our assessment of risks of material misstatement
Key audit matters are those matters that, in our professional judgment, were of most significance in the audit of the financial statements and include 
the most significant assessed risks of material misstatement (whether or not due to fraud) identified by us, including those which had the greatest 
effect on: the overall audit strategy; the allocation of resources in the audit; and directing the efforts of the engagement team. 

We summarise below the key audit matters in decreasing order of audit significance, in arriving at our audit opinion above, together with our 
key audit procedures to address those matters and, as required for public interest entities, our results from those procedures. These matters 
were addressed, and our results are based on procedures undertaken, in the context of, and solely for the purpose of, our audit of the financial 
statements as a whole, and in forming our opinion thereon, and consequently are incidental to that opinion, and we do not provide a separate 
opinion on these matters.

Recognition and measurement of provisions for uncertain tax provisions  
Included in current tax payable ($233 million; 2016: $231 million)
The risk
Uncertain outcome
The Group has extensive international operations and is 
subject to complex local and international tax legislation 
in the normal course of business. 

uncertain tax exposures.

As a result of the complexities of tax rules on transfer 
pricing and other tax legislation, the provisioning for 
uncertain direct tax positions is judgemental and 
requires the Directors to make estimates in relation to 
these uncertainties.

Risk vs 2016:

Our response
Our procedures included: 
 – Control operation: Testing the controls that Group has in place to identify and quantify its 

 – Our taxation expertise: Using our international and local tax specialists to assess the Group’s 
direct tax positions and to analyse and challenge the assumptions used to determine provisions 
based on our knowledge and experience of the application of the international and local 
legislation by the relevant authorities and courts.

 – Test of detail: Examining the calculations prepared by the Directors and agreeing assumptions 

used to underlying data where possible. 

 – With the help of our tax specialists, considering the judgements applied to each significant 

provision including the maximum potential exposure and the likelihood of a payment 
being required. 

 – Inspecting correspondence with relevant tax authorities and assessing third party tax advice 
received to evaluate the conclusions drawn from the advice where relevant to the significant 
exposures faced by the Group.

Our results: 
From the evidence we obtained we found the level of provisioning in respect of uncertain direct tax 
positions to be acceptable.

Refer to page 75 (Audit Committee Report) and pages 114 and 127–129 (accounting policy and financial disclosures).

Liability provisioning for metal-on-metal hip products  
($157 million; 2016: $163 million)
The risk
Subjective estimate
As disclosed in note 17 the Group holds a provision of 
$157 million in respect of potential liabilities arising from 
the ongoing exposure for metal-on-metal hip products. 

Our response
Our procedures included: 
 – Control operation: Testing the controls that Group has in place to identify and quantify its 

uncertain legal provisions. 

 – Enquiry of lawyers: Inspection of correspondence with external counsel and formal 

Risk vs 2016:

The estimate for this provision requires the Directors 
to use a statistical model and make a number of key 
assumptions which include the expected number of 
claimants, projected value of each settlement and the 
likely time period expected for the settlements. 

confirmations from counsel of open cases. 

 – Test of detail: Examining the calculations prepared by the Directors and agreeing assumptions 

used to underlying data where possible. 

 – For the cases identified in external counsel confirmations that all these have been adequately 

considered by the Directors in making their judgement on any provisioning that may be required. 

 – Our actuary expertise: Using our actuarial specialists to challenge the critical assumptions 

used in statistical projections in determining the estimated liability by reference to historical data 
including settlement amounts. 

 – Assessing transparency: Assessing the adequacy of the Group’s disclosures in respect of the 

metal-on-metal hip provision. 

Our results: 
The results of our testing were satisfactory and we considered the liability recognised to 
be acceptable.

Refer to page 74 (Audit Committee Report) and pages 114 and 148–150 (accounting policy and financial disclosures)

SMITH & NEPHEW ANNUAL REPORT 2017 110

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

GROUP FINANCIAL STATEMENTS
INDEPENDENT AUDITOR’S UK REPORT continued

Advanced Wound Care, Bioactives and Devices revenue related rebates 

Risk vs 2016

The risk
Subjective estimate 
The Group has a variety of agreements with wholesalers 
and distributors whereby contractual rebates are due 
to customers based on the actual quantity of goods 
purchased over a defined period of time. 

The contractual arrangement for rebates can vary by 
customer, product type and jurisdiction. 

The amount of revenue recognised for products sold 
through these channels (wholesale customers and 
distributors) require the Directors to calculate estimates 
for these contractual rebates which are deducted in 
arriving at revenue recorded in the period. 

Due to the variations in complexity of these 
arrangements, we consider that there is a risk of error in 
calculating the estimates of rebates that have yet to be 
agreed with the customer. 

Our response
Our procedures included:
 – Control operation: Evaluating controls that the Group has in place over the identification, 

estimation and settlement of rebates.

 – Inspection of customer contracts: Inspecting underlying contractual terms and 

correspondence with customers for a selection of arrangements in place and considering 
whether the accounting policy had been applied appropriately to the terms of the rebate, 
discount and/or returns.

 – Test of detail: Performing detailed testing on a sample basis of the largest rebates with 

particular attention to whether these adjustments were recognised in the correct period and the 
completeness and appropriateness of any rebates accrued at the year-end.

 – Historical comparisons: Comparing provisions held in prior years to actual outcomes to assess 

the accuracy by which the Directors were able to estimate these provisions.

Our results: 
The results of our testing were satisfactory and we considered the rebates estimated to 
be acceptable. 

Refer to page 122 (accounting policy and financial disclosures).

Excess and Obsolescence (E&O) provision for Orthopaedics Inventory 

Risk vs 2016:

The risk
Forecast-based valuation
In line with industry practice, the Group has high 
levels of Orthopaedics Inventory located at customer 
premises to be available for immediate use by surgeons.  
Complete product sets include outsizes which are 
used less frequently. Towards the end of a product’s 
life cycle, finished goods inventory levels may exceed 
requirements, in particular as it relates to inventory used 
less frequently.  

Historical sales of this inventory is often indicative of 
future usage, adjusted for changes in market demand, 
technological advancements or other factors.  

In calculating the provision for excess and obsolete 
inventory (E&O provision) the Directors have to estimate 
the utilisation of inventory on hand based on forecast 
production and sales.

Our response
Our procedures included: 
 – Control operation: Evaluating controls the Group has in place over the preparation, review 

and approval of E&O provision, as well as over the review of the Group wide inventory 
provisioning policy. 

 – Methodology implementation: Comparing the calculation of E&O provision to the principles 

outlined in the Group accounting policy.

 – Test of detail: Testing the accuracy of E&O provision calculation and assessing key underlying 
assumptions. These include expected usage of inventory based on historical sales and other 
internal or external factors which may impact the demand for the product. Corroborating key 
assumptions against source documents such as prior year audited information.

 – Inquiry of management: Performing inquiry of management to corroborate the Directors’ plans 

for launching new or discontinuing product lines. 

 – Historical comparisons: Comparing provisions held in prior years to actual inventory write-offs 

to assess the accuracy by which the Directors were able to forecast this E&O provision. 
 – Assessing transparency: Assessing the adequacy of the Group’s disclosures in respect of 

E&O provision. 

Our results: 
The results of our testing were satisfactory and we considered the E&O provisions made to 
be acceptable.  

Refer to page 74 (Audit Committee Report) and pages 114 and 137 (accounting policy and financial disclosures).

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

GROUP FINANCIAL STATEMENTS
INDEPENDENT AUDITOR’S UK REPORT continued

Parent company financial statements: Recoverability of parent company’s investment in subsidiaries  
Investments ($7,092 million; 2016: $5,322 million)
The risk
Low risk, high value
The carrying amount of the Company’s investments in 
subsidiaries held at cost less impairment represents 
94% (2016: 86%) of the Company’s total assets. 

Our response
Our procedures included: 
 – Test of details: Comparing a sample of the highest value investments representing 98% 

(2016: 97%) of the total investment balance with the relevant subsidiaries’ draft balance sheets 
to identify whether their net assets, being an approximation of their minimum recoverable 
amount, were in excess of their carrying amount and assessing whether those subsidiaries have 
historically been profit-making.

Risk vs 2016:

We do not consider the valuation of these investments 
to be at a high risk of significant misstatement, or to be 
subject to a significant level of judgement. However, 
due to their materiality in the context of the Company 
financial statements as a whole, this is considered to 
be the area which had the greatest effect on our overall 
audit strategy and allocation of resources in planning 
and completing our parent company audit.

 – Assessing subsidiary audits: Assessing the work performed by the subsidiary audit team on 

that sample of those subsidiaries and considering the results of that work, on those subsidiaries’ 
profits and net assets.

Our results: 
We found the Directors’ assessment of the carrying value of investments to be acceptable.

Acquisition intangible assets 
Oasis, the main asset at risk of impairment in the acquisition intangibles portfolio, was impaired in previous years. Whilst we continue to perform 
audit procedures over the valuation of remaining acquisition intangibles, these assets have continued to perform in line with expectations. 
Therefore, we no longer consider the valuation of acquisition intangible assets as a key audit matter and, consequently, is not separately identified 
in our audit report this year.

3. Our application of materiality and an overview of the scope of our audit
Materiality for the Group financial statements as a whole was set at $42 million (2016: $44 million), determined with reference to a benchmark of 
Group profit before tax, normalised to exclude acquisition related credit of $10 million, impairment charges of $10 million and a net credit for legal 
and other items of $13 million as disclosed in Note 2 of which it represents 4.8% (2016: 5.3%). In addition to a net charge for legal and other items  
of $20 million, the normalisation adjustments in 2016 also included a gain on disposal of a business of $326 million, acquisition related costs  
of $9 million, impairment charges of $48 million and restructuring and rationalisation expenses of $62 million. There was no disposal of business  
in 2017 and the restructuring programme was completed at the end of 2016. 

We believe that pre-tax profit excluding these items provides us with a consistent year-on-year basis for determining materiality and is the most 
relevant performance measure to the users of the financial statements. Materiality for the parent company financial statements as a whole was set 
at $31 million (2016: $31 million), determined with reference to a benchmark of company total assets, of which it represents 0.4% (2016: 1%). 

Group normalised profit 
before tax

Group materiality
$42m

2016 
$44 million

$866m

2016 
$835 million

$19m

$2m
2016 
$2.2m

Group normalised profit before tax

Group materiality

Whole financial statements materiality 

Range of materiality at 37 components ($3m–$19m);
(2016: $5m to $35m)
 Misstatements reported to the Audit Committee 

We agreed to report to the Audit Committee any corrected or uncorrected identified misstatements exceeding $2.0 million (2016: $2.2 million),  
in addition to other identified misstatements that warranted reporting on qualitative grounds. 

Of the Group’s 110 (2016: 145) reporting components, we subjected 24 (2016: 46) to full scope audits for Group purposes and 13 (2016: 13) to audits 
of specific account balances including revenue, receivables, inventory and taxation. The latter were not individually financially significant enough to 
require a full scope audit for Group purposes, but did present specific individual risks that needed to be addressed or were included in the scope 
of our Group reporting work in order to provide further coverage over the Group’s results. 

The components within the scope of our work accounted for the percentages illustrated. 

The remaining 16% (2016: 21%) of total Group revenue, 13% (2016: 9%) of group profit before tax and 14% (2016: 13%) of total Group assets is 
represented by 73 (2016: 86) reporting components, none of which individually represented more than 2% (2016: 4%) of any of total Group revenue, 
Group profit before tax or total Group assets. For these residual components, we performed analysis at an aggregated Group level to re-examine 
our assessment that there were no significant risks of material misstatement within these. 

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INDEPENDENT AUDITOR’S UK REPORT continued

The Group team instructed component auditors as to the significant areas to be covered, including the relevant risks detailed above and the 
information to be reported back. The Group team approved component materialities, which ranged from $3 million to $19 million (2016: $5 million 
to $35 million), having regard to the mix of size and risk profile of the Group across the components. The work on 19 of the 37 components  
(2016: 40 of the 59 components) was performed by component auditors and the rest, including the audit of the parent company, was performed 
by the Group team. The Group team performed procedures on the items excluded from normalised Group profit before tax. 

The Group team visited 10 (2016: 5) component locations in USA, China, France, Italy, Spain, UK, South Africa, Costa Rica, Switzerland and Germany 
(2016: USA, UK, Brazil, Germany and Switzerland) to assess the audit risk and strategy. Video and telephone conference meetings were also held 
with these component auditors and others that were not physically visited. At these visits and meetings, the findings reported to the Group team 
were discussed in more detail, and any further work required by the Group team was then performed by the component auditor.

Group revenue 

Group total assets 

Group profit before tax

16

21

14

13

84%

2016 
79%

25  17

62 

59 

16

30

86%

2016 
87%

71

56 

13

9

10

21

87%

2016 
91%

81

66

Full scope for group audit 
purposes 2017 

Audit of specific account
balances 2017 

Full scope for group audit 
purposes 2016  

Audit of specific account 
balances 2016 

Residual components

4. We have nothing to report on going concern 
We are required to report to you if:
 – we have anything material to add or draw attention to in relation to the Directors’ statement in note 1 to the financial statements on the use of the 
going concern basis of accounting with no material uncertainties that may cast significant doubt over the Group and Company’s use of that basis 
for a period of at least twelve months from the date of approval of the financial statements; or 

 – the related statement under the Listing Rules set out on page 77 is materially inconsistent with our audit knowledge. 

We have nothing to report in these respects. 

5. We have nothing to report on the other information in the Annual Report
The Directors are responsible for the other information presented in the Annual Report together with the financial statements. Our opinion on the 
financial statements does not cover the other information and, accordingly, we do not express an audit opinion or, except as explicitly stated below, 
any form of assurance conclusion thereon. 

Our responsibility is to read the other information and, in doing so, consider whether, based on our financial statements audit work, the information 
therein is materially misstated or inconsistent with the financial statements or our audit knowledge. Based solely on that work we have not identified 
material misstatements in the other information.

Strategic report and directors’ report 
Based solely on our work on the other information: 
 – we have not identified material misstatements in the strategic report and the directors’ report; 
 – in our opinion the information given in those reports for the financial year is consistent with the financial statements; and 
 – in our opinion those reports have been prepared in accordance with the Companies Act 2006. 

Directors’ remuneration report 
In our opinion the part of the Directors’ Remuneration Report to be audited has been properly prepared in accordance with the Companies Act 2006. 

Disclosures of principal risks and longer-term viability 
Based on the knowledge we acquired during our financial statements audit, we have nothing material to add or draw attention to in relation to: 
 – the Directors’ confirmation within the viability statement on page 48–49 that they have carried out a robust assessment of the principal risks 

facing the Group, including those that would threaten its business model, future performance, solvency and liquidity; 
 – the Principal Risks disclosures describing these risks and explaining how they are being managed and mitigated; and 
 – the Directors’ explanation in the viability statement of how they have assessed the prospects of the Group, over what period they have done so 
and why they considered that period to be appropriate, and their statement as to whether they have a reasonable expectation that the Group 
will be able to continue in operation and meet its liabilities as they fall due over the period of their assessment, including any related disclosures 
drawing attention to any necessary qualifications or assumptions. 

Under the Listing Rules we are required to review the viability statement. We have nothing to report in this respect. 

Corporate governance disclosures 
We are required to report to you if: 
 – we have identified material inconsistencies between the knowledge we acquired during our financial statements audit and the Directors’ 

statement that they consider that the annual report and financial statements taken as a whole is fair, balanced and understandable and provides 
the information necessary for shareholders to assess the Group’s position and performance, business model and strategy; or 

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INDEPENDENT AUDITOR’S UK REPORT continued

 – the section of the annual report describing the work of the Audit Committee does not appropriately address matters communicated by us to the 

Audit Committee. 

We are required to report to you if the Corporate Governance Statement does not properly disclose a departure from the eleven provisions of the 
UK Corporate Governance Code specified by the Listing Rules for our review. 

We have nothing to report in these respects. 

6. We have nothing to report on the other matters on which we are required to report by exception 
Under the Companies Act 2006, we are required to report to you if, in our opinion: 
 – adequate accounting records have not been kept by the parent Company, or returns adequate for our audit have not been received from 

branches not visited by us; or 

 – the parent Company financial statements and the part of the Directors’ Remuneration Report to be audited are not in agreement with the 

accounting records and returns; or  

 – certain disclosures of directors’ remuneration specified by law are not made; or  
 – we have not received all the information and explanations we require for our audit. 

We have nothing to report in these respects. 

7. Respective responsibilities 
Directors’ responsibilities 
As explained more fully in their statement set out on page 107, the directors are responsible for: the preparation of the financial statements including 
being satisfied that they give a true and fair view; such internal control as they determine is necessary to enable the preparation of financial statements 
that are free from material misstatement, whether due to fraud or error; assessing the Group and parent Company’s ability to continue as a going 
concern, disclosing, as applicable, matters related to going concern; and using the going concern basis of accounting unless they either intend to 
liquidate the Group or the parent Company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities 
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether 
due to fraud, other irregularities (see below), or error, and to issue our opinion in an auditor’s report. Reasonable assurance is a high level of 
assurance, but does not guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. 
Misstatements can arise from fraud, other irregularities or error and are considered material if, individually or in aggregate, they could reasonably be 
expected to influence the economic decisions of users taken on the basis of the financial statements. 

A fuller description of our responsibilities is provided on the FRC’s website at www.frc.org.uk/auditorsresponsibilities. 

Irregularities – ability to detect
We identified areas of laws and regulations that could reasonably be expected to have a material effect on the financial statements from our sector 
experience, through discussion with the directors and other management (as required by auditing standards), and from inspection of the Group’s 
regulatory and legal correspondence as necessary. We had regard to laws and regulations in areas that directly affect the financial statements 
including financial reporting (including related company legislation) and taxation legislation. We considered the extent of compliance with those laws 
and regulations as part of our procedures on the related financial statements items. 

In addition we considered the impact of laws and regulations in the specific areas of compliance with the Food and Drug Administration in the USA 
and the compliance of business practices with the UK Bribery Act and the US Foreign Corrupt Practices Act recognising the regulated nature of 
the Group’s activities. With the exception of any known or possible non-compliance, and as required by auditing standards, our work in respect 
of these was limited to enquiry of the directors and other management, testing the effectiveness of relevant entity level controls and inspection of 
relevant regulatory and legal correspondence. We considered the effect of any known or possible non-compliance in these areas as part of our 
procedures on the related financial statements items.  

We communicated identified laws and regulations throughout our team and remained alert to any indications of non-compliance throughout the 
audit. This included communication from the Group to component audit teams of relevant laws and regulations identified at Group level, with a 
request to report on any indications of potential existence of non-compliance with relevant laws and regulations (irregularities) in these areas, or 
other areas directly identified by the component team.

As with any audit, there remained a higher risk of non-detection of non-compliance with relevant laws and regulations irregularities, as these may 
involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls.

8. The purpose of our audit work and to whom we owe our responsibilities 
This report is made solely to the Company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit 
work has been undertaken so that we might state to the Company’s members those matters we are required to state to them in an auditor’s report 
and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Company and 
the Company’s members, as a body, for our audit work, for this report, or for the opinions we have formed. 

Stephen Oxley (Senior Statutory Auditor)  
for and on behalf of KPMG LLP, Statutory Auditor 

Chartered Accountants  
15 Canada Square, London E14 5GL 
22 February 2018

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GROUP FINANCIAL STATEMENTS
CRITICAL JUDGEMENTS AND ESTIMATES

The Group prepares its consolidated financial statements in accordance with IFRS as issued by the IASB and IFRS as adopted by the EU, 
the application of which often requires judgements and estimates to be made by management when formulating the Group’s financial position and 
results. Under IFRS, the Directors are required to adopt those accounting policies most appropriate to the Group’s circumstances for the purpose of 
presenting fairly the Group’s financial position, financial performance and cash flows.

The Group’s accounting policies do not include any critical judgements. The Group’s accounting policies are set out in Notes 1–23 of the Notes to 
the Group accounts. Of those, the policies which require the most use of management’s estimation are as follows:

VALUATION OF INVENTORIES
A feature of the Orthopaedic Reconstruction and Trauma & Extremities franchises (whose finished goods inventory make up approximately 79% 
of the Group’s total finished goods inventory) is the high level of product inventory required, some of which is located at customer premises and 
is available for customers’ immediate use. Complete sets of products, including large and small sizes, have to be made available in this way. 
These sizes are used less frequently than standard sizes and towards the end of the product life cycle are inevitably in excess of requirements. 
Adjustments to carrying value are therefore required to be made to orthopaedic inventory to anticipate this situation. These adjustments are 
calculated in accordance with a formula based on levels of inventory compared with historical usage. This formula is applied on an individual 
product line basis and is first applied when a product group has been on the market for two years. This method of calculation is considered 
appropriate based on experience, but it does require management estimate in respect of customer demand, effectiveness of inventory deployment, 
length of product lives, phase-out of old products and efficiency of manufacturing planning systems.

IMPAIRMENT
In carrying out impairment reviews of intangible assets, a number of significant assumptions have to be made when preparing cash flow 
projections. These include the future rate of market growth, discount rates, the market demand for the products acquired, the future profitability of 
acquired businesses or products, levels of reimbursement and success in obtaining regulatory approvals. If actual results should differ or changes 
in expectations arise, impairment charges may be required which would adversely impact operating results.

LIABILITY PROVISIONING
The recognition of provisions for legal disputes is subject to a significant degree of estimation. Provision is made for loss contingencies when 
it is considered probable that an adverse outcome will occur and the amount of the loss can be reasonably estimated. In making its estimates, 
management takes into account the advice of internal and external legal counsel. Provisions are reviewed regularly and amounts updated where 
necessary to reflect developments in the disputes. The ultimate liability may differ from the amount provided depending on the outcome of court 
proceedings and settlement negotiations or if investigations bring to light new facts.

TAXATION
The Group operates in numerous tax jurisdictions around the world and it is Group policy to submit its tax returns to the relevant tax authorities as 
promptly as possible. At any given time, the Group is involved in disputes and tax audits and will have a number of tax returns potentially subject 
to audit. Significant issues may take several years to resolve. In estimating the probability and amount of any tax charge, management takes into 
account the views of internal and external advisers and updates the amount of tax provision whenever necessary. The ultimate tax liability may 
differ from the amount provided depending on interpretations of tax law, settlement negotiations or changes in legislation.

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GROUP FINANCIAL STATEMENTS
GROUP INCOME STATEMENT

Revenue
Cost of goods sold
Gross profit
Selling, general and administrative expenses
Research and development expenses
Operating profit
Interest income
Interest expense
Other finance costs
Share of results of associates
Profit on disposal of business
Profit before taxation
Taxation
Attributable profit for the year1
Earnings per ordinary share1
Basic
Diluted

Notes

2

3
3
2 & 3
4
4
4
11
21

5

6

Year ended 
31 December 
2017 
$ million

Year ended 
31 December 
2016 
$ million

Year ended 
31 December 
2015 
$ million

 4,765 
 (1,248)
 3,517 
 (2,360)
 (223)
 934 
 6 
 (57)
 (10)
 6 
 – 
 879 
 (112)
 767 

87.8¢
87.7¢

4,669
(1,272)
3,397
(2,366)
(230)
801
6
(52)
(16)
(3)
326 
1,062
(278)
784

88.1¢
87.8¢

4,634
(1,143)
3,491
(2,641)
(222)
628
11
(49)
(15)
(16)
–
559
(149)
410

45.9¢
45.6¢

GROUP STATEMENT OF COMPREHENSIVE INCOME

Attributable profit for the year1
Other comprehensive income:
Items that will not be reclassified to income statement
Re-measurement of net retirement benefit obligations
Taxation on other comprehensive income
Total items that will not be reclassified to income statement

Items that may be reclassified subsequently to income statement
Cash flow hedges – forward foreign exchange contracts

– (losses)/gains arising in the year
– losses/(gains) transferred to inventories for the year

Fair value remeasurement of available for sale asset
Exchange differences on translation of foreign operations 
Total items that may be reclassified subsequently to income statement
Other comprehensive income/(loss) for the year, net of taxation
Total comprehensive income for the year1

1  Attributable to equity holders of the Company and wholly derived from continuing operations.

The Notes on pages 119–162 are an integral part of these accounts.

Notes

18
5

Year ended 
31 December 
2017 
$ million

 767 

Year ended 
31 December 
2016 
$ million

784

Year ended 
31 December 
2015 
$ million

410

 64 
 (9)
 55 

 (45)
21
 (10)
 181 
 147 
 202 
 969 

(81)
10 
(71)

(15)
20
10 
(134)
(119)
(190)
594

(8)
10
2

34
(50)
–
(176)
(192)
(190)
220

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GROUP FINANCIAL STATEMENTS
GROUP BALANCE SHEET

Assets
Non-current assets

Property, plant and equipment
Goodwill
Intangible assets
Investments
Investments in associates
Other non-current assets
Retirement benefit assets
Deferred tax assets

Current assets
Inventories
Trade and other receivables
Cash at bank

Total assets

Equity and liabilities
Equity attributable to owners of the Company
Share capital
Share premium
Capital redemption reserve
Treasury shares
Other reserves
Retained earnings
Total equity
Non-current liabilities
Long-term borrowings
Retirement benefit obligations
Other payables
Provisions 
Deferred tax liabilities

Current liabilities
Bank overdrafts and loans
Trade and other payables 
Provisions
Current tax payable

Total liabilities
Total equity and liabilities

At 
31 December 
2017 
$ million

At  
31 December  
2016  
$ million

Notes

7
8
9
10
11
13
18
5

12
13
15

19

19

15
18
14
17
5

15
14
17
5

 1,049 
 2,371 
 1,371 
 21 
 118 
 16 
 62 
 127 
 5,135 

 1,304 
 1,258 
 169 
 2,731
 7,866 

 178 
 605 
 17 
 (257)
 (228)
 4,329 
 4,644 

 1,423 
 131 
 128 
 97 
 97 
 1,876 

 27 
 957 
 129 
 233 
 1,346 
 3,222 
 7,866 

982
2,188
1,411
25
112
–
–
97 
4,815

1,244
1,185
100
2,529
7,344

180
600
15
(432)
(375)
3,970
3,958

1,564
164
82
134
94
2,038

86
884
147
231
1,348
3,386
7,344

The accounts were approved by the Board and authorised for issue on 22 February 2018 and are signed on its behalf by:

Roberto Quarta 
Chairman 

Olivier Bohuon 
Chief Executive Officer 

Graham Baker
Chief Financial Officer

The Notes on pages 119–162 are an integral part of these accounts.

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GROUP FINANCIAL STATEMENTS
GROUP CASH FLOW STATEMENT

Cash flows from operating activities 
Profit before taxation
Net interest expense
Depreciation, amortisation and impairment
Loss on disposal of property, plant and equipment and software
Distribution from trade investments
Share-based payments expense (equity settled)
Share of results of associates
Profit on disposal of business
Net movement in post-retirement benefit obligations
Increase in inventories
Increase in trade and other receivables
(Decrease)/increase in trade and other payables and provisions
Cash generated from operations1
Interest received
Interest paid
Income taxes paid
Net cash inflow from operating activities
Cash flows from investing activities 
Acquisitions, net of cash acquired
Capital expenditure
Investment in associate
Purchase of investments
Proceeds on disposal of business
Tax on disposal of business
Net cash used in investing activities
Cash flows from financing activities 
Proceeds from issue of ordinary share capital
Purchase of own shares
Proceeds from borrowings due within one year
Settlement of borrowings due within one year
Proceeds from borrowings due after one year
Settlement of borrowings due after one year
Proceeds from own shares
Settlement of currency swaps
Equity dividends paid
Net cash used in financing activities
Net increase/(decrease) in cash and cash equivalents 
Cash and cash equivalents at beginning of year
Exchange adjustments
Cash and cash equivalents at end of year2

Notes

4

23
11
21

21
2
11
10
21

20
20
20
20

20
19

20
20

Year ended  
31 December  
2017  
$ million

Year ended  
31 December  
2016  
$ million

Year ended  
31 December  
2015  
$ million

 879 
 51 
 447 
 13 
 – 
 31 
 (6)
 – 
 (40)
 (17) 
 (40)
 (45)
 1,273 
 2 
 (50)
 (135)
 1,090 

 (159)
 (376)
 – 
 (8)
 – 
 – 
 (543)

 5 
 (52)
 53 
 (64)
 570 
 (706)
 5 
 24 
 (269)
 (434)
 113 
 38 
 4 
 155 

1,062
46
463
15
–
27
3
(326)
(85)
(47)
(74)
(49)
1,035
3
(48)
(141)
849

(214)
(392)
–
(2)
343
(118)
(383)

10
(368)
34
(38)
890
(759)
6
(25)
(279)
(529) 
(63)
102
(1)
38 

559
38
493
15
3
29
16
–
(57)
(83)
(26)
216
1,203
8
(44)
(137)
1,030

(44)
(358)
(25)
(2)
–
–
(429)

16
(77)
42
(26)
831
(1,062)
5
(15)
(272)
(558)
43
65
(6)
102

1 

Includes $15m (2016: $62m, 2015: $52m) of outgoings on restructuring and rationalisation expenses, $3m (2016: $24m, 2015: $36m) of acquisition-related costs and $25m (2016: $36m, 2015: $3m) of legal and 
other costs.

2  Cash and cash equivalents is net of bank overdrafts of $14m (2016: $62m, 2015: $18m). 

The Notes on pages 119–162 are an integral part of these accounts.

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GROUP FINANCIAL STATEMENTS
GROUP STATEMENT OF CHANGES IN EQUITY

At 31 December 2014
Attributable profit for the year1
Other comprehensive (expense)/income
Equity dividends declared and paid
Share-based payments recognised
Taxation on share-based payments
Purchase of own shares
Cost of shares transferred to beneficiaries
Cancellation of treasury shares
Issue of ordinary share capital4
At 31 December 2015
Attributable profit for the year1
Other comprehensive expense
Equity dividends declared and paid
Share-based payments recognised
Taxation on share-based payments
Purchase of own shares
Cost of shares transferred to beneficiaries
Cancellation of treasury shares
Issue of ordinary share capital4
At 31 December 2016
Attributable profit for the year1
Other comprehensive income
Equity dividends declared and paid
Share-based payments recognised
Taxation on share-based payments
Purchase of own shares
Cost of shares transferred to beneficiaries
Cancellation of treasury shares
Issue of ordinary share capital4
At 31 December 2017

Share  
capital  
$ million

Share  
premium  
$ million

Capital 
redemption  
reserve  
$ million

Treasury

shares2 

$ million

Other 
reserves3 
$ million

Retained  
earnings  
$ million

Total  
equity  
$ million

184
–
–
–
–
–
–
–
(1)
–
183
–
–
–
–
–
–
–
(3)
–
180
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 (2)
 – 
 178 

574
–
–
–
–
–
–
–
–
16
590
–
–
–
–
–
–
–
–
10
600
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 5 
 605 

11
–
–
–
–
–
–
–
1
–
12
–
–
–
–
–
–
–
3 
–
15
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 2 
 – 
 17 

(315)
–
–
–
–
–
(77)
38
60
–
(294)
–
–
–
–
–
(368)
40
190
–
(432)
 – 
 – 
 – 
 – 
 – 
 (52)
 26 
 201 
 – 
 (257)

(64)
–
(192)
–
–
–
–
–
–
–
(256)
–
(119)
–
–
–
–
–
–
–
(375)
 – 
 147 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 (228)

3,650
410
2
(272)
29
5
–
(33)
(60)
–
3,731
784
(71)
(279)
27
2
–
(34)
(190)
–
3,970
 767 
 55 
 (269)
 31 
 (3)
 – 
 (21)
 (201)
 – 
 4,329 

4,040
410
(190)
(272)
29
5
(77)
5
–
16
3,966
784 
(190)
(279)
27
2
(368)
6
–
10
3,958
 767 
 202 
 (269)
 31 
 (3)
 (52)
 5 
 – 
 5 
 4,644 

1  Attributable to equity holders of the Company and wholly derived from continuing operations.

2  Refer to Note 19.2 for further information.

3  Other reserves comprises gains and losses on cash flow hedges, foreign exchange differences on translation of foreign operations and net changes on fair value of trading investments. The cumulative translation 

loss within other reserves at 31 December 2017 was $207m (2016: $388m loss, 2015: $254m loss).

4 

Issue of ordinary share capital as a result of options being exercised.

The Notes on pages 119–162 are an integral part of these accounts.

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NOTES TO THE GROUP ACCOUNTS

1 BASIS OF PREPARATION
Smith & Nephew plc (the Company) is a public limited company incorporated in England and Wales. In these accounts, the ‘Group’ means the 
Company and all its subsidiaries. The principal activities of the Group are to develop, manufacture, market and sell medical devices and services.

As required by the European Union’s IAS Regulation and the Companies Act 2006, the Group has prepared its accounts in accordance with International 
Financial Reporting Standards (IFRS) as adopted by the European Union (EU) effective as at 31 December 2017. The Group has also prepared its accounts 
in accordance with IFRS as issued by the International Accounting Standards Board (IASB) effective as at 31 December 2017. IFRSs as adopted by the EU 
differs in certain respects from IFRS as issued by the IASB. However, the differences have no impact for the periods presented.

The preparation of accounts in conformity with IFRS requires management to use estimates and assumptions that affect the reported amounts 
of assets and liabilities and disclosure of contingent assets and liabilities at the date of the accounts and the reported amounts of revenues 
and expenses during the year. The accounting policies requiring management to use significant estimates and assumptions are: inventories, 
impairment, taxation and liability provisions. These are discussed on page 114. Although these estimates are based on management’s best 
knowledge of current events and actions, actual results ultimately may differ from those estimates. Estimates and underlying assumptions are 
reviewed on an ongoing basis. Revisions to estimates are recognised prospectively. 

The Directors continue to adopt the going concern basis for accounting in preparing the annual financial statements. The Directors have a 
reasonable expectation that the Group has adequate resources to continue in operational existence for the foreseeable future. Further information 
regarding the Group’s business activities, together with the factors likely to affect its future development, performance and position, are set out in 
Our Business & Marketplace on pages 8–17. 

As described in Note 15, the Group meets its funding requirements through a mixture of shareholders’ funds, bank borrowings and private 
placement notes. At 31 December 2017, the Group had committed borrowing facilities of $2.4bn and total liquidity of $1.2bn, including net cash 
and cash equivalents of $155m and undrawn committed borrowing facilities of $1bn. The earliest expiry date of the Group’s committed borrowing 
facilities is in respect of a $300m bilateral term loan facility due to expire in April 2020. In addition, Note 16 includes the Group’s objectives, policies 
and processes for managing its capital; our financial risk management objectives; details of our financial instruments and hedging activities; and 
our exposures to foreign exchange, interest rates and credit risk.

The Group’s forecasts and projections, taking into account reasonably possible changes in trading performance, show that the Group has sufficient 
financial resources. The Directors have reasonable expectation that the Company and the Group are well placed to manage their business risks 
and to continue in operational existence for a period of at least three years from the date of the approval of the financial statements. Accordingly, the 
Directors continue to adopt the going concern basis (in accordance with the guidance ‘Guidance on Risk Management, Internal Control and Related 
Financial and Business Reporting’ issued by the FRC) in preparing the consolidated financial statements.

There have been no new accounting pronouncements impacting the Group in 2017.

New accounting standards effective 2018
A number of new standards, amendments to standards and interpretations are effective for the Group’s annual periods beginning on or after 
1 January 2018, and have not been applied in preparing these consolidated accounts. These include IFRS 15 Revenue from contracts with customers 
and IFRS 9 Financial Instruments which will be adopted from 1 January 2018. 

IFRS 15
The Group has undertaken a detailed impact assessment applying IFRS 15 to all the current ways in which the Group delivers products or 
services to customers to identify divergence with current practice and has concluded that IFRS 15 will not have a significant impact on the timing 
and recognition of revenue. The performance obligations involved in the sale of an orthopaedic implant are all considered to occur at the time of 
procedure giving rise to no difference in the timing of revenue recognition. The instrument set and implant used in an orthopaedic procedure are 
considered to be part of a single performance obligation. In line with past practice we will continue to measure and recognise revenue based on 
invoiced amounts at the time of the procedure. Revenue recognised on the sale of products in our other surgical and wound businesses have also 
been considered with reference to IFRS 15 with no impact identified in relation to the timing and measurement of revenue. The Group has also 
considered the impact on provisions for returns, trade discounts and rebates and has determined that the current policy is aligned with IFRS 15. 

The Group intends to apply the practical expedients in IFRS 15 to not disclose the amount of the transaction price allocated to the remaining 
performance obligations and an explanation of when the Group expects to recognise that amount as revenue for all reporting periods presented 
before 1 January 2018. The Group also intends to apply the practical expedients in relation to contracts with variable consideration and contracts 
that were completed at the beginning of the earliest period presented and/or modified before the beginning of the earliest period presented. 
The Group has concluded that applying these practical expedients will not have a significant impact on the timing, measurement and recognition 
of revenue. 

The Group has assessed the disclosure requirements of IFRS 15 and has preliminarily determined that the majority of the disclosures are either 
currently included in the financial statements or can be prepared using data currently available. The Group continues to assess the disclosure 
requirements in relation to unsatisfied performance obligations and the disaggregation of revenue.

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IFRS 9
The amendments to IFRS 9 mainly relate to the classification and measurement of financial instruments, and will not have a significant impact to the 
Group financial statements. When initially applying IFRS 9, the Group may choose as its accounting policy to continue to apply the hedge accounting 
requirements of IAS 39 instead of the requirements in IFRS 9. The Group will continue to apply the hedge requirements of IAS 39 on transition. 
The Group has considered the expected credit loss model and has determined that it will not have a significant impact on the provision for bad and 
doubtful debts. The Group has elected, from 1 January 2018, to present changes in the fair value of trade investments in the income statement. 

New accounting standards effective 2019
IFRS 16 
IFRS 16 Leases will be adopted retrospectively with the cumulative effect of initially applying the standard recognised at 1 January 2019 and the 
Group is currently assessing the application and impact of the standard.

1.1 Consolidation
The Group accounts include the accounts of Smith & Nephew plc and its subsidiaries for the periods during which they were members of 
the Group.

Subsidiaries are entities controlled by the Group. The Group controls an entity when it is exposed to, or has rights to, variable returns from its 
involvement with the entity and has the ability to affect those returns through its power over the entity. Subsidiaries are consolidated in the Group 
accounts from the date that the Group obtains control, and continue to be consolidated until the date that such control ceases. Intra-group 
balances and transactions, and any unrealised income and expenses arising from intra-group transactions, are eliminated on consolidation. 
All subsidiaries have year ends which are co-terminus with the Group’s, with the exception of jurisdictions whereby a different year end is required 
by local legislation.

When the Group loses control over a subsidiary, it derecognises the assets and liabilities of the subsidiary and any related components of equity. 
Any resulting gain or loss is recognised in profit or loss. Any retained interest in the former subsidiary is measured at fair value.

1.2 Foreign currencies
Functional and presentation currency
The Group accounts are presented in US Dollars. The Company’s functional currency is US Dollars.

Foreign currency transactions
Transactions in foreign currencies are translated to the respective functional currencies of Group companies at exchange rates at the dates of the 
transactions. Monetary assets and liabilities denominated in foreign currencies are retranslated to the functional currency as at the exchange rate at 
the reporting date. Non-monetary items are not retranslated.

Foreign operations
Balance sheet items of foreign operations, including goodwill and fair value adjustments arising on acquisition are translated into US Dollars on 
consolidation at the exchange rates at the reporting date. Income statement items and the cash flows of foreign operations are translated at average 
rates as an approximation to actual transaction rates, with actual transaction rates used for large one off transactions.

Foreign currency differences are recognised in ‘Other comprehensive income’ and accumulated in ‘Other reserves’ within equity. These include: 
exchange differences on the translation at closing rates of exchange of non-US Dollar opening net assets; the differences arising between 
the translation of profits into US Dollars at actual (or average, as an approximation) and closing exchange rates; to the extent that the hedging 
relationship is effective, the difference on translation of foreign currency borrowings or swaps that are used to finance or hedge the Group’s 
net investments in foreign operations; and the movement in the fair value of forward foreign exchange contracts used to hedge forecast foreign 
exchange cash flows.

The exchange rates used for the translation of currencies into US Dollars that have the most significant impact on the Group results were:

Average rates 
Sterling
Euro
Swiss Franc
Year end rates
Sterling
Euro
Swiss Franc

2017

 1.29 
 1.13 
 1.02 

 1.35 
 1.20 
 1.02

2016

1.35
1.11
1.02

1.23
1.05
0.98

2015

1.53
1.11
1.04

1.48
1.09
1.00

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
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2 BUSINESS SEGMENT INFORMATION
The Group is engaged in a single business activity, being the development, manufacture and sale of medical technology products and services.

Development, manufacturing, supply chain and central functions are managed globally for the Group as a whole. Sales are managed through 
two geographical selling regions: US and International; with a president for each who is responsible for the commercial review of that region. 
The Executive Committee (‘ExCo’), comprises geographical presidents and certain heads of function and is chaired by the Chief Executive Officer 
(‘CEO’). ExCo is the body through which the CEO uses the authority delegated to him by the Board of Directors to manage the operations and 
performance of the Group. All significant operating decisions regarding the allocation and prioritisation of the Group’s resources and assessment of 
the Group’s performance are made by ExCo, and whilst the members have individual responsibility for the implementation of decisions within their 
respective areas, it is at the ExCo level that these decisions are made. Accordingly, ExCo is considered to be the Group’s chief operating decision 
maker as defined by IFRS 8 Operating Segments.

In making decisions about the prioritisation and allocation of the Group’s resources, ExCo reviews financial information on an integrated basis 
for the Group as a whole and determines the best allocation of resources to Group-wide projects. This information is prepared substantially on 
the same basis as the Group’s IFRS financial statements aside from the adjustments described in Note 2.2. In assessing performance, ExCo 
also considers financial information presented on a geographical selling region and product franchise basis for revenue. Financial information for 
corporate and functional costs is presented on a Group-wide basis.

The types of products and services offered by the Group’s global business segment are as follows:

 – Sports Medicine Joint Repair, which offers surgeons a broad array of instruments, technologies and implants necessary to perform minimally 

invasive surgery of the joints;

 – Arthroscopic Enabling Technologies, which offers healthcare providers a variety of technologies such as fluid management equipment for surgical 

access, high definition cameras, digital image capture, scopes, light sources and monitors to assist with visualisation inside the joints, radio 
frequency, electromechanical and mechanical tissue resection devices, and hand instruments for removing damaged tissue;

 – Trauma & Extremities, consisting of internal and external devices used in the stabilisation of severe fractures and deformity correction procedures;

 – Other Surgical Businesses, which includes robotics-assisted surgery, various products and technologies to assist in surgical treatment of the ear, 

nose and throat, and gynaecological instrumentation, until the Gynaecology business disposal in August 2016;

 – Knee Implants, which offers an innovative range of products for specialised knee replacement procedures;

 – Hip Implants, which offers a range of specialist products for reconstruction of the hip joint;

 – Advanced Wound Care, which includes products for the treatment and prevention of acute and chronic wounds, including leg, diabetic and 

pressure ulcers, burns and post-operative wounds; 

 – Advanced Wound Bioactives, which includes biologics and other bioactive technologies that provide unique approaches to debridement and 

dermal repair/regeneration; and

 – Advanced Wound Devices, which consists of traditional and single-use Negative Pressure Wound Therapy and hydrosurgery systems.

The segment information is prepared in conformity with the accounting policies of the Group and the accounting standard IFRS 8 
Operating Segments.

The segment profit measure reported to the Chief Executive Officer and the ExCo for the purposes of resource allocation and assessment is trading 
profit and excludes the effects of non-recurring, infrequent, non-cash and other items that management does not otherwise believe are indicative 
of the underlying performance of the consolidated Group as discussed in Note 2.2. Group financing (including interest receivable and payable) is 
managed on a net basis outside the business segment. 

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2 BUSINESS SEGMENT INFORMATION continued
2.1 Revenue by business segment and geography

Accounting policy
Revenue comprises sales of products and services to third parties at amounts invoiced net of trade discounts and rebates, excluding taxes 
on revenue. Revenue from the sale of products is recognised upon transfer to the customer of the significant risks and rewards of ownership. 
This is generally when goods are delivered to customers. There is no significant revenue associated with the provision of discrete services.
In Established Markets we typically sell direct to healthcare institutions while in our Emerging Markets we typically sell to distributors and 
intermediaries. In general our surgical business is more direct to hospitals and ambulatory service centres whereas in our wound business, and 
in particular products used in community and homecare facilities, it is through wholesalers. Sales of inventory located at customer premises 
and available for customers’ immediate use are recognised when notification is received that the product has been implanted or used. 
Appropriate provisions for returns, trade discounts and rebates are deducted from revenue. Rebates comprise retrospective volume discounts 
granted to certain customers on attainment of certain levels of purchases from the Group. These are accrued over the course of the arrangement 
based on estimates of the level of business expected and adjusted at the end of the arrangement to reflect actual volumes.

Segment revenue reconciles to statutory revenues from continuing operations as follows:

Reportable segment revenue
Revenue from external customers

2017 
$ million

2016 
$ million

2015 
$ million

 4,765 

4,669

4,634

In presenting information on the basis of geographical segments, segment revenue is based on location of Smith & Nephew businesses:

Geographical segment revenue
United Kingdom
United States of America
Other1
Consolidated revenue from continuing operations

2017 
$ million

 244 
 2,332 
 2,189 
 4,765 

2016 
$ million

2015 
$ million

266
2,299
2,104
4,669

301
2,217
2,116
4,634

1 

 No other country represents more than 6% of consolidated sales revenue from continuing operations.

The table below shows revenue by product type from continuing operations. Included within the 2015 analysis is a reclassification of $58m 
of product sales formerly included in the Sports Medicine Joint Repair franchise which has now been included in the Arthroscopic Enabling 
Technologies franchise in order to present analysis in line with 2017 management reporting on a consistent basis.

Revenue by product from continuing operations
Knee Implants
Hip Implants
Trauma & Extremities
Sports Medicine Joint Repair
Arthroscopic Enabling Technologies
Other Surgical Businesses
Advanced Wound Care
Advanced Wound Bioactives
Advanced Wound Devices
Consolidated revenue from continuing operations

Major customers
No single customer generates revenue greater than 10% of the consolidated revenue.

2017 
$ million

2016 
$ million

2015 
$ million

 984 
 599 
 495 
 627 
 615 
 189 
 720 
 342 
 194 
 4,765 

932
597
475
587
631
214
719
342
172
4,669 

883
604
497
548
631
205
755
344
167
4,634

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2.2 Trading and operating profit by business segment
Trading profit is a trend measure which presents the long-term profitability of the Group excluding the impact of specific transactions that 
management considers affects the Group’s short-term profitability. The Group presents this measure to assist investors in their understanding of 
trends. The Group has identified the following items, where material, as those to be excluded from operating profit when arriving at trading profit: 
acquisition and disposal-related items; amortisation and impairment of acquisition intangibles; significant restructuring programmes; gains and 
losses arising from legal disputes; and other significant items. Further detail is provided in Notes 2.3, 2.4 and 2.5. Operating profit reconciles to 
trading profit as follows:

Operating profit of the business segment
Acquisition-related costs
Restructuring and rationalisation expenses
Amortisation and impairment of acquisition intangibles
Legal and other
Trading profit of the business segment

2017 
$ million

 934 
 (10)
 – 
 140
 (16)
 1,048 

2016 
$ million

 801 
9 
62 
 178 
 (30)
 1,020 

2015 
$ million

 628 
 12 
 65 
 204 
 190 
 1,099 

2.3 Acquisition-related costs
Acquisition-related costs credit of $10m (2016: $9m charge, 2015: $12m charge) relates to a remeasurement of contingent consideration for a prior 
year acquisition partially offset by costs associated with the acquisition of Rotation Medical, Inc.

2.4 Restructuring and rationalisation expenses
No restructuring and rationalisation costs were incurred in 2017 (2016: $62m, 2015: $65m). In 2016 and 2015, these costs primarily related to the 
ongoing implementation of the Group Optimisation Plan which was completed in 2016. 

2.5 Legal and other 
The legal and other credit within operating profit of $16m (2016: $30m credit, 2015: $190m charge) primarily related to a $54m credit recognised 
following a settlement payment received from Arthrex relating to patent litigation, partially offset by legal expenses for patent litigation with Arthrex 
and ongoing metal-on-metal hip claims. In 2017 there was a $10m increase in the provision that reflects the present value of the estimated costs to 
reduce all other known and anticipated metal-on-metal hip claims.

2.6 Assets and liabilities by business segment and geography

Reconciliation of assets of the business segment  
to the consolidated group 
Assets of the business segment 
Unallocated corporate assets:

– Deferred tax assets 
– Retirement benefit assets 
– Cash at bank

Total assets of the consolidated group 

2017 
$ million

2016 
$ million

2015
$ million

 7,508 

 127 
 62 
 169 
 7,866 

7,147

97
–
100
7,344

6,929

105
13
120
7,167

In presenting information on the basis of geographical segments, non-current segment assets are based on their location:

Geographical segment assets
United Kingdom
United States of America
Other
Total non-current assets of the consolidated group1

1 

 Non-current assets excludes retirement benefit assets and deferred tax assets.

2017 
$ million

 364 
 3,295 
 1,287 
 4,946 

2016 
$ million

2015 
$ million

335
3,145
1,238
4,718

366
2,982
1,226
4,574

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Reconciliation of liabilities of the business segment  
to the consolidated group 
Liabilities of the business segment 
Unallocated corporate liabilities: 

– Long-term borrowings
– Retirement benefit obligations 
– Deferred tax liabilities 
– Bank overdrafts and loans – current
– Current tax payable

Total liabilities of the consolidated group 

Depreciation, amortisation and impairment of the business segment
Depreciation of property, plant and equipment
Amortisation of acquisition intangibles
Amortisation of other intangible assets 
Total depreciation and amortisation 
Impairment losses on acquisition intangibles1
Impairment loss/(reversal) on trade investments1
Total depreciation, amortisation and impairment

1 

Impairments recognised in operating profit, within the administrative expenses line.

2017 
$ million

2016 
$ million

2015 
$ million

 1,311

 1,423 
 131 
 97 
 27 
 233 
 3,222 

 243 
 130 
 62 
 435 
 10 
 2 
 447 

1,247

1,564
164
94
86
231
3,386

224
130
61
415
48
–
463

1,197

1,434
184
77
46
263
3,201 

226
153
66
445
51
(3)
493

Segment acquisition of property, plant and equipment and intangibles reconciles to that of the consolidated group, and comprises the following: 

Additions to property, plant and equipment
Additions to intangibles 
Capital expenditure (excluding business combinations) 
Trade investments
Acquisitions – Goodwill
Acquisitions – Intangible assets
Acquisitions – Property, plant and equipment 
Capital and acquisition expenditure 

2017 
$ million

2016 
$ million

2015 
$ million

 308 
 68 
 376 
8
132
61
 1 
 578 

320
72
392
2
211
85
2
692

303
55
358
2
34
19
6
419

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3 OPERATING PROFIT

Accounting policies
Research and development
Research expenditure is expensed as incurred. Internal development expenditure is only capitalised if the recognition criteria in IAS 38 
Intangible Assets have been satisfied. The Group considers that the regulatory, technical and market uncertainties inherent in the development 
of new products mean that in most cases development costs should not be capitalised as intangible assets until products receive approval from 
the appropriate regulatory body. 

Payments to third parties for research and development projects are accounted for based on the substance of the arrangement. If the 
arrangement represents outsourced research and development activities the payments are generally expensed except in limited circumstances 
where the respective development expenditure would be capitalised under the principles established in IAS 38. By contrast, the payments are 
capitalised if the arrangement represents consideration for the acquisition of intellectual property developed at the risk of the third party. 

Capitalised development expenditures are amortised on a straight-line basis over their useful economic lives from product launch.

Advertising costs
Advertising costs are expensed as incurred.

Revenue
Cost of goods sold
Gross profit
Research and development expenses
Selling, general and administrative expenses:

Marketing, selling and distribution expenses
Administrative expenses1,2,3,4

Operating profit

2017  
$ million

 4,765 
 (1,248)
 3,517 
 (223)

(1,781)
(579)
(2,360)
934

2016  
$ million

4,669
(1,272)
3,397
(230)

(1,712)
(654)
(2,366)
801

2015  
$ million

4,634
(1,143)
3,491
(222)

(1,735)
(906)
(2,641)
628

1  2017 includes $62m of amortisation of software and other intangible assets (2016: $61m, 2015: $66m).

2  2017 includes $140m of amortisation and impairment of acquisition intangibles (2016: $62m of restructuring and rationalisation expenses and $178m of amortisation and impairment of acquisition intangibles, 2015: 

$65m of restructuring and rationalisation expenses and $204m of amortisation and impairment of acquisition intangibles).

3  2017 includes $16m credit relating to legal and other items (2016: $30m credit, 2015: $190m charge).

4  2017 includes $10m credit of acquisition-related costs (2016: $9m charge, 2015: $12m charge).

Note that items detailed in 2, 3, 4 are excluded from the calculation of trading profit, the segment profit measure.

Operating profit is stated after charging/(crediting) the following items:

Other operating income
Amortisation of intangibles
Impairment of intangible assets
Depreciation of property, plant and equipment
Loss on disposal of property, plant and equipment and intangible assets
Operating lease payments for land and buildings
Operating lease payments for other assets
Advertising costs

2017  
$ million

2016  
$ million

2015  
$ million

(66)
 192 
 10 
 243
 13 
36
21
 102

(25)
191
48
224
15
39
19
88

(41)
219
51
226
15
37
20
91

In 2017 other operating income primarily relates to a gain relating to patent litigation (2016: insurance recovery relating to metal-on-metal claims, 
2015: net gain relating to patent litigation).

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3 OPERATING PROFIT continued
3.1 Staff costs and employee numbers
Staff costs during the year amounted to:

Wages and salaries
Social security costs
Pension costs (including retirement healthcare)1
Share-based payments

Notes

18
23

2017  
$ million

 1,157 
 178 
 64 
 31 
 1,430 

2016  
$ million

1,227
129
23
27
1,406

2015  
$ million

1,193
135
58
30
1,416

1 

In 2016, pension costs include the past service cost credit of $49m arising primarily from the closure of the UK defined benefit scheme to future accrual.

During the year ended 31 December 2017, the average number of employees was 16,333 (2016: 15,584, 2015: 14,686).

3.2 Audit Fees – information about the nature and cost of services provided by the auditor

Audit services: 

Group accounts
Local statutory audit pursuant to legislation

Other services: 

Non-audit services

Taxation services:

Compliance services
Advisory services

Total auditor’s remuneration
Arising:

In the UK
Outside the UK

4 INTEREST AND OTHER FINANCE COSTS
4.1 Interest income/(expense)

Interest income
Interest expense:

Bank borrowings
Private placement notes
Other

Net interest expense

4.2 Other finance costs

Retirement benefit net interest expense
Unwinding of discount
Other
Other finance costs

2017  
$ million

2016  
$ million

2015  
$ million

2.4
2.0

0.1

–
–
4.5

2.5
2.0
4.5

2.0
2.0

0.5

0.1
–
4.6

2.5
2.1
4.6

2.1
2.0

0.5

0.5
–
5.1

2.5
2.6
5.1

2017  
$ million

2016  
$ million

2015  
$ million

6

(11)
(38)
(8)
(57)
(51)

6

(9)
(37)
(6)
(52)
(46)

11

(9)
(37)
(3)
(49)
(38)

Notes

18

2017  
$ million

2016  
$ million

2015  
$ million

(5)
(5)
–
(10)

(7)
(9)
–
(16)

(11)
(3)
(1)
(15)

Foreign exchange gains or losses arose primarily on the translation of intercompany and third party borrowings and amounted to a net $25m loss in 
2017 (2016: net $22m gain, 2015: net $11m gain). These amounts were matched by the fair value gains or losses on currency swaps held to manage 
this currency risk.

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5 TAXATION

Accounting policy
The charge for current taxation is based on the results for the year as adjusted for items which are non-assessable or disallowed. It is calculated 
using tax rates that have been enacted or substantively enacted by the balance sheet date.

The Group operates in numerous tax jurisdictions around the world and it is Group policy to submit its tax returns to the relevant tax authorities 
as promptly as possible. At any given time, the Group is involved in disputes and tax audits and will have a number of tax returns potentially 
subject to audit. Significant issues may take several years to resolve. In estimating the probability and amount of any tax charge, management 
takes into account the views of internal and external advisers and updates the amount of tax provision whenever necessary. The ultimate tax 
liability may differ from the amount provided depending on interpretations of tax law, settlement negotiations or changes in legislation.

Deferred tax is recognised in respect of temporary differences between the carrying amounts of assets and liabilities for financial reporting 
purposes and the amounts used for taxation purposes. 

Deferred tax is not recognised: for temporary differences related to investments in subsidiaries and associates where the Group is able to control 
the timing of the reversal of the temporary difference and it is probable that this will not reverse in the foreseeable future; on the initial recognition 
of non-deductible goodwill; and on the initial recognition of an asset or liability in a transaction that is not a business combination and that, at the 
time of the transaction, does not affect the accounting or taxable profit.

Deferred tax assets are recognised to the extent that it is probable that future taxable profits will be available against which they can be used. 
Deferred tax assets are reviewed at each reporting date. 

Deferred tax is measured on an undiscounted basis, and at the tax rates that have been enacted or substantively enacted by the reporting date 
that are expected to apply in the periods in which the asset or liability is settled. It is recognised in the income statement except when it relates 
to items credited or charged directly to other comprehensive income or equity, in which case the deferred tax is also recognised within other 
comprehensive income or equity respectively.

Deferred tax assets and liabilities are offset when they relate to income taxes levied by the same taxation authority, when the Group intends to 
settle its current tax assets and liabilities on a net basis and that authority permits the Group to make a single net payment.

5.1 Taxation charge attributable to the Group

Current taxation:
UK corporation tax 
Overseas tax
Current income tax charge
Adjustments in respect of prior periods
Total current taxation
Deferred taxation:
Origination and reversal of temporary differences
Changes in tax rates
Adjustments to estimated amounts arising in prior periods
Total deferred taxation
Total taxation as per the income statement
Taxation in other comprehensive income
Taxation in equity
Taxation attributable to the Group

2017  
$ million

2016  
$ million

2015  
$ million

 23 
 177 
 200 
 (60)
 140 

 32 
 (49)
 (11)
 (28)
 112 
 9 
 3 
 124 

23
261
284
(53)
231

24
–
23
47
278
(10)
(2)
266

31
219
250
(56)
194

(73)
(3)
31
(45)
149
(10)
(5)
134

The 2017 and 2016 net prior period adjustment benefits of $71m and $30m respectively mainly relate to provision releases following agreement 
reached with the IRS on US tax matters after the conclusion of US tax audits in 2017 and 2016, provision releases on the expiry of statute of 
limitations and tax accrual to tax return adjustments, partially offset by an increase in certain other tax provisions. The 2015 net prior period 
adjustment benefit of $25m mainly relates to provision releases after settlement with tax authorities or the expiry of statute of limitations and tax 
accrual to tax return adjustments. 

Included in the total tax charge is a $32m net benefit as a result of the new US tax reform legislation enacted in December 2017, which comprises 
a benefit from a revaluation of deferred tax balances included within changes in tax rates, partially offset by a current tax charge relating to the 
deemed repatriation of foreign profits not previously taxed in the US. 

Total taxation as per the income statement of $112m includes a $58m net credit (2016: $48m net charge, 2015: $130m net credit) as a consequence 
of the net benefit from US tax reform, acquisitions and disposals, amortisation and impairment of acquisition intangibles and legal and other.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
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GROUP AND OTHER 
INFORMATION

5 TAXATION continued 
Factors affecting future tax charges
The Group operates in numerous tax jurisdictions around the world and is subject to factors that may affect future tax charges including the recently 
enacted US tax reform, the review by the European Commission into whether the UK CFC financing exemption rules constitute illegal State Aid, 
implementation of the OECD’s BEPS actions, tax rate changes, tax legislation changes, expiry of the statute of limitations and resolution of tax audits 
and disputes.

At any given time the Group has unagreed years outstanding in various countries and is involved in tax audits and disputes, some of which may 
take several years to resolve. Current tax payable of $233m includes $201m of provisions for uncertain tax positions in respect of various countries. 
The Group believes that it has made adequate provision in respect of additional tax liabilities that may arise from these unagreed years, tax audits 
and disputes, the majority of which relate to transfer pricing matters as would be expected for a Group operating internationally. However, the actual 
liability for any particular issue may be higher or lower than the amount provided resulting in a negative or positive effect on the tax charge in any 
given year, including a reduction in the tax charge because of an expiry of the relevant statute of limitations. Whilst the impact can vary from year 
to year, the negative or positive effect on the tax charge for 2018 is not expected to result in a net prior period adjustment for 2018 which is greater 
than that realised in 2017.

The Group has completed its review of the new US tax reform legislation, as enacted, including the reduction of the US federal tax rate from 35% to 
21%, which came into effect on 1 January 2018. As a result, the Group expects a positive impact on its tax charge for future years in addition to the 
one-off net tax benefit of $32m in 2017. However, it should be noted that parts of the new legislation are subject to questions of interpretation, and 
further regulations may be issued in the future to clarify or change certain elements, which may affect future tax charges.

In December 2016, the Group appealed to the First Tier Tribunal in the UK against a decision by HM Revenue and Customs (HMRC) relating to 
the tax deductibility of certain historical foreign exchange losses. The decision of the Tribunal was released on 8 February 2017 and it upheld the 
Group’s appeal. HMRC appealed against this decision and their appeal will be heard by the Upper Tribunal in June 2018. No tax benefit has been 
recognised to date in respect of these foreign exchange losses. In the event that the Group is ultimately successful in the Courts, then the Group’s 
tax charge would be reduced, in the year of success, as a result.

In 2016, the UK Government enacted legislation to reduce the main rate of UK statutory corporation tax to 19.0% from 1 April 2017 and 17.0% from 
1 April 2020.

The UK standard rate of corporation tax for 2017 is 19.3% (2016: 20.0%, 2015: 20.3%). Overseas taxation is calculated at the rates prevailing in the 
respective jurisdictions. The table below reconciles the expected tax charge at the UK statutory rate with the actual tax charge:

Profit before taxation
Expected taxation at UK statutory rate of 19.3% (2016: 20.0%, 2015: 20.3%)
Differences in overseas taxation rates1
Disposal of the Gynaecology business (mainly at the US tax rate)
Benefit of US Manufacturing deduction
R&D credits
Tax losses not recognised
Utilisation of previously unrecognised tax losses
Impact of US tax reform
Expenses not deductible for tax purposes
Changes in tax rates
Adjustments in respect of prior years2
Total taxation as per the income statement

2017  
$ million

2016  
$ million

2015  
$ million

 879 
 169 
 48 
 – 
 (9)
 (3)
 10 
 (6)
 (32)
 11 
(5)
 (71)
 112 

1,062
 212 
 34 
 56 
 (7)
 (3)
 1 
 (9)
 – 
 23
1
 (30)
278

559
 113 
 52 
 – 
 (7)
 (6)
 11 
 – 
 – 
 14 
(3)
 (25)
149

1  Mainly relates to profits taxed in the US at a rate higher than the UK statutory rate and includes the impact of intra-group loans provided to finance US acquisitions and business operations.

2  The adjustments in respect of prior years are explained on the previous page. 

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 129

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INFORMATION

5 TAXATION continued 
5.2 Deferred taxation
Movements in the main components of deferred tax assets and liabilities were as follows: 

At 31 December 2015
Exchange adjustment
Movement in income statement – current year
Movement in income statement – prior years
Movement in other  
comprehensive income
Movement in equity
Changes in tax rate
Acquisitions
At 31 December 2016
Exchange adjustment
Movement in income statement – current year
Movement in income statement – prior years
Movement in other  
comprehensive income
Movement in equity
Changes in tax rate
Acquisitions
At 31 December 2017

Represented by:

Deferred tax assets
Deferred tax liabilities
Net position at 31 December

Accelerated  
tax  
depreciation  
$ million
(62)
–
–
(11)

Intangibles  
$ million
(223)
2
34
6

Retirement  
benefit obligation  
$ million
39
–
(16)
(2)

Macrotexture  
$ million
52
–
–
–

Inventory, 
provisions, 
losses and other 
differences  
$ million
222
(3)
(42)
(16)

–
–
–
–
(73)
 1 
 (9)
 2 

 – 
 – 
 29 
 – 
 (50)

–
–
1
(29)
(209)
 (2)
 15 
 4 

 – 
 – 
 71 
 (22)
 (143)

7
–
–
–
28
 2 
 (6)
–

 (17)
 – 
 – 
 – 
 7 

–
–
–
–
52
 – 
 (1)
 – 

 – 
 – 
 (18)
 – 
 33 

(1)
2 
(1)
44
205
 13 
 (31)
 5 

 4 
 (3)
 (33)
 23 
 183 

Total  
$ million
28
(1)
(24)
(23)

6
2
–
15
3
 14 
 (32)
 11 

 (13)
 (3)
 49 
 1 
 30 

2017  
$ million

 127 
 (97)
 30 

2016  
$ million

97
(94)
3

The Group has gross unused trading and non-trading tax losses of $271m (2016: $230m) and gross unused capital losses of $113m (2016: $122m) 
available for offset against future profits of which $32m of trading losses will expire within 3-8 years from the balance sheet date if not utilised. 
A deferred tax asset of $38m (2016: $45m) has been recognised in respect of $132m (2016: $109m) of the trading and non-trading tax losses. 
No deferred tax asset has been recognised on the remaining unused tax losses as they are not expected to be realised in the foreseeable future. 
There are no temporary differences in respect of investments in subsidiaries and associates for which deferred tax liabilities have not been 
recognised (2016: temporary differences of approximately $483m).

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 130

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6 EARNINGS PER ORDINARY SHARE

Accounting policies
Earnings per share
Basic earnings per share is calculated by dividing the profit attributable to equity holders by the weighted average number of ordinary shares in 
issue during the year, excluding shares held by the Company in the Employees’ Share Trust or as treasury shares.

Diluted earnings per share
Diluted earnings per share is calculated by adjusting the basic earnings per share for the effect of conversion to ordinary shares associated with 
dilutive potential ordinary shares, which comprise share options and awards granted to employees.

Adjusted earnings per share
Adjusted earnings per share is a trend measure, which presents the long-term profitability of the Group excluding the impact of specific 
transactions that management considers affects the Group’s short-term profitability. The Group presents this measure to assist investors in 
their understanding of trends. Adjusted attributable profit is the numerator used for this measure. The Group has identified the following items 
as those to be excluded when arriving at adjusted attributable profit: acquisitions and disposals related items including amortisation and 
impairment of acquisition intangible assets; significant restructuring programmes; significant gains and losses arising from legal disputes and 
other significant items (including US tax reform) and taxation thereon. 

The calculations of the basic, diluted and adjusted earnings per ordinary share are based on the following attributable profit and numbers of shares:

Earnings
Attributable profit for the year
Adjusted attributable profit (see below)

Attributable profit is reconciled to adjusted attributable profit as follows:

Attributable profit for the year
Acquisition-related costs
Restructuring and rationalisation expenses
Amortisation and impairment of acquisition intangibles
Legal and other1
Profit on disposal of business
US tax reform
Taxation on excluded items
Adjusted attributable profit

2017  
$ million

2016  
$ million

2015  
$ million

 767 
 826 

784
735

410
761

Notes

2017  
$ million

2016  
$ million

2015  
$ million

3
9

21
5
5

 767 
 (10)
 – 
 140 
 (13)
 – 
(32)
 (26)
 826 

784 
9 
62 
178 
(20)
(326)
–
48 
735 

410
25
65
204
187
–
–
(130)
761

1 

 Legal and other credit in 2017 includes $16m within operating profits (refer to Note 2.5), and a $3m charge within other finance costs for unwinding of the discount on the provision for known, anticipated and settled 
metal-on-metal hip claims. In 2016 the legal and other credit includes $30m within operating profits (refer to Note 2.5), a $5m charge within other finance costs for unwinding of the discount on the provision for 
known, anticipated and settled metal-on-metal hip claims, and a $5m charge within share of results of associates for expenses incurred by Bioventus for an aborted initial public offering of shares. In 2015 legal and 
other costs include $190m within operating profit (refer to Note 2.5) and a $3m net interest credit.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 131

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INFORMATION

6 EARNINGS PER ORDINARY SHARE continued

The numerators used for basic and diluted earnings per ordinary share are the same. The denominators used for all categories of earnings for basic 
and diluted earnings per ordinary share are as follows:

Number of shares (millions)
Basic weighted number of shares
Dilutive impact of share options outstanding
Diluted weighted average number of shares
Earnings per ordinary share
Basic
Diluted
Adjusted2

2 

 Adjusted earnings per share is calculated using the basic weighted number of shares.

7 PROPERTY, PLANT AND EQUIPMENT

2017 

 874 
 1 
 875 

 87.8¢ 
 87.7¢ 
 94.5¢ 

2016 

890
3
893

88.1¢
87.8¢
82.6¢

2015 

894
5
899

45.9¢
45.6¢
85.1¢

Accounting policies
Property, plant and equipment
Items of property, plant and equipment are stated at cost less accumulated depreciation and any accumulated impairment losses.

Depreciation is calculated to write off the cost of items of property, plant and equipment less their estimated residual values using the straight-
line method over their estimated useful lives, and is ultimately recognised in profit or loss. Leased assets are depreciated over the shorter of the 
lease term and their useful lives unless it is reasonably certain that the Group will obtain ownership by the end of the lease term. Freehold land is 
not depreciated. The estimated useful lives of items of property, plant and equipment is 3–20 years and for buildings is 20–50 years. 

Assets in course of construction are not depreciated until they are available for use.

Depreciation methods, useful lives and residual values are reviewed at each reporting date and adjusted if appropriate. 

Finance costs relating to the purchase or construction of property, plant and equipment and intangible assets that take longer than one year to 
complete are capitalised based on the Group weighted average borrowing costs. All other finance costs are expensed as incurred.

Impairment of assets
The carrying values of property, plant and equipment are reviewed for impairment when events or changes in circumstances indicate the 
carrying value may be impaired. If any such indication exists, the recoverable amount of the asset is estimated in order to determine the extent 
of impairment loss. Where it is not possible to estimate the recoverable amount of an individual asset, the Group estimates the recoverable 
amount of the cash-generating unit to which it belongs.

An asset’s recoverable amount is the higher of an asset’s or cash-generating unit’s fair value less costs to sell and its value-in-use. In assessing 
value-in-use, its estimated future cash flow is discounted to its present value using a pre-tax discount rate that reflects the current market 
assessment of the time value of money and the risks specific to the asset.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 132

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7 PROPERTY, PLANT AND EQUIPMENT continued

Land and buildings

Plant and equipment

Notes

Freehold  
$ million

Leasehold  
$ million

Instruments  
$ million

Other  
$ million

Assets in  
course of 
construction  
$ million

Total  
$ million

Cost
At 1 January 2016
Exchange adjustment
Acquisitions
Additions

Disposals
Transfers
At 31 December 2016
Exchange adjustment
Acquisitions
Additions
Disposals
Transfers
At 31 December 2017
Depreciation and impairment
At 1 January 2016
Exchange adjustment
Charge for the year
Disposals
At 31 December 2016
Exchange adjustment
Charge for the year
Disposals
Transfers
At 31 December 2017
Net book amounts
At 31 December 2017
At 31 December 2016

21

21

21

154
(6)
–
1

–
16
165
 6 
 – 
 1 
 – 
 56 
 228 

 48 
 (3)
 5 
 – 
 50 
 3 
 6 
 – 
 2 
 61 

 167 
 115 

58
–
–
1

–
60
119
 1 
 – 
 – 
 (27)
 (20)
 73 

 35 
 – 
 7 
 – 
 42 
 – 
 7 
 (22)
 3 
 30 

 43 
 77 

1,042
(22)
2
166

(76)
4
1,116
 63 
 – 
 176 
 (73)
 2 
 1,284 

 732 
 (15)
 131 
 (67)
 781 
 45 
 146 
 (67)
 (1)
 904 

 380 
 335 

1,003
(46)
–
72 

(39)
33
1,023
 33 
 1 
 28 
 (79)
 56 
 1,062 

 655 
 (34)
 81 
 (30)
 672 
 24 
 84 
 (74)
 (9)
 697 

 365 
 351 

156
(5)
–
80

(3)
(113)
115
 3 
 – 
 103 
 (12)
 (115)
 94 

 11 
 – 
 – 
 – 
 11 
 – 
 – 
 (11) 
 – 
  –

 94 
 104 

2,413
(79)
2
320

(118)
–
2,538
 106 
 1 
 308 
 (191)
 (21)
 2,741 

 1,481 
 (52)
 224 
 (97)
 1,556 
 72 
 243 
 (174)
 (5)
 1,692 

 1,049 
 982 

Land and buildings includes land with a cost of $21m (2016: $19m) that is not subject to depreciation. There were no assets held under finance 
leases at 31 December 2017 (2016: assets held under finance leases with a net book value of $5m were included within land and buildings).

Transfers from assets in course of construction includes $4m (2016: $nil) of software and $12m (2016: $nil) net book value of other non-
current assets.

Group capital expenditure relating to property, plant and equipment contracted but not provided for amounted to $26m (2016: $55m).

The amount of borrowing costs capitalised in 2017 and 2016 was minimal.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
    
    
    
    
    
    
    
    
    
    
    
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133

OVERVIEW

8 GOODWILL

Accounting policy
Goodwill is not amortised but is reviewed for impairment annually. Goodwill is allocated to the cash-generating unit (CGU) that is expected 
to benefit from the acquisition. The goodwill is tested annually for impairment by comparing the recoverable amount to the carrying value of 
the CGUs. The CGUs identified by management are at the aggregated product franchise levels of Orthopaedics, Other Surgical Devices and 
Advanced Wound Management, in the way the core assets are used to generate cash flows.

If the recoverable amount of the CGU is less than its carrying amount then an impairment loss is determined to have occurred. Any impairment 
losses that arise are recognised immediately in the income statement and are allocated first to reduce the carrying amount of goodwill and then 
to the carrying amounts of the other assets of the CGU.

In carrying out impairment reviews of goodwill a number of significant assumptions have to be made when preparing cash flow projections. 
These include the future rate of market growth, discount rates, the market demand for the products acquired, the future profitability of acquired 
businesses or products, levels of reimbursement and success in obtaining regulatory approvals. If actual results should differ, or changes in 
expectations arise, impairment charges may be required which would adversely impact operating results.

Cost
At 1 January
Exchange adjustment
Acquisitions
At 31 December
Impairment
At 1 January and 31 December
Net book amounts

Notes

2017  
$ million

2016  
$ million

21

 2,188 
 51 
 132 
 2,371 

 – 
 2,371 

2,012
(35)
211
2,188

–
2,188

Management has identified four CGUs in applying the provisions of IAS 36 Impairment of Assets: Orthopaedics (Reconstruction and Trauma), Other 
Surgical Devices, Advanced Wound Care & Devices and Bioactives.

For the purpose of goodwill impairment testing, the Advanced Wound Care & Devices and Bioactives CGUs have been aggregated (Advanced 
Wound Management), as this is the level at which goodwill is monitored and level at which the economic benefits relating to the goodwill within 
these CGUs is realised.

Goodwill is allocated to the Group’s CGUs as follows:

Orthopaedics

Other Surgical Devices
Advanced Wound Management

2017
$ million

 566 

 1,501 
 304 
 2,371 

2016  
$ million

 551 

 1,351 
 286 
 2,188 

Impairment reviews were performed in September 2017 and September 2016 by comparing the recoverable amount of each CGU with its carrying amount, 
including goodwill. These were updated during December, taking into account any significant events that occurred between September and December.

For each CGU, the recoverable amounts are based on value-in-use which is calculated from pre-tax cash flow projections for five years using data 
from the Group’s budget and strategic planning process, the results of which are reviewed and approved by the Board. These projections exclude any 
estimated future cash inflows or outflows expected to arise from future restructurings. The five-year period is in line with the Group’s strategic planning 
process. In determining the growth rates used in the calculations of the value-in-use, management considered annual revenue growth. Projections are 
based on anticipated volume and value growth in the markets served by the Group and assumptions as to market share movements. Each year the 
projections for the previous year are compared to actual results and variances are factored into the assumptions used in the current year. 

The discount rates used in the value-in-use calculations reflect management’s assessment of risks specific to the assets of each CGU. 

8.1 Orthopaedics CGU
The sales growth and trading profit margin used in the value-in-use calculation for the Orthopaedics CGU, which includes the Reconstruction and 
Trauma businesses, reflects management’s distinctive orthopaedic reconstruction strategy, which combines cutting edge innovation, disruptive 
business models and a strong Emerging Markets platform to drive outperformance.

Revenue growth rates for the five-year period ranged from 1.0% to 10.6% for the various components of the Orthopaedics CGU. The average growth 
rate used to extrapolate the cash flows beyond the five-year period in calculating the terminal value is 2.0%. The pre-tax discount rate used in the 
Orthopaedics CGU value-in-use calculation reflects the geographical mix and is 10.0%.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
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8 GOODWILL continued
8.2 Other Surgical Devices CGU
The value-in-use calculation for the Other Surgical Devices CGU reflects growth rates and trading profit margins consistent with management’s 
strategy to rebalance Smith & Nephew towards higher growth areas such as, for example, Sports Medicine.

Revenue growth rates for the five-year period ranged from 1.0% to 9.0% for the various components of the Other Surgical Devices CGU. The weighted 
average growth rate used to extrapolate the cash flows beyond the five-year period in calculating the terminal value is 2.0%. The pre-tax discount rate 
used in the Other Surgical Devices CGU value-in-use calculation reflects the geographical mix of the revenues and is 10.0%.

8.3 Advanced Wound Management CGU
The aggregated Advanced Wound Management CGU comprises the Advanced Wound Care & Devices and Bioactives CGUs.

In performing the value-in-use calculation for this combined CGU, management considered the Group’s focus across the wound product 
franchises, focusing on widening access to the customer, the higher added value sectors of healing chronic wounds and tissue repair using 
bioactives, and by continuing to improve efficiency.

Revenue growth rates for the five-year period ranged from 2.0% to 17.3% for the various components of the Advanced Wound Management CGU. 
The weighted average growth rate used to extrapolate the cash flows beyond the five-year period in calculating the terminal value is 2.0%. The pre-tax 
discount rate used in the Advanced Wound Management CGU value-in-use calculation reflects the geographical mix and industry sector and is 10.0%.

8.4 Sensitivity to changes in assumptions used in value-in-use calculations
The calculations of value-in-use for the identified CGUs are most sensitive to changes in discount and growth rates. Management’s consideration of 
these sensitivities is set out below:

 – Growth of market and market share – management has considered the impact of a variance in market growth and market share. The value-

in-use calculations shows that if the assumed long-term growth rates were reduced to nil, the recoverable amount of each CGU would still be 
greater than its carrying value.

 – Discount rate – management has considered the impact of an increase in the discount rate applied to the value-in-use calculations. 

This sensitivity analysis shows that for the recoverable amount of each CGU to be less than its carrying value, the discount rate would have to be 
increased to 29.5% for the Orthopaedics CGU, 16.6% for the Other Surgical Devices CGU and 26.3% for the Advanced Wound Management CGU.

9 INTANGIBLE ASSETS

Accounting policies
Intangible assets
Intangible assets acquired separately from a business combination (including purchased patents, know-how, trademarks, licences and distribution 
rights) are initially measured at cost. The cost of intangible assets acquired in a material business combination (referred to as acquisition intangibles) 
is the fair value as at the date of acquisition. Following initial recognition, intangible assets are carried at cost less any accumulated amortisation 
and any accumulated impairment losses. All intangible assets are amortised on a straight-line basis over their estimated useful economic lives. 
The estimated useful economic life of an intangible asset ranges between three and 20 years depending on its nature. Internally-generated 
intangible assets are expensed in the income statement as incurred. Purchased computer software and certain costs of information technology 
projects are capitalised as intangible assets. Software that is integral to computer hardware is capitalised as plant and equipment.

Contingent consideration
Contingent consideration receivable associated with the sale of product rights and other assets outside a business combination is recognised at 
the time of purchase to the extent that the future event upon which the contingent consideration is conditional is within the Group’s control, or to 
the extent that it is considered to be virtually certain that the contingent consideration will become due. If the contingent consideration is outside 
the Group’s control or it cannot be considered virtually certain that it will become due, an asset and corresponding entry in profit and loss is 
recognised only once it becomes virtually certain that the contingent consideration will become due.

Contingent consideration payable associated with the purchase of product rights and other assets outside a business combination is recognised 
at the time of sale to the extent that the future event upon which the contingent consideration is conditional is under the control of the seller and 
it is considered probable that the contingent consideration will become due. Contingent consideration associated within a contingent condition 
that is within the Group’s control is recognised at the point when the contingent condition is met.

Impairment of intangible assets
The carrying values of intangible assets are reviewed for impairment when events or changes in circumstances indicate the carrying value 
may be impaired. If any such indication exists, the recoverable amount of the asset is estimated in order to determine the extent of impairment 
loss. Where it is not possible to estimate the recoverable amount of an individual asset, the Group estimates the recoverable amount of the 
CGU to which it belongs. An asset’s recoverable amount is the higher of an asset’s or CGU’s fair value less costs to sell and its value-in-use. 
In assessing value-in-use, its estimated future cash flow is discounted to its present value using a pre-tax discount rate that reflects the current 
market assessments of the time value of money and the risks specific to the asset. 

In carrying out impairment reviews of intangible assets a number of significant assumptions have to be made when preparing cash flow 
projections. These include the future rate of market growth, discount rates, the market demand for the products acquired, the future profitability 
of acquired businesses or products, levels of reimbursement and success in obtaining regulatory approvals. If actual results should differ, 
or changes in expectations should arise, impairment charges may be required which would adversely impact operating results.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 135

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9 INTANGIBLE ASSETS continued

Cost
At 1 January 2016
Exchange adjustment
Acquisitions1
Additions
Disposals
At 31 December 2016
Exchange adjustment
Acquisitions1
Additions
Disposals
Transfers 
At 31 December 2017
Amortisation and impairment
At 1 January 2016
Exchange adjustment
Charge for the year – amortisation2
Charge for the year – impairment
Disposals
At 31 December 2016
Exchange adjustment
Charge for the year – amortisation
Charge for the year – impairment
Disposals
Transfers 
At 31 December 2017
Net book amounts
At 31 December 2017
At 31 December 2016

Technology  
$ million

Product- 
related  
$ million

Customer and 
distribution  
related  
$ million

Software 
$ million

Total  
$ million

235
(2)
68
–
–
301
 10 
 59 
 – 
 (6)
 (6)
 358 

 21 
 – 
 15 
 – 
 – 
 36 
 2 
 6 
 – 
 11 
 (4)
 51 

 307 
265

1,864
(20)
17
24
(36)
1,849
 38 
 2 
 2 
 (43)
 6 
 1,854 

 759 
 (16)
 131 
 48 
 (36)
 886 
 21 
 133 
 10 
 (61)
 4 
 993 

 861
963

119
2
–
–
–
121
 1 
 – 
 3 
 (5)
 – 
 120 

69
1 
10
–
–
80
 1 
 15 
 – 
 (3)
 – 
 93 

 27 
41

289
(8)
–
48
–
329
 12 
 – 
 63 
 (5)
 4 
 403 

156
(4)
35
–
–
187
 6 
 38 
 – 
 (4)
 – 
 227 

 176 
142

2,507
(28)
85
72
(36)
2,600
 61 
 61 
 68 
 (59)
 4 
 2,735 

1,005
(19)
191
48
(36)
1,189
 30 
 192 
 10 
 (57)
 – 
 1,364 

 1,371 
1,411

1 

In 2017 this relates to technology and product-related intangibles acquired with the purchase of Rotation Medical, Inc. In 2016 this relates to technology and product related intangibles acquired with the purchase of 
Blue Belt Technologies Inc. and BST-CarGel. 

2  The amortisation charge between technology and product-related intangibles has been restated by $33m with no impact on the total net book value of intangible assets.

Amortisation and impairment of acquisition intangibles is set out below:

Technology
Product-related
Customer and distribution related
Total

2017
$ million

 6 
 124 
 10 
 140 

2016
$ million

48
126
4
178

Group capital expenditure relating to software contracted but not provided for amounted to $nil (2016: $9m). In 2017, a product-related intangible 
asset was determined to have a value in use below its carrying value, resulting in an impairment charge of $10m being recognised. 

In determining the recoverable amount of the Coblation technology asset acquired with the purchase of ArthoCare in 2014, revenue from products 
utilising this technology was assumed to have a growth rate of 4-5% in the medium term. This supported the carrying value of the Coblation 
technology asset but a reduction of 4% would give rise to there being no headroom.

In 2016, two product-related intangible assets were determined to have a value in use below their carrying value, resulting in an impairment charge 
being recognised. The impairment charge primarily relates to $32m from Oasis, calculated using a discount rate of 10.3%, a product right acquired 
with the Healthpoint acquisition in 2012. The continued reimbursement pressure in 2016 resulted in revenues not increasing at the previously 
expected rate. The second product-related intangible asset has no residual carrying value. 

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
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10 INVESTMENTS

Accounting policy
Investments, other than those related to associates, are initially recorded at fair value plus any directly attributable transaction costs on the trade 
date. The Group has investments in unquoted entities and an entity that holds mainly unquoted equity securities, which by their nature have no 
fixed maturity date or coupon rate. These investments are classed as ‘available-for-sale’ carried at fair value. The fair value of these investments 
are based on the underlying fair value of the equity securities: marketable securities are valued by reference to closing prices in the market; 
and non-marketable securities are estimated considering factors including the purchase price; prices of recent significant private placements 
of securities of the same issuer and estimates of liquidation value. Changes in fair value are recognised in other comprehensive income except 
where management considers that there is objective evidence of an impairment of the underlying equity securities. Objective evidence would 
include a significant or prolonged decline in the fair value of the investment below its cost less any impairment loss previously recognised. 
Impairment losses are recognised by reclassifying the losses accumulated in other reserves to profit or loss. 

At 1 January
Additions
Fair value remeasurement
Impairment
At 31 December

11 INVESTMENTS IN ASSOCIATES

2017  
$ million

2016  
$ million

 25 
 8 
 (10)
(2)
 21 

13
2
10
–
25

Accounting policy
Investments in associates, being those entities over which the Group has a significant influence and which is neither a subsidiary nor a 
joint venture, are accounted for using the equity method, with the Group recording its share of the associates’ profit and loss and other 
comprehensive income. The Group’s share of associates’ profit or loss is included in one separate income statement line and is calculated 
after deduction of their respective taxes. 

At 31 December 2017 and 31 December 2016, the Group holds 49% of Bioventus LLC (Bioventus). Bioventus is a limited liability company 
operating as a partnership. The company’s headquarters is located in Durham, North Carolina, US. Bioventus focuses its medical product 
development around its core competencies of orthobiologic therapies and orthopaedic diagnostics from which it develops and markets clinically 
proven orthopaedic therapies and diagnostic tools, including osteoarthritis pain treatments, bone growth stimulators and ultrasound devices. 
Bioventus sells bone healing stimulation devices and is a provider of osteoarthritis injection therapies. The Group’s ability to recover the value of its 
investment is dependent upon the ongoing clinical and commercial success of these products. The profit after taxation recognised in the income 
statement relating to Bioventus was $6m (2016: loss after taxation $3m).

The carrying amount of this investment was reviewed for impairment as at the balance sheet date. For the purposes of impairment testing the 
recoverable amount of this investment was based on its fair value less cost to sell, estimated using discounted cash flows.

The amounts recognised in the balance sheet and income statement for associates are as follows:

Balance sheet
Income statement profit/(loss)

2017  
$ million

 118 
 6 

2016  
$ million

112
(3)

Summarised financial information for significant associates
Set out below is the summarised financial information for Bioventus, adjusted for differences with Group accounting policies:

Summarised statement of comprehensive income
Revenue
Attributable profit/(loss) for the year
Group adjustments1
Total comprehensive profit/(loss)
Group share of profit/(loss) for the year at 49%

2017  
$ million

2016  
$ million

 301 
 1 
 11 
 12 
 6 

282
(21)
15
(6)
(3)

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 137

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11 INVESTMENTS IN ASSOCIATES continued

Summarised balance sheet
Non-current assets
Current assets
Non-current liabilities 
Current liabilities
Net assets
Group’s share of net assets at 49%
Group adjustments1
Group’s carrying amount of investment at 49%

2017  
$ million

2016  
$ million

 332 
 122 
 (246)
 (47)
 161 
 79 
 35 
 114 

364
105
(258)
(53)
158
77
32
109

1  Group adjustments include an adjustment to align the useful life of intangible assets with Group policy.

At December 2017, the Group held an equity investment in one other associate (2016: one) with a carrying value of $3m (2016: $3m).

12 INVENTORIES

Accounting policy
Finished goods and work-in-progress are valued at factory cost, including appropriate overheads, on a first-in first-out basis. Raw materials 
and bought-in finished goods are valued at purchase price. All inventories are reduced to net realisable value where lower than cost. 
Inventory acquired as part of a business acquisition is valued at selling price less costs to sell and a profit allowance for selling efforts.

Orthopaedic instruments are generally not sold but provided to customers and distributors for use in surgery. They are recorded as inventory 
until they are deployed at which point they are transferred to plant and equipment and depreciated over their useful economic lives of between 
three and seven years.

A feature of the orthopaedic business is the high level of product inventory required, some of which is located at customer premises and is 
available for customers’ immediate use (referred to as consignment inventory). Complete sets of product, including large and small sizes, have 
to be made available in this way. These outer sizes are used less frequently than standard sizes and towards the end of the product life cycle 
are inevitably in excess of requirements. Adjustments to carrying value are therefore required to be made to orthopaedic inventory to anticipate 
this situation. These adjustments are calculated in accordance with a formula based on levels of inventory compared with historical or forecast 
usage. This formula is applied on an individual product line basis and is first applied when a product group has been on the market for two 
years. This method of calculation is considered appropriate based on experience but it involves management judgements on effectiveness of 
inventory deployment, length of product lives, phase-out of old products and efficiency of manufacturing planning systems.

Raw materials and consumables
Work-in-progress
Finished goods and goods for resale

2017  
$ million

 207 
 69 
 1,028 
 1,304 

2016  
$ million

213
55
976
1,244

2015  
$ million

205
84
928
1,217

Reserves for excess and obsolete inventories were $296m (2016: $303m, 2015: $322m). The decrease in reserves of $7m in the year comprised 
a $20m reduction in the reserve relating to the write-off of inventory which was partially offset by foreign exchange movements of $13m. 
The determination of the estimate of excess and obsolete inventory is a critical accounting estimate and includes assumptions on the future usage 
of all different items of finished goods. This estimate is not considered to have a range of potential outcomes that is significantly different to the 
$296m held at 31 December 2017. 

The cost of inventories recognised as an expense and included in cost of goods sold amounted to $1,013m (2016: $1,131m, 2015: $961m). In addition, 
$68m was recognised as an expense within cost of goods sold resulting from inventory write-offs (2016: $85m, 2015: $73m).  

Notwithstanding inventory acquired within acquisitions, no inventory is carried at fair value less costs to sell in any year.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 138

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13 TRADE AND OTHER RECEIVABLES

Accounting policy
Trade and other receivables are carried at amortised cost, less any allowances for uncollectible amounts. They are included in current assets, 
except for maturities greater than 12 months after the balance sheet date. These are classified as non-current assets.

The Group manages credit risk through credit limits which require authorisation commensurate with the size of the limit and which are regularly 
reviewed. Credit limit decisions are made based on available financial information and the business case. Significant receivables are regularly 
reviewed and monitored at Group level. The Group has no significant concentration of credit risk, with exposure spread over a large number of 
customers and geographies. Furthermore, the Group’s principal customers are backed by government and public or private medical insurance 
funding, which historically represent a lower risk of default. The maximum exposure to credit risk at the reporting date is the fair value of each 
class of receivable. The Group does not hold any collateral as security.

Trade and other receivables due within one year
Trade receivables
Less: provision for bad and doubtful debts
Trade receivables – net
Derivatives – forward foreign exchange, currency swaps and interest rate contracts
Other receivables
Prepayments

Due after more than one year
Other non-current assets

2017  
$ million

2016  
$ million

2015  
$ million

 1,125 
 (69)
 1,056 
 28 
 92 
 82 
 1,258 

16
 1,274 

1,042
(54)
988
48
76
73
1,185

–
1,185

1,003
(64)
939
33
83
83
1,138

–
1,138

Trade receivables are classified as loans and receivables. Management considers that the carrying amount of trade and other receivables 
approximates to the fair value.

The provision for bad and doubtful debts is based on specific assessments of risk and reference to past default experience. The bad debt expense 
for the year was $17m (2016: $7m expense, 2015: $25m expense). 

Other non-current assets primarily relate to long-term prepayments.

The amount of trade receivables that were past due was as follows:

Past due not more than three months
Past due more than three months and not more than six months
Past due more than six months and not more than one year
Past due more than one year

Neither past due nor impaired
Provision for bad and doubtful debts
Trade receivables – net

2017  
$ million

 225 
 65 
 66 
 105 
 461 
 664 
 (69)
 1,056 

2016  
$ million

2015  
$ million

142
51
70
54
317
725
(54)
988

154
45
57
53
309
694
(64)
939

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 139

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13 TRADE AND OTHER RECEIVABLES continued
Movements in the provision for bad and doubtful debts were as follows:

At 1 January
Exchange adjustment
Acquisitions
Net receivables provided during the year
Utilisation of provision
At 31 December

Trade receivables include amounts denominated in the following major currencies:

US Dollar
Sterling
Euro
Other
Trade receivables – net

14 TRADE AND OTHER PAYABLES

Trade and other payables due within one year
Trade and other payables
Derivatives – forward foreign exchange, currency swaps and interest rate contracts
Acquisition consideration

Other payables due after one year
Acquisition consideration
Other payables

2017  
$ million

2016  
$ million

2015  
$ million

54
3
1
17
(6)
69

64
(3)
–
7
(14)
54

47
(3)
–
25
(5)
64

2017  
$ million

2016  
$ million

2015  
$ million

418
54
212
372
1,056

416
57
193
322
988

362
58
192
327
939

2017  
$ million

2016  
$ million

 873 
 48 
 36 
 957 

 124 
 4 
 128 

807
39
38
884

82
–
82

The acquisition consideration includes $104m (2016: $56m) contingent upon future events.

The acquisition consideration due after more than one year is expected to be payable as follows: $50m in 2019, $24m in 2020, $43m in 2021,  
$2m in 2022, and $5m due in over five years (2016: $29m in 2018, $8m in 2019, $20m in 2020, $11m in 2021, and $14m due in over five years).

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 140

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15 CASH AND BORROWINGS
15.1 Net debt
Net debt comprises borrowings and credit balances on currency swaps less cash at bank.

Bank overdrafts and loans due within one year
Long-term bank borrowings and finance leases
Private placement notes
Borrowings
Cash at bank
(Debit)/credit balance on derivatives – currency swaps
Credit/(debit) balance on derivatives – interest rate swaps
Net debt

Borrowings are repayable as follows:

2017  
$ million

 27 
 300 
 1,123 
 1,450 
 (169)
 (2)
 2 
 1,281 

2016  
$ million

86
440
1,124
1,650
(100)
1
(1)
1,550

At 31 December 2017:
Bank loans
Bank overdrafts
Private placement notes

At 31 December 2016:
Bank loans
Bank overdrafts
Finance lease liabilities
Private placement notes

Within  
one year or  
on demand  
$ million

Between  
one and  
two years  
$ million

Between  
two and  
three years  
$ million

Between  
three and  
four years  
$ million

Between  
four and  
five years  
$ million

After  
five years  
$ million

Total  
$ million

 13
 14
 – 
 27

22
62
2
–
86

 – 
 – 
 124
 124

–
–
2
–
2

 300
 – 
–
 300

300
–
3
125
428

 – 
 – 
 264
 264

–
–
–
–
– 

 – 
 – 
 125
 125

135
–
–
264
399

 – 
 – 
 610
 610

–
–
–
735
735

 313
 14
 1,123
 1,450

457
62
7
1,124
1,650

15.2 Assets pledged as security
Assets are pledged as security under normal market conditions. Secured borrowings and pledged assets are as follows:

Finance lease liabilities – due within one year
Finance lease liabilities – due after one year
Total amount of secured borrowings
Total net book value of assets pledged as security:
Property, plant and equipment

2017  
$ million

2016  
$ million

 –
 –
–

–
–

2
5
7

5
5

15.3 Liquidity risk exposures
The Board has established a set of policies to manage funding and currency risks. The Group uses derivative financial instruments only to manage 
the financial risks associated with underlying business activities and their financing.

Liquidity risk is the risk that the Group is not able to settle or meet its obligations on time or at a reasonable price. The Group’s policy is to ensure 
that there is sufficient funding and facilities in place to meet foreseeable borrowing requirements. The Group manages and monitors liquidity risk 
through regular reporting of current cash and borrowing balances and periodic preparation and review of short and medium-term cash forecasts, 
having regard to the maturities of investments and borrowing facilities.

The Group has available committed facilities of $2.4bn (2016: $2.4bn). The interest payable on borrowings under committed facilities is either at 
fixed or floating rates. Floating rates are typically based on the LIBOR (or other reference rate) relevant to the term and currency concerned.

The Company is subject to restrictive covenants under its principal facility agreements. These financial covenants are tested at the end of each 
half year for the 12 months ending on the last day of the testing period. As of 31 December 2017, the Company was in compliance with these 
covenants. The facilities are also subject to customary events of default, none of which are currently anticipated to occur.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 141

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15 CASH AND BORROWINGS continued
The Group’s committed facilities are:

Facility

$80 million 2.47% Senior Notes
$45 million Floating Rate Senior Notes
$300 million bilateral, term loan facility
$75 million 3.23% Senior Notes
$1.0 billion syndicated, revolving credit facility
$190 million 2.97% Senior Notes
$75 million 3.46% Senior Notes
$50 million 3.15% Senior Notes
$105 million 3.26% Senior Notes
$100 million 3.89% Senior Notes
$305 million 3.36% Senior Notes
$25 million Floating Rate Senior Notes
$75 million 3.99% Senior Notes

Date due

November 2019 
November 2019
April 2020
January 2021
March 2021
November 2021 
January 2022
November 2022
November 2023
January 2024
November 2024
November 2024
January 2026

15.4 Year end financial liabilities by contractual maturity
The table below analyses the Group’s year end financial liabilities by contractual maturity date, including contractual interest payments and 
excluding the impact of netting arrangements:

At 31 December 2017

Non-derivative financial liabilities:
Bank overdrafts and loans
Trade and other payables
Private placement notes
Acquisition consideration

Derivative financial liabilities:
Currency swaps/forward foreign exchange contracts – outflow
Currency swaps/forward foreign exchange contracts – inflow

At 31 December 2016
Non-derivative financial liabilities:
Bank overdrafts and loans
Trade and other payables
Finance lease liabilities
Private placement notes
Acquisition consideration

Derivative financial liabilities:
Currency swaps/forward foreign exchange contracts – outflow
Currency swaps/forward foreign exchange contracts – inflow

Within one  
year or on  
demand  
$ million

Between  
one and  
two years  
$ million

Between  
two and  
five years  
$ million

After  
five years  
$ million

Total  
$ million

 27
 873 
 36
 36

 2,737
 (2,739) 
 970

86
807
3
36
38

2,284
(2,285) 
969

 – 
 1 
 161
 50

 – 
 – 
 212

–
–
3
36
30

–
–
69

 300
 1 
 476
 69

 – 
 – 
 846

435
–
3
491
46

–
–
975

 – 
 2 
 647
 5

 – 
 – 
 654

–
–
–
800
16

–
–
816

 327
 877 
 1,320
 160

 2,737
 (2,739) 
 2,682

521
807
9
1,363
130

2,284
(2,285) 
2,829

The amounts in the tables above are undiscounted cash flows, which differ from the amounts included in the balance sheet where the underlying 
cash flows have been discounted.

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15 CASH AND BORROWINGS continued 
15.5 Finance leases

Accounting policy
Leases are classified as finance leases when the terms of the lease transfer substantially all the risks and rewards of ownership to the Group. 
All other leases are classified as operating leases.

The leased assets are measured initially at an amount equal to the lower of their fair value and the present value of the minimum lease 
payments. Assets held under finance leases are capitalised as property, plant or equipment and depreciated accordingly. Minimum lease 
payments are apportioned between the finance expense and the reduction in the outstanding liability. The finance expense is allocated to each 
period during the lease term so as to produce a constant periodic rate of interest on the remaining balance of the liability.

Future minimum lease payments under finance leases together with the present value of the minimum lease payments are as follows:

Within one year
After one and within two years
After two and within three years
After three and within four years
After four and within five years 
After five years
Total minimum lease payments
Discounted by imputed interest
Present value of minimum lease payments

2017  
$ million

2016  
$ million

 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 

3
3
3
–
–
–
9
(2)
7

In 2017, the Group terminated its finance lease. Present value of minimum lease payments can be split out as: $nil (2016: $2m) due within one year, 
$nil (2016: $5m) due between one to five years and $nil (2016: $nil) due after five years.

Liquidity and capital resources
The Group’s policy is to ensure that it has sufficient funding and facilities to meet foreseeable borrowing requirements.

At 31 December 2017, the Group held $155m (2016: $38m, 2015: $102m) in cash net of bank overdrafts. The Group had committed facilities available 
of $2,425m at 31 December 2017 of which $1,425m was drawn. Smith & Nephew intends to repay the amounts due within one year using available 
cash and drawing down on the longer-term facilities. 

The principal variations in the Group’s borrowing requirements result from the timing of dividend payments, acquisitions and disposals of 
businesses, timing of capital expenditure and working capital fluctuations. Smith & Nephew believes that its capital expenditure needs and its 
working capital funding for 2018, as well as its other known or expected commitments or liabilities, can be met from its existing resources and 
facilities. The Group’s net debt decreased from $1,550m at the beginning of 2017 to $1,281m at the end of 2017, representing an overall decrease  
of $269m. 

The Group’s planned future contributions are considered adequate to cover the current underfunded position in the Group’s defined benefit plans.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 143

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16 FINANCIAL INSTRUMENTS AND RISK MANAGEMENT

Accounting policy
Derivative financial instruments
Derivative financial instruments are initially recognised at fair value on the date a derivative contract is entered into and are subsequently 
remeasured at their fair value at subsequent balance sheet dates.

Changes in the fair value of derivative financial instruments that are designated and effective as cash flow hedges of forecast third party and 
intercompany transactions are recognised in other comprehensive income until the associated asset or liability is recognised. Amounts taken 
to other comprehensive income are transferred to the income statement in the period in which the hedged transaction affects profit and loss. 
Where the hedged item is the cost of a non-financial asset, the amounts taken to other comprehensive income are transferred to the initial 
carrying value of the asset.

Currency swaps to match foreign currency net assets with foreign currency liabilities are fair valued at the balance sheet date. Changes in the 
fair values of currency swaps that are designated and effective as net investment hedges are matched in other comprehensive income against 
changes in value of the related net assets.

Interest rate derivatives transacted to fix interest rates on floating rate borrowings are accounted for as cash flow hedges and changes in the fair 
values resulting from changes in market interest rates are recognised in other comprehensive income. Amounts taken to other comprehensive 
income are transferred to the income statement when the hedged transaction affects profit and loss.

Interest rate derivatives transacted to convert fixed rate borrowings into floating rate borrowings are accounted for as fair value hedges and 
changes in the fair values resulting from changes in market interest rates are recognised in the income statement.

Any ineffectiveness on hedging instruments and changes in the fair value of derivative financial instruments that do not qualify for hedge 
accounting are recognised in the income statement within other finance costs as they arise.

Hedge accounting is discontinued when the hedging instrument expires or is sold, terminated or exercised, or no longer qualifies for hedge 
accounting. At that point in time, any cumulative gain or loss on the hedging instrument recognised in other comprehensive income is retained 
there until the forecast transaction occurs. If a hedged transaction is no longer expected to occur, the net cumulative gain or loss recognised in 
other comprehensive income is transferred. 

16.1 Foreign exchange exposures
The Group operates in many countries and as a consequence has transactional and translational foreign exchange exposure. It is Group policy for 
operating units not to hold material unhedged monetary assets or liabilities other than in their functional currencies.

Foreign exchange variations affect trading results in two ways. Firstly, on translation of overseas sales and profits into US Dollars and secondly, 
transactional exposures arising where some, or all of the costs of sale are incurred in a different currency from the sale. The principal transactional 
exposures arise as the proportion of costs in US Dollars, Sterling and Swiss Francs exceed the proportion of sales in each of these currencies and 
correspondingly the proportion of sales in Euros exceeds the proportion of costs in Euros.

The impact of currency movements on the cost of purchases is partly mitigated by the use of forward foreign exchange contracts. The Group uses 
forward foreign exchange contracts, designated as cash flow hedges, to hedge forecast third party and intercompany trading cash flows up to one 
year. When a commitment is entered into, forward foreign exchange contracts are normally used to increase the hedge to 100% of the exposure. 
Cash flows relating to cash flow hedges are expected to occur within 12 months of inception and profits and losses on hedges are expected to 
enter into the determination of profit (within cost of goods sold) within a further 12-month period. The principal currencies hedged by forward foreign 
exchange contracts are US Dollars, Euros, Sterling and Singapore Dollars. At 31 December 2017, the Group had contracted to exchange within one 
year the equivalent of $2.3bn (2016: $1.8bn). Based on the Group’s net borrowings as at 31 December 2017, if the US Dollar were to weaken against 
all currencies by 10%, the Group’s net borrowings would decrease by $3m (2016: decrease by $1m) as the Group held a higher amount of foreign 
denominated cash than foreign denominated borrowings.

If the US Dollar were to weaken by 10% against all other currencies, then the fair value of the forward foreign exchange contracts as at 31 December 
2017 would have been $53m lower (2016: $51m lower). Similarly, if the Euro were to weaken by 10% against all other currencies, then the fair value of 
the forward foreign exchange contracts as at 31 December 2017 would have been $12m higher (2016: $17m higher). Movements in the fair value of 
forward foreign exchange contracts would be recognised in other comprehensive income and accumulated in the hedging reserve.

A 10% strengthening of the US Dollar or Euro against all other currencies at 31 December 2017 would have had the equal but opposite effect to the 
amounts shown above, on the basis that all other variables remain constant.

The Group’s policy is to hedge all actual foreign exchange exposures and the Group’s forward foreign exchange contracts are designated as cash 
flow hedges. The net impact of transaction related foreign exchange on the income statement from a movement in exchange rates on the value of 
forward foreign exchange contracts is not significant. In addition, the movements in the fair value of other financial instruments used for hedging 
such as currency swaps for which hedge accounting is not applied, offset movements in the values of assets and liabilities and are recognised 
through the income statement.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 144

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16 FINANCIAL INSTRUMENTS AND RISK MANAGEMENT continued 
16.2 Interest rate exposures
The Group is exposed to interest rate risk on cash, borrowings and certain currency and interest rate swaps which are at floating rates. 
When required the Group uses interest rate derivatives to meet its objective of protecting borrowing costs within parameters set by the Board. 
These interest rate derivatives are accounted for as cash flow hedges and, as such, changes in fair value resulting from changes in market interest 
rates are recognised in other comprehensive income and accumulated in the hedging reserve, with the fair value of the interest rate derivatives 
recorded in the balance sheet.

Additionally, the Group uses interest rate swaps to reduce the overall level of fixed rate debt, within parameters set by the Board. When used in 
this way, interest rate derivatives are accounted for as fair value hedges. The fair value movement of the derivative is offset in the income statement 
against the fair value movement in the underlying fixed rate debt.

Based on the Group’s gross borrowings as at 31 December 2017, if interest rates were to increase by 100 basis points in all currencies then the 
annual net interest charge would increase by $6m (2016: $7m). A decrease in interest rates by 100 basis points in all currencies would have an 
equal but opposite effect to the amounts shown above.

16.3 Credit risk exposures
The Group limits exposure to credit risk on counterparties used for financial instruments through a system of internal credit limits. The financial 
exposure of a counterparty is determined as the total of cash and deposits, plus the risk on derivative instruments, assessed as the fair value of 
the instrument plus a risk element based on the nominal value and the historic volatility of the market value of the instrument. The Group does not 
anticipate non-performance of counterparties and believes it is not subject to material concentration of credit risk as the Group operates within a 
policy of counterparty limits designed to reduce exposure to any single counterparty.

The maximum credit risk exposure on derivatives at 31 December 2017 was $28m (2016: $48m), being the total debit fair values on forward foreign 
exchange contracts and currency swaps. The maximum credit risk exposure on cash at bank at 31 December 2017 was $169m (2016: $100m). 
The Group’s exposure to credit risk is not material as the amounts are held in a wide number of banks in a number of different countries.

Credit risk on trade receivables is detailed in Note 13.

16.4 Currency and interest rate profile of interest bearing liabilities and assets
Short-term debtors and creditors are excluded from the following disclosures.

Currency and interest rate profile of interest bearing liabilities:

At 31 December 2017
US Dollar
Other
Total interest bearing liabilities
At 31 December 2016
US Dollar
Other
Total interest bearing liabilities

Gross  
borrowings  
$ million

Currency  
swaps  
$ million

Interest rate 
swaps 
$million

Total  
liabilities  
$ million

Floating  
rate liabilities  
$ million

Fixed rate  
liabilities  
$ million

 (1,428)
 (22)
 (1,450)

(1,588)
(62)
(1,650)

 (291)
 (95)
 (386)

(367)
(81)
(448)

 (2)
 – 
 (2)

(1)
–
(1)

 (1,721)
 (117)
 (1,838)

(1,956)
(143)
(2,099)

 (866)
 (117)
 (983)

(1,108)
(129)
(1,237)

 (855)
 – 
 (855)

(862)
–
(862)

Fixed rate liabilities

Weighted  
average  
interest rate  
%

Weighted  
average time  
for which  
rate is fixed  
Years

 3.4 
 – 

3.5 
–

 5.8 
 – 

6.8 
–

At 31 December 2017, $nil (2016: $7m) of fixed rate liabilities related to finance leases. In 2017, the Group also had liabilities due for deferred and 
contingent acquisition consideration (denominated in US Dollars, Euros, Turkish Lira and Russian Rubles) totalling $160m (2016: $120m, 2015: $27m) 
on which no interest was payable (see Note 14). There were no other significant interest bearing financial liabilities.

Floating rates on liabilities are typically based on the one, three or six-month LIBOR (or other reference rate) relevant to the currency concerned. 
The weighted average interest rate on floating rate borrowings as at 31 December 2017 was 3% (2016: 2%).

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
    
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16 FINANCIAL INSTRUMENTS AND RISK MANAGEMENT continued 
Currency and interest rate profile of interest bearing assets:

At 31 December 2017
US Dollars
Other
Total interest bearing assets
At 31 December 2016
US Dollars
Other
Total interest bearing assets

Interest
rate swaps
$ million

Cash
at bank
$ million

Currency  
swaps  
$ million

Total assets 
$ million

Floating
rate assets 
$ million

Fixed  
rate assets  
$ million

 – 
 – 
 – 

–
–
–

 110 
 59 
 169 

29
71
100

 94 
 294 
 388 

83
366
449

 204 
 353 
 557 

112
437
549

 204 
 353 
 557 

112
437
549

 – 
 – 
 – 

–
–
–

Floating rates on assets are typically based on the short-term deposit rates relevant to the currency concerned. 

16.5 Fair value of financial assets and liabilities

Accounting policy
Measurement of fair values
A number of the Group’s accounting policies and disclosures require the measurement of fair values, for both financial assets and liabilities and 
non-financial assets acquired in a business combination (see Note 21).

When measuring the fair value of an asset or liability, the Group uses market observable data as far as possible. Fair values are categorised into 
different levels in the fair value hierarchy based on the inputs used in the valuation techniques as follows: Level 1: quoted prices (unadjusted) 
in active markets for identical assets or liabilities; Level 2: inputs other than quoted prices included in Level 1 that are observable for the asset 
or liability, either directly (i.e. as prices) or indirectly (i.e. derived from prices); and Level 3: inputs for the asset or liability that are not based on 
observable data (unobservable inputs).

The Group recognises transfers between the levels of the fair value hierarchy at the end of the reporting period during which the change 
has occurred.

There has been no change in the classification of financial assets and liabilities, the method and assumptions used in determining fair value and 
the categorisation of financial assets and liabilities within the fair value hierarchy from those disclosed in the Annual Report for the year ended 
31 December 2016. 

The Group enters into derivative financial instruments with financial institutions with investment grade credit ratings. The fair value of forward foreign 
exchange contracts is calculated by reference to quoted market forward exchange rates for contracts with similar maturity profiles. The fair value of 
currency swaps is determined by reference to quoted market spot rates. As a result, foreign forward exchange contracts and currency swaps are 
classified as Level 2 within the fair value hierarchy. The changes in counterparty credit risk had no material effect on the hedge effectiveness for 
derivatives designated in hedge relationships and other financial instruments recognised at fair value.

The fair value of investments is based upon third party pricing models for share issues. As a result, investments are considered Level 3 in the fair 
value hierarchy. There were no transfers between Levels 1, 2 and 3 during 2017 and 2016. For cash and cash equivalents, short-term loans and 
receivables, overdrafts and other short-term liabilities which have a maturity of less than three months, the book values approximate the fair values 
because of their short-term nature.

Long-term borrowings are measured in the balance sheet at amortised cost. As the Group’s long-term borrowings are not quoted publicly and 
as market prices are not available, their fair values are estimated by discounting future contractual cash flows to net present values at the current 
market interest rates available to the Group for similar financial instruments as at the year end.

The fair value of the private placement notes is determined using a discounted cash flow model based on prevailing market rates.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 146

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16 FINANCIAL INSTRUMENTS AND RISK MANAGEMENT continued 
The following table shows the carrying amounts and fair values of financial assets and financial liabilities, including their levels in the fair value 
hierarchy. It does not include fair value information for financial assets and financial liabilities not measured at fair value if the carrying amount is  
a reasonable approximation of fair value.

At 31 December 2017
Financial assets measured 
at fair value
Forward foreign exchange contracts
Investments
Currency swaps

Financial liabilities measured 
at fair value
Acquisition consideration
Forward foreign exchange contracts
Currency swaps
Interest rate swaps
Private placement debt

Financial assets not measured 
at fair value
Trade and other receivables
Cash at bank

Financial liabilities not measured 
at fair value
Acquisition consideration
Bank overdrafts
Bank loans
Private placement debt
Trade and other payables

Designated  
at fair  
value  
$ million

Fair value –  
hedging  
instruments  
$ million

Loans  
and  
receivables  
$ million

Available  
for sale  
$ million

Other  
financial 
liabilities  
$ million

Total  
$ million

Level 2  
$ million

Level 3  
$ million

Total  
$ million

Carrying 
amount

Fair value

 – 
 – 
 3 
 3 

 (104)
 – 
 (1)
 – 
 – 
 (105)

 – 
 – 
 – 

 (56)
 – 
 – 
 – 
 – 
 (56)

 25 
 – 
 – 
 25 

 – 
 (45)
 – 
 (2)
 – 
 (47)

 – 
 – 
 – 

 – 
 – 
 – 
 – 
 – 
 – 

 – 
 – 
 – 
 – 

 – 
 – 
 – 
 – 
 (198)
 (198)

 1,148 
 169 
 1,317 

 – 
 – 
 – 
 – 
 – 
 – 

 – 
 21 
 – 
 21 

 – 
 – 
 – 
 – 
 – 
 – 

 – 
 – 
 – 

 – 
 – 
 – 
 – 
 – 
 – 

 – 
 – 
 – 
 – 

 – 
 – 
 – 
 – 
 – 
 – 

 – 
 – 
 – 

 25 
 21 
 3 
 49 

 (104)
 (45)
 (1)
 (2)
 (198)
 (350)

 1,148 
 169 
 1,317 

 – 
 (14)
 (313)
 (925)
 (877)
 (2,129)

 (56)
 (14)
 (313)
 (925)
 (877)
 (2,185)

 25 
 – 
 3 

 – 
 (45)
 (1)
 (2)
 (198)

 – 
 21 
 – 

 (104)
 – 
 – 
 – 
 – 

 25 
 21 
 3 

 (104)
 (45)
 (1)
 (2)
 (198)

 (931)

 – 

 (931)

Total acquisition consideration measured at fair value increased from $56m at 31 December 2016 to $104m at 31 December 2017 due to the addition 
of $72m relating to the Rotation Medical, Inc. acquisition which was partially offset by $14m of acquisition payments and a remeasurement reduction 
of $10m. The fair value of contingent consideration is estimated using a discounted cash flow model. The valuation model considers the present 
value of expected payment, discounted using a risk-adjusted discount rate. The expected payment is determined by considering the possible 
scenarios, which relate to the achievement of established milestones and targets, the amount to be paid under each scenario and the probability of 
each scenario. As a result, contingent consideration is classified as Level 3 within the fair value hierarchy. 

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017     
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
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16 FINANCIAL INSTRUMENTS AND RISK MANAGEMENT continued 

At 31 December 2016
Financial assets measured 
at fair value
Forward foreign exchange contracts
Investments
Currency swaps
Interest rate swaps

Financial liabilities measured 
at fair value
Acquisition consideration
Forward foreign exchange contracts
Currency swaps
Interest rate swaps
Private placement debt

Financial assets not measured 
at fair value
Trade and other receivables
Cash at bank

Financial liabilities not measured 
at fair value
Acquisition consideration
Bank overdrafts
Bank loans
Private placement debt
Finance lease liabilities
Trade and other payables

Designated  
at fair  
value  
$ million

Fair value –  
hedging  
instruments  
$ million

Loans  
and  
receivables  
$ million

Available  
for sale  
$ million

Other  
financial 
liabilities  
$ million

Total  
$ million

Level 2  
$ million

Level 3  
$ million

Total  
$ million

Carrying 
amount

Fair value

–
–
3 
–
3

(56)
–
(2)
–
–
(58)

–
–
–

(64)
–
–
–
–
–
(64)

45 
–
–
–
45

–
(36)
–
(1)
–
(37)

–
–
–

–
–
–
–
–
–
–

–
–
–
–
–

–
–
–
–
(199)
(199)

1,064
100 
1,164

–
–
–
–
–
–
–

–
25
–
–
25

–
–
–
–
–
–

–
–
–

–
–
–
–
–
–
–

–
–
–
–
–

–
–
–
–
–
–

–
–
–

–
(62)
(457)
(925)
(7)
(807)
(2,258)

45
25
3 
–
73

(56)
(36)
(2)
(1)
(199)
(294)

1,064
100 
1,164

(64)
(62)
(457)
(925)
(7)
(807)
(2,322)

45
–
3 
–

–
(36)
(2)
(1)
(199)

–
25
–
–

(56)
–
–
–
–

45
25
3 
–

(56)
(36)
(2)
(1)
(199)

(935)

–

(935)

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 148

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17 PROVISIONS AND CONTINGENCIES

Accounting policy
In the normal course of business the Group is involved in various legal disputes. Provisions are made for loss contingencies when it is deemed 
probable that an adverse outcome will occur and the amount of the losses can be reasonably estimated. Where the Group is the plaintiff in 
pursuing claims against third parties, legal and associated expenses are charged to the income statement as incurred. 

The recognition of provisions for legal disputes is subject to a significant degree of estimation. In making its estimates management takes into 
account the advice of internal and external legal counsel. Provisions are reviewed regularly and amounts updated where necessary to reflect 
developments in the disputes. The ultimate liability may differ from the amount provided depending on the outcome of court proceedings or 
settlement negotiations or as new facts emerge.

A provision for onerous contracts is recognised when the expected benefits to be derived by the Group from a contract are lower than the 
unavoidable cost of meeting its obligations under the contract. For the purpose of calculating any onerous lease provision, the Group takes the 
discounted future lease payments (if any), net of expected rental income. Before a provision is established, the Group recognises any impairment 
loss on the assets associated with that contract.

A provision for rationalisation is recognised when the Group has approved a detailed and formal restructuring plan, and the restructuring either 
has commenced or has been announced publicly. Future operating losses are not provided for.

17.1 Provisions

At 1 January 2016
Net charge to income statement
Acquisitions
Unwinding of discount
Utilised
Exchange adjustment
At 31 December 2016
Net charge to income statement
Unwinding of discount
Utilised
Transfers
Exchange adjustment
At 31 December 2017
Provisions – due within one year
Provisions – due after one year
At 31 December 2017
Provisions – due within one year
Provisions – due after one year
At 31 December 2016

Rationalisation  
provisions  
$ million

Metal-on-metal
$ million

Legal and other  
provisions  
$ million

Total 
$ million

23
12
–
–
(14)
(1)
20
–
–
(15)
–
1
6
6
–
6
20
–
20

185
–
–
5
(27)
–
163
10
3
(19)
–
–
157
73
84
157
43
120
163

118
(1)
10 
–
(30)
1
98
2
–
(28)
(9)
–
63
50
13
63
84
14
98

326
11
10 
5 
(71)
–
281
12
3
(62)
(9)
1
226
129
97
226
147
134
281

The principal elements within rationalisation provisions relate to the Group Optimisation programme (mainly severance) announced in May 2014. 

Following the settlement of a large part of the US metal-on-metal hip claims (discussed below) the Group has estimated a provision of $157m  
(2016: $163m) relating to the present value at 31 December 2017 of the estimated costs to resolve all other known and anticipated metal-on-metal 
hip claims. The estimated value of the provision has been determined using an actuarial model. Given the inherent uncertainty in assumptions 
relating to factors such as the number of claims and outcome the actual costs may differ significantly from this estimate. A range of expected 
outcomes between the 25th and 75th percentile generated by the actuarial model would not give rise to a significantly different outcome in 2018. 
The provision does not include any possible insurance recoveries on these claims or legal fees associated with defending claims. The Group carries 
considerable product liability insurance, and will continue to defend claims vigorously.

The legal and other provisions mainly relate to various other product liability and intellectual property litigation matters.

All provisions are expected to be substantially utilised within five years of 31 December 2017 and none are treated as financial instruments.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 149

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17 PROVISIONS AND CONTINGENCIES continued
17.2 Contingencies
The Company and its subsidiaries are party to various legal proceedings, some of which include claims for substantial damages. The outcome of 
these proceedings cannot readily be foreseen, but except as described herein management believes none of them is likely to result in a material 
adverse effect on the financial position of the Group. The Group provides for outcomes that are deemed to be probable and can be reliably 
estimated. There is no assurance that losses will not exceed provisions or will not have a significant impact on the Group’s results of operations  
in the period in which they are realised.

In August 2003, the Group withdrew voluntarily from all markets the macrotextured versions of its OXINIUM femoral knee components. A charge 
of $154m was recorded in 2004 for anticipated expenses in connection with macrotexture claims. Most of that amount has since been applied to 
settlements of such claims, and all claims have now been resolved. The aggregate cost at 31 December 2017 related to this matter is approximately 
$205m. The Group has sought recovery from its primary and excess insurers for costs of resolving the claims. The primary insurance carrier has 
paid $60m in full settlement of its policy liability. However, the excess carriers have denied coverage, citing defences relating to the wording of the 
insurance policies and other matters. In December 2004, the Group brought suit against them in the US district court for the Western District of 
Tennessee, for which a trial has not yet begun. An additional $22m was received during 2007 from a successful settlement with a third party.

17.3 Legal proceedings
Product liability claims
The Group faces claims from time to time for alleged defects in its products and has on occasion recalled or withdrawn products from the market. 
Such claims are endemic to the medical device industry. The Group maintains product liability insurance subject to limits and deductibles that 
management believes are reasonable. All policies contain exclusions and limitations, however, and there can be no assurance that insurance will 
be available or adequate to cover all claims.

In recent years, there has been heightened concern about possible adverse effects of hip implant products with metal-on-metal bearing surfaces, 
and the Group has incurred, and will continue to incur expenses to defend claims in this area. As of February 2018, and giving effect to the US 
settlements described below, approximately 740 such claims were pending with the Group around the world, of which approximately 430 had given 
rise to pending legal proceedings. Most claims relate to the Group’s Birmingham Hip Resurfacing (BHR) product and its two modular metal-on-metal 
components: the Birmingham Hip Modular Head (BHMH) and the optional metal liner component of the R3 Acetabular System (R3ML). The BHMH 
and R3ML are no longer on the market: the R3ML was withdrawn in 2012 and the BHMH was phased out in 2014. In 2015, the Group ceased offering 
smaller sizes of the BHR and restricted instructions for BHR use in female patients. These actions were taken to ensure that the BHR is only used in 
those patient groups where it continues to demonstrate strong performance.

In 2015 and 2016, the Group’s US subsidiary settled a large part of the majority of its US metal-on-metal hip lawsuits in two group settlements, 
without admitting liability. Insurance receipts covered most of the amounts paid, with the net cash cost being $25m. In November 2017, the Group’s 
US subsidiary entered into a memorandum of understanding to settle a third group of claims, without admitting liability. The third settlement is 
expected to be finalised in 2018. These cases principally related to the Group’s modular metal-on-metal hip components, which are no longer on 
the market. On 5 April 2017, the Judicial Panel on Multidistrict Litigation (MDL) ordered Smith & Nephew BHR cases pending or later filed in US 
federal court to be consolidated for pre-trial proceedings and transferred to the federal court in Baltimore, Maryland. There are currently 253 cases 
pending in the MDL in the United States. In England and Wales, the Group’s UK subsidiary entered into a group settlement in 2017 to settle 150 
claims principally related to the Group’s modular metal-on-metal hip component, which are no longer on the market. Metal-on-metal hip implant 
claims against various companies in England and Wales have been consolidated for trials under group litigation orders in the High Court in London. 
The BHR and other claims pending against the Group have been stayed and will not be reactivated until the outcome of those trials is known.

The Group has requested indemnity from its product liability insurers for most of these metal-on-metal hip implant claims. Each insurer makes 
its own decision as to coverage issues, and the liability of some insurers depends on exhaustion of lower levels of coverage. Insurers of the 
lower layers of the Group’s insurances have indemnified the Group in respect of these claims up to the limits of those insurances. The Group has 
commenced arbitration proceedings against another insurer in respect of that insurer’s share of the claims and associated defence costs in the 
amount of $50m. 

Litigation outcomes are difficult to predict and defence costs can be significant. The Group takes care to monitor the clinical evidence relating to its 
metal hip implant products and ensure that its product offerings are designed to serve patients’ interests.

Intellectual property disputes
The Group is engaged, as both plaintiff and defendant, in litigation with various competitors and others over claims of patent infringement and other 
intellectual property matters. These disputes are being heard in courts in the US and other jurisdictions and also before agencies that examine 
patents. Outcomes are rarely certain and costs are often significant. 

The Group prosecuted and defended a series of patent infringement suits against Arthrex in US federal courts in Oregon and Texas starting in 2004, 
principally relating to suture anchors for use in shoulder surgery. Arthrex paid $99m in June 2015 in connection with the Oregon litigation, and most 
of that award (net of various expenses) was recognised in the Group’s operating profit at that time. The Group asserted the same patent against 
additional Arthrex products in a follow-up suit that was scheduled for trial in February 2017 in the Oregon court. Arthrex asserted its own suture 
anchor patents against Smith & Nephew in 2014 and 2015 in the US District Court for the Eastern District of Texas. In December 2016, the jury in that 
case decided that two of the Group’s US subsidiaries infringed two asserted Arthrex patents and awarded Arthrex $17.4m. In February 2017, the 
parties reached a settlement resulting in the dismissal of all patent litigation in Oregon and Texas. Smith & Nephew agreed to pay Arthrex $8m, and 
each party agreed to additional payments contingent on the outcome of patent validity proceedings currently pending at the US Patent & Trademark 
Office relating to the asserted patents. In November 2017, the US Patent & Trademark Office issued a Reexamination Certificate confirming validity 
of certain claims of US Patent No. 5,601,557 asserted by Smith & Nephew against Arthrex in the Oregon litigation. The issuing of the Reexamination 
Certificate triggered a payment of $80m which was received by Smith & Nephew in December 2017, and $54m (net of various expenses) is 
recognised in the Group’s 2017 operating profit. The Group has fully provided for any possible additional payment relating to its historical sales.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 150

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17 PROVISIONS AND CONTINGENCIES continued 
In February 2016, ConforMIS, Inc. filed suit against the Group’s US subsidiary in the Eastern Division of the US District Court for the District of 
Massachusetts, alleging that a number of its patents (generally directed to patient specific instrumentation associated with knee arthroplasty) are 
infringed by Smith & Nephew’s VISIONAIRE cutting guides and associated knee implants. The suit requests damages and an injunction. Smith 
& Nephew seeks to invalidate the asserted patents at the US Patent & Trademark Office and has also filed counterclaims for infringement by 
ConforMIS of the Group’s US patents. 

17.4 Tax Matters
At any given time the Group has unagreed years outstanding in various countries and is involved in tax audits and disputes, some of which may 
take several years to resolve. The Group believes that it has made adequate provision in respect of related additional tax liabilities that may arise. 
See Note 5 for further details.

18 RETIREMENT BENEFIT OBLIGATIONS

Accounting policy
The Group sponsors defined benefit plans in a number of countries. A defined benefit pension plan defines an amount of pension benefit that 
an employee will receive on retirement or a minimum guaranteed return on contributions, which is dependent on various factors such as age, 
years of service and final salary. The Group’s obligation is calculated separately for each plan by discounting the estimated future benefit that 
employees have earned in return for their service in the current and prior periods. The fair value of any plan assets is deducted to arrive at the 
net liability.

The calculation of the defined benefit obligation is performed annually by external actuaries using the projected unit credit method.  
Re-measurements arising from defined benefit plans comprise actuarial gains and losses and the return on the plan assets net of the costs 
of managing the plan assets. The Group recognises these immediately in other comprehensive income (OCI) and all other expenses, such as 
service cost, net interest cost, administration costs and taxes, are recognised in the income statement.

A number of key assumptions are made when calculating the fair value of the Group’s defined benefit pension plans. These assumptions impact 
the balance sheet asset and liabilities, operating profit, finance income/costs and other comprehensive income. The most critical assumptions 
are the discount rate, the rate of inflation and mortality assumptions to be applied to future pension plan liabilities. The discount rate is based on 
the yield at the reporting date on bonds that have a credit rating of AA, denominated in the currency in which the benefits are expected to be 
paid and have a maturity profile approximately the same as the Group’s obligations. In determining these assumptions management take into 
account the advice of professional external actuaries and benchmarks its assumptions against external data.

The Group determines the net interest expense/income on the net defined benefit liability/asset for the period by applying the discount rate 
used to measure the defined benefit obligation at the beginning of the annual period to the net defined benefit liability/asset.

The Group also operates a number of defined contribution plans. A defined contribution plan is a pension plan under which the Group and 
employees pay fixed contributions to a third party financial provider. The Group has no further payment obligations once the contributions have 
been paid. Contributions are recognised as an employee benefit expense when they are due.

18.1 Retirement benefit net obligations/(assets)
The Group’s retirement benefit obligations/(assets) comprise:

Funded plans:
UK Plan
US Plan
Other plans

Unfunded plans:
Other plans
Retirement healthcare

Amount recognised on the balance sheet – liability
Amount recognised on the balance sheet – asset

2017  
$ million

2016  
$ million

 (53)
 (9)
 46 
 (16)

 60 
 25 

 69 
 131 
 (62)

4
27
52
83

55
26

164
164
–

The Group sponsors defined benefit pension plans for its employees or former employees in 16 countries and these are established under the 
laws of the relevant country. Funded plans are funded by the payment of contributions and the assets are held by separate trust funds or insurance 
companies. The provision of retirement and related benefits across the Group is kept under regular review. Employees’ retirement benefits are 
the subject of regular management review. The Group’s defined benefit plans provide employees with an entitlement to retirement benefits 
varying between 1.3% and 66.7% of final salary on attainment of retirement age. The level of entitlement is dependent on the years of service of 
the employee.

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18 RETIREMENT BENEFIT OBLIGATIONS continued 
The Group’s two major defined benefit pension plans are in the UK and US. Both these plans were closed to new employees in 2003 and defined 
contribution plans are offered to new joiners. The US and UK Plans were closed to future accrual in March 2014 and December 2016 respectively.

The UK Plan operates under trust law and responsibility for its governance lies with a Board of Trustees. This Board is composed of representatives 
of the Group, plan participants and an independent trustee, who act on behalf of members in accordance with the terms of the Trust Deed and 
Rules and relevant legislation. The UK Plan’s assets are held by the trust. Annual increases on benefits in payment are dependent on inflation.  

There is no legislative minimum funding requirement in the UK, however the Group has agreed with the Board of Trustees to pay a schedule of 
supplementary payments (see Note 18.8). The Trust Deed of the UK Plan and the Plan Document of the US Plan provide the Group with a right 
to a refund of surplus assets assuming the full settlement of plan liabilities in the event of a plan wind-up. Furthermore, in the ordinary course of 
business the UK trustee and US committee have no rights to unilaterally wind up, or otherwise augment the benefits due to members of the plans. 
Based on these rights, any net surplus in the UK and US Plans is recognised in full.

The US Plan is governed by a US Pension Committee which is comprised of both plan participants and representatives of the Group. In the US, the 
Pension Protection Act (2006) established both a minimum required contribution and a maximum deductible contribution. Failure to contribute at 
least the minimum required amount will subject the Company to significant penalties, and contributions in excess of the maximum deductible have 
negative tax consequences. The minimum funding requirement is intended to fully fund the present value of accrued benefits over seven years.

18.2 Reconciliation of benefit obligations and pension assets
The movement in the Group’s pension benefit obligation and pension assets is as follows:

Amounts recognised on the balance sheet at  
beginning of the period
Income statement expense:
Current service cost
Past service credit
Settlements
Interest (expense)/income
Administration costs and taxes 
Costs recognised in income statement
Re-measurements:
Actuarial gain due to liability experience
Actuarial loss due to financial assumptions change
Actuarial gain due to demographic assumptions
Return on plan assets greater than discount rate
Re-measurements recognised in OCI
Cash:
Employer contributions
Employee contributions
Benefits paid directly by the Group
Benefits paid, taxes and administration costs paid from scheme assets
Net cash

Exchange rate movements
Amount recognised on the balance sheet
Amount recognised on the balance sheet – liability
Amount recognised on the balance sheet – asset

Obligation  
$ million

Asset  
$ million

Total  
$ million

Obligation  
$ million

Asset  
$ million

Total  
$ million

2017

2016

(1,577)

1,413

(164)

(1,521)

1,350 

(171)

(12)
4
–
(44)
(3)
(55)

1
(38)
42
–
5

–
(4)
2
102
100

(98)
(1,625)
(290)
(1,335)

–
–
–
42
–
42

–
–
–
59
59

53
4
(2)
 (102)
 (47)

89
1,556
159
1,397

(12)
4
–
(2)
(3)
(13)

1
(38)
42
59
64

53
–
– 
 – 
 53 

(9)
(69)
(131)
62

(19)
51
7 
(52)
(3)
(16)

7
(301)
33
–
(261)

–
(4)
3
61
60

–
–
(7)
48
–
41

–
–
–
180 
180

60
4
(3)
(61)
–

161
(1,577)
(1,577)
–

(158)
1,413
1,413
–

(19)
51
–
(4)
(3)
25

7
(301)
33
180
(81)

60
–
–
–
60

3
(164)
(164)
–

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18 RETIREMENT BENEFIT OBLIGATIONS continued 
Represented by:

UK Plan
US Plan
Other Plans
Total

Obligation  
$ million

(854)
(481)
(290)
(1,625)

Asset  
$ million

907
490
159
1,556

2017

Total  
$ million

53
9
(131)
(69)

Obligation  
$ million

(844)
(461)
(272)
(1,577)

Asset  
$ million

840
434
139 
1,413 

2016

Total  
$ million

(4)
(27)
(133)
(164)

All benefits are vested at the end of each reporting period. The weighted average duration of the defined benefit obligation at the end of the 
reporting period is 20 years and 11 years for the UK and US Plans respectively.

18.3 Plan assets
The market value of the US, UK and Other Plans assets are as follows:

2017  
$ million

2016  
$ million

2015  
$ million

UK Plan:
Assets with a quoted market price:
Cash and cash equivalents
Equity securities
Other bonds
Liability driven investments
Diversified growth funds

Other assets:
Insurance contract
Market value of assets
US Plan:
Assets with a quoted market price:
Cash and cash equivalents
Equity securities
Government bonds – fixed interest
Corporate bonds
Market value of assets
Other Plans:
Assets with a quoted market price:
Cash and cash equivalents
Equity securities
Government bonds – fixed interest
– index linked

Corporate and other bonds
Insurance contracts
Property
Other quoted securities

Other assets:

Insurance contracts
Market value of assets
Total market value of assets

8
235
43
192
152
630

277
907

–
88
201
201
490

4
43
4
3
11
36
19
2
122

37
159
1,556

6
213
38
239
130
626

214
840

–
178
128
128
434

4
35
3
3
11
34
12
2
104

35
139
1,413

5
234
43
171
144
597

214
811

–
166
119
119
404

9
35
5
9
13
28
8
1
108

27
135
1,350

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18 RETIREMENT BENEFIT OBLIGATIONS continued 
No plans invest directly in property occupied by the Group or in financial securities issued by the Group. 

Both the UK and US Plans hold a mixture of growth assets and matching assets. The growth assets of the UK and US Plans are invested in a 
diversified range of industries across a broad range of geographies. The UK Plan matching assets include liability matching assets and annuity 
policies purchased by the trustees, which aim to match the benefits to be paid to certain members from the plan and therefore remove the 
investment, inflation and demographic risks in relation to those liabilities. The terms of the policy define that the contract value exactly matches 
the amount and timing of the pensioner obligations covered by the contract. In accordance with IAS19R Employee Benefits, the fair value of the 
insurance contract is deemed to be the present value of the related obligations which is discounted at the AA corporate bond rate. In December 
2014, the low risk asset portfolio held by the UK Plan was transferred into liability driven investments (LDI) which invests in a mixture of gilts 
and swaps.

18.4 Expenses recognised in the income statement
The total expense relating to retirement benefits recognised for the year is $64m (2016: $23m, 2015: $58m). Of this cost recognised for the year, 
$51m (2016: $48m, 2015: $49m) relates to defined contribution plans and $13m (2016: $25m net credit, 2015: $9m net expense) relates to defined 
benefit plans.

The cost charged in respect of the Group’s defined contribution plans represents contributions payable to these plans by the Group at rates 
specified in the rules of the plans. These were charged to operating profit in selling, general and administrative expenses. There were $nil 
outstanding payments as at 31 December 2017 due to be paid over to the plans (2016: $nil, 2015: $nil).

In 2016, the $25m net credit for the year includes a $44m curtailment gain arising from the closure of the UK Plan to future accrual and $5m past 
service credit relating to redundancies.

In 2015, the $9m net expense for the year includes a $16m past service cost credit arising from amendments to the US Retirement Healthcare plan 
and a $5m gain arising from benefit options offered to members of the UK Plan.

Defined benefit plan costs comprise service cost which is charged to operating profit in selling, general and administrative expenses and net 
interest cost and administration costs and taxes which are reported as other finance costs.

The defined benefit pension costs charged for the UK and US Plans are:

Service cost
Past service credit
Settlement loss
Net interest cost,  
administration  
and taxes

UK Plan  
$ million

2017

US Plan  
$ million

– 
– 
– 

1
1

– 
– 
– 

2
2

UK Plan  
$ million

7 
(49)
1 

– 
(41)

2016

US Plan  
$ million

UK Plan  
$ million

2015

US Plan  
$ million

– 
– 
– 

3 
3 

9
(7)
2

3
7

–
–
–

4
4

18.5 Principal actuarial assumptions
The following are the principal financial actuarial assumptions used at the reporting date to determine the UK and US defined benefit obligations 
and expense.

UK Plan:
Discount rate
Future salary increases
Future pension increases
Inflation (RPI)
Inflation (CPI)
US Plan:
Discount rate
Future salary increases
Inflation

2017  
% per annum

2016  
% per annum

2015  
% per annum

2.4
n/a
3.2
3.2
2.2

3.5
n/a
n/a

2.6 
3.8 
3.3 
3.3 
2.3 

4.0 
n/a
n/a

3.8
3.6
3.1
3.1
2.1

4.3
n/a
n/a

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18 RETIREMENT BENEFIT OBLIGATIONS continued 
Actuarial assumptions regarding future mortality are based on mortality tables. The UK uses the S2NA with projections in line with the CMI 2016 
table and the US uses the RP2014 table with MP2016 scale. The current longevities underlying the values of the obligations in the defined benefit 
plans are as follows:

Life expectancy at age 60
UK Plan:
Males
Females
US Plan:
Males
Females
Life expectancy at age 60 in 20 years’ time
UK Plan:
Males
Females
US Plan:
Males
Females

2017  
years

2016  
years

2015  
years

28.8
30.3

25.2
27.4

31.0
31.8

25.5
28.0

29.7 
31.1 

25.1 
27.4 

32.5 
33.0 

25.4 
27.9 

29.6
31.3

25.8
28.2

32.6
33.4

27.6
29.9

18.6 Sensitivity analysis
The calculation of the defined benefit obligation is sensitive to the assumptions used. The following table summarises the increase/decrease on the 
UK and US defined benefit obligation and pension costs as a result of reasonably possible changes in some of the assumptions while holding all 
other assumptions consistent. The sensitivity to the inflation assumption change includes corresponding changes to the future salary increases and 
future pension increase assumptions. The analysis does not take into account the full distribution of cash flows expected under the plan.

Changes to the inflation assumption will not have any effect on the US Pension Plan as it was closed to future accrual in 2014.

$ million

UK Plan:
Discount rate
Inflation
Mortality
US Plan:
Discount rate
Inflation
Mortality

Increase in pension obligation

Increase in pension cost

+50bps/+1yr

-50bps/-1yr

+50bps/+1 yr

-50bps/-1yr

–80.9
+88.1
+38.0

–25.5
n/a
+11.4

+92.6
–77.3
–37.7

+27.9
n/a
–11.6

–2
+2
+1

–1
n/a
–

+2
–2
–1

+1
n/a
–

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18 RETIREMENT BENEFIT OBLIGATIONS continued 
18.7 Risk
The pension plans expose the Group to the following risks:

Interest rate risk

Inflation risk

Volatility in financial markets can change the calculations of the obligation significantly as the calculation of the 
obligation is linked to yields on AA-rated corporate bonds. A decrease in the bond yield will increase the measure of 
plan liabilities, although this will be partially offset by increases in the value of matching plan assets such as bonds 
and insurance contracts.

In the UK, the liability matching portfolio held in conventional and index-linked gilts was transferred into liability driven 
investments in order to reduce interest rate risk.

The UK Plan is linked to inflation. A high rate of inflation will lead to a higher liability. This risk is managed by holding 
inflation-linked bonds and an inflation-linked insurance contract in respect of some of the obligation. In the UK, the 
liability matching portfolio held in conventional and index-linked gilts was transferred into liability driven investments in 
order to reduce inflation risk. 

The UK and US Plans have been closed to future accrual which eliminates the exposure to this risk.

Investment risk

If the return on plan assets is below the discount rate, all else being equal, there will be an increase in the plan deficit.

In the UK, this risk is partially managed by a portfolio of liability matching assets and a bulk annuity, together with a 
dynamic de-risking policy to switch growth assets into liability matching assets over time.

The US Plan has a dynamic de-risking policy to shift plan assets into longer-term stable asset classes. The policy 
established 10 pre-determined funded status levels and when each trigger point is reached, the plan assets are 
re-balanced accordingly. In 2017, two trigger points were reached and the plan assets were re-balanced such that 
there was reduced investment in equity securities and increased investment in government and corporate bonds.

The present value of the plans defined benefit liability is calculated by reference to the best estimate of the mortality 
of the plan participants both during and after their employment. An increase in the life expectancy of plan participants 
above that assumed will increase the benefit obligation.

The UK Plan, in order to minimise longevity risk, has entered into an insurance contract which covers a portion of 
pensioner obligations.

The calculation of the defined benefit obligation uses the future estimated salaries of plan participants. Increases in 
the salary of plan participants above that assumed will increase the benefit obligation.

The exposure to salary risk in the UK and US has been eliminated with the closure of these Plans to future accrual.

Longevity risk

Salary risk

18.8 Funding
A full valuation is performed by actuaries for the Trustees of each plan to determine the level of funding required. Employer contributions rates, 
based on these full valuations, are agreed between the Trustees of each plan and the Group. The assumptions used in the actuarial valuations 
used for funding purposes may differ from those assumptions above.

UK Plan
The most recent full actuarial valuation of the UK Plan was undertaken as at 30 September 2015. The next full actuarial valuation will take place as 
at 30 September 2018. Contributions to the UK Plan in 2017 were $24m (2016: $32m, 2015: $37m). This included supplementary payments of $24m 
(2016: $26m, 2015: $29m).

The Group has currently agreed to pay annual supplementary payments of $25m until 2021. These supplementary payments will be reviewed when 
the 30 September 2018 valuation has been completed.

US Plan
A full actuarial valuation for the US Plan was last undertaken as at 20 September 2013 before the closure of the Plan to future accrual. 
Contributions to the US Plan were $20m (2016: $20m, 2015: $20m) which represented supplementary payments of $20m. 

The planned supplementary contribution for 2018 is being kept under review given the funding status.

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19 EQUITY

Accounting policy
Incremental costs directly attributable to the issue of ordinary shares, net of any tax effects, are recognised as a deduction from equity.

When shares recognised as equity are repurchased, the amount of the consideration paid, which includes directly attributable costs, net of any 
tax effects, is recognised as a deduction from equity. Repurchased shares are classified as treasury shares and are presented in the treasury 
share reserve. When treasury shares are sold or reissued subsequently, the amount received is recognised as an increase in equity and the 
resulting surplus or deficit on the transaction is presented within share premium.

19.1 Share capital

Authorised
At 31 December 2015
At 31 December 2016
At 31 December 2017
Allotted, issued and fully paid
At 1 January 2015
Share options
Shares cancelled
At 31 December 2015

Share options
Shares cancelled
At 31 December 2016
Share options
Shares cancelled
At 31 December 2017

Ordinary shares (20¢)

Deferred shares (£1.00)

Thousand

$ million

Thousand

$ million

Total 
$ million

1,223,591
1,223,591
1,223,591

917,942
1,855
(4,350)
915,447

1,283
(13,007)
903,723
655
(13,523)
890,855

245
245
245

184
–
(1)
183

–
(3)
180
 – 
 (2)
 178 

50
50
50

50
–
–
50

–
–
50
 – 
 – 
 50 

–
–
–

–
–
–
–

–
–
–
 – 
 – 
 – 

245
245
245

184
–
(1)
183

–
(3)
180
 – 
 (2)
 178 

The deferred shares were issued in 2006 in order to comply with English Company law. They are not listed on any stock exchange and have 
extremely limited rights and effectively have no value. These rights are summarised as follows:

 – The holder shall not be entitled to participate in the profits of the Company;

 – The holder shall not have any right to participate in any distribution of the Company’s assets on a winding up or other distribution except that 

after the return of the nominal amount paid up on each share in the capital of the Company of any class other than the deferred shares and the 
distribution of a further $1,000 in respect of each such share there shall be distributed to a holder of a deferred share (for each deferred share 
held) an amount equal to the nominal value of the deferred share;

 – The holder shall not be entitled to receive notice, attend, speak or vote at any general meeting of the Company; and

 – The Company may create, allot and issue further shares or reduce or repay the whole or any part of its share capital or other capital reserves 

without obtaining the consent of the holders of the deferred shares.

The Group’s objectives when managing capital are to ensure the Group has adequate funds to continue as a going concern and sufficient 
flexibility within the capital structure to fund the ongoing growth of the business and to take advantage of business development opportunities 
including acquisitions.

The Group determines the amount of capital taking into account changes in business risks and future cash requirements. The Group reviews  
its capital structure on an ongoing basis and uses share buy-backs, dividends and the issue of new shares to adjust the retained capital.

The Group considers the capital that it manages to be as follows:

Share capital
Share premium
Capital redemption reserve
Treasury shares
Retained earnings and other reserves

2017 
$ million

 178 
 605 
 17 
 (257)
 4,101 
 4,644 

2016 
$ million

180
600
15
(432)
3,595
3,958

2015 
$ million

183
590
12
(294)
3,475
3,966

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19.2 Treasury shares
Treasury shares represent the holding of the Company’s own shares in respect of the Smith & Nephew Employees’ Share Trust and shares bought 
back as part of the share buy-back programme. In 2017 the Group purchased a total of 3.2m shares for a cost of $52m as part of the ongoing 
programme to buy back an equivalent number of shares to those vesting as part of the employee share plans. During 2016, a total of 24.0m (2.7%) 
ordinary shares were purchased at a cost of $368m and 13.0m (1.5%) ordinary shares were cancelled. This included a $300m share buy-back 
programme following the sale of the Group’s Gynaecology business that completed in December 2016. 

The Smith & Nephew 2004 Employees’ Share Trust (Trust) was established to hold shares relating to the long-term incentive plans referred to in 
the ‘Directors’ Remuneration Report’. The Trust is administered by an independent professional trust company resident in Jersey and is funded by 
a loan from the Company. The cost of the Trust is charged to the income statement as it accrues. A dividend waiver is in place in respect of those 
shares held under the long-term incentive plans. The Trust only accepts dividends in respect of nil-cost options and deferred bonus plan shares. 
The waiver represents less than 1% of the total dividends paid.

The movements in Treasury shares and the Employees’ Share Trust are as follows:

At 1 January 2016
Shares purchased
Shares transferred from treasury
Shares transferred to Group beneficiaries
Shares cancelled
At 31 December 2016
Shares purchased
Shares transferred from treasury
Shares transferred to Group beneficiaries
Shares cancelled
At 31 December 2017

At 1 January 2016
Shares purchased
Shares transferred from treasury
Shares transferred to Group beneficiaries
Shares cancelled
At 31 December 2016
Shares purchased
Shares transferred from treasury
Shares transferred to Group beneficiaries
Shares cancelled
At 31 December 2017

Treasury  
$ million

Employees’  
Share Trust  
$ million

Total  
$ million

264
368
(18)
(13)
(190)
411
 52 
 (19)
 (9)
 (201)
 234 

30
–
18
(27)
–
21
 – 
 19 
 (17)
 – 
 23 

294
368
–
(40)
(190)
432
 52 
 – 
 (26)
 (201)
 257 

Number  
of shares  
million

Number  
of shares  
million

Number  
of shares  
million

18.9
24.0
(1.2)
(0.9)
(13.0)
27.8
 3.2 
 (1.3)
 (0.6)
 (13.5)
 15.6 

2.3
–
1.2 
(2.0)
–
1.5
 – 
 1.3 
 (1.2)
 – 
 1.6 

21.2
24.0
–
(2.9)
(13.0)
29.3
 3.2 
 – 
 (1.8)
 (13.5)
 17.2 

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19 EQUITY continued 
19.3 Dividends

The following dividends were declared and paid in the year:
Ordinary final of 18.5¢ for 2016 (2015: 19.0¢, 2014: 18.6¢) paid 10 May 2017
Ordinary interim of 12.3¢ for 2017 (2016: 12.3¢, 2015: 11.8¢) paid 1 November 2017

2017 
$ million

2016 
$ million

2015 
$ million

 162 
 107 
 269 

170
109
279

166
106
272

A final dividend for 2017 of 22.7¢ per ordinary share was proposed by the Board on 8 February 2018 and will be paid, subject to shareholder 
approval, on 9 May 2018 to shareholders on the Register of Members on 6 April 2018. The estimated amount of this dividend is $198m. The Group 
pursues a progressive dividend policy, with the aim of increasing the US Dollar value of ordinary dividends over time broadly based on the Group’s 
underlying growth in earnings, while taking into account capital requirements and cash flows. Future dividends will be dependent upon future 
earnings, the future financial condition of the Group and the Board’s dividend policy. The Board reviews the appropriate level of total annual 
dividend each year at the time of the full year results. The Board intends that the interim dividend will be set by a formula and will be equivalent 
to 40% of the total dividend for the previous year. Smith & Nephew plc, the Parent Company of the Group, is a non-trading investment holding 
company which derives its distributable reserves from dividends paid by subsidiary companies. The distributable reserves of the parent company 
approximate to the balance on the profit and loss account reserve, less treasury shares and exchange reserves, which at 31 December 2017 
amounted to $2,569m.

20 CASH FLOW STATEMENT

Accounting policy
In the Group cash flow statement, cash and cash equivalents includes cash at bank, other short-term liquid investments with original maturities 
of three months or less and bank overdrafts. In the Group balance sheet, bank overdrafts are shown within bank overdrafts and loans under 
current liabilities.

Analysis of net debt

At 1 January 2015
Net cash flow impact
Exchange adjustment
At 31 December 2015
Net cash flow impact
Exchange adjustment
At 31 December 2016
Net cash flow impact
Termination of finance lease
Exchange adjustment
At 31 December 2017

Cash  
$ million

Overdrafts  
$ million

Due within  
one year  
$ million

Due after  
one year  
$ million

Net 
currency swaps  
$ million

Net
 interest swaps
 $ million

Borrowings

93
34
(7)
120
(18)
(2)
100
 64 
 – 
 5 
 169 

(28)
9
1
(18)
(45)
1
(62)
 49 
 – 
 (1)
 (14)

(11)
(17)
–
(28)
4
–
(24)
 9 
 2 
 – 
 (13)

(1,666)
231
1
(1,434)
(129)
(1)
(1,564)
 139 
 3
 (1)
 (1,423)

(1)
15
(16)
(2)
25
(22)
1
 (24)
–  
 25 
 2 

–
1
–
1
(2)
–
(1)
 (1)
 – 
 – 
 (2)

Reconciliation of net cash flow to movement in net debt

Net cash flow from cash net of overdrafts
Settlement of currency swaps
Net cash flow from borrowings
Change in net debt from net cash flow
Termination of finance lease
Exchange adjustment
Change in net debt in the year
Opening net debt
Closing net debt

2017 
$ million

 113 
 (24)
 147 
 236 
 5 
 28 
 269 
 (1,550)
 (1,281)

2016 
$ million

(63)
25
(127)
(165)
–
(24)
(189)
(1,361)
(1,550)

Total  
$ million

(1,613)
273
(21)
(1,361)
(165)
(24)
(1,550)
 236 
 5
 28
 (1,281)

2015 
$ million

43
15
215
273
–
(21)
252
(1,613)
(1,361)

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 159

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20 CASH FLOW STATEMENT continued
Cash and cash equivalents
For the purposes of the Group cash flow statement cash and cash equivalents at 31 December 2017 comprise cash at bank net of bank overdrafts.

Cash at bank
Bank overdrafts
Cash and cash equivalents

2017 
$ million

 169 
 (14)
 155 

2016 
$ million

100
(62)
38

2015 
$ million

120
(18)
102

The Group operates in over 100 countries around the world, some of which impose restrictions over cash movement. These restrictions have only a 
minimal impact of the management of the Group’s cash.

Cash (inflows)/outflows arising from financing activities

Repayment
of bank 
loans 
$ million

770
–
770

Repayment
of bank 
loans 
$ million

797
–
797

Repayment
of bank 
loans 
$ million

1,088
–
1,088

Borrowing
of bank 
loans 
$ million

Cash 
(inflow)/outflow 
from other 
$ million

(623)
–
(623)

(24)
–
(24)

Borrowing
of bank 
loans 
$ million

Cash 
(inflow)/outflow 
from other 
$ million

(924)
–
(924)

25
–
25 

Borrowing
of bank 
loans 
$ million

Cash 
(inflow)/outflow 
from other 
$ million

(873)
–
(873)

15
–
15  

Dividends 
$ million

–
269
269

Dividends 
$ million

–
279
279

Dividends 
$ million

–
272
272

Purchase of 
own shares 
$ million

Proceeds from own 
shares/issue of 
ordinary shares 
$ million

–
52
52

–
(10)
(10)

Purchase of 
own shares 
$ million

Proceeds from own 
shares/issue of 
ordinary shares 
$ million

–
368
368

–
(16)
(16)

Purchase of 
own shares 
$ million

Proceeds from own 
shares/issue of 
ordinary shares 
$ million

–
77
77

–
(21)
(21)

2017

Total 
$ million

123
311
434

2016

Total 
$ million

(102)
631
529

2015

Total 
$ million

230
328
558

Debt
Equity
Total

Debt
Equity
Total

Debt
Equity
Total

21 ACQUISITIONS AND DISPOSALS

Accounting policy
The Group accounts for business combinations using the acquisition method when control is transferred to the Group. The consideration 
transferred in the acquisition is measured at fair value, as are the identifiable net assets acquired. Any goodwill that arises is tested annually for 
impairment. Any gain on a bargain purchase is recognised in profit or loss immediately. Transaction costs are expensed as incurred, except if 
related to the issue of debt or equity securities.

Any contingent consideration payable is measured at fair value at the acquisition date. If the contingent consideration is classified as equity, 
then it is not re-measured and settlement is accounted for within equity. Otherwise, subsequent changes in the fair value of the contingent 
consideration are recognised in profit or loss.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 160

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21 ACQUISITIONS AND DISPOSALS continued 
21.1 Acquisitions
Year ended 31 December 2017
During the year ended 31 December 2017, the Group acquired one medical technology business deemed to be a business combination within the 
scope of IFRS 3 Business Combinations.

On 5 December 2017, the Group completed the acquisition of 100% of the share capital of Rotation Medical, Inc., a developer of a novel tissue 
regeneration technology for shoulder rotator cuff repair. The acquisition furthers our strategy to invest in disruptive technologies that accelerate the 
transformation of Smith & Nephew to higher growth. The maximum consideration payable of $210m has a fair value of $196m and includes $17m 
of deferred and $72m of contingent consideration. The fair value of the contingent consideration is determined from the acquisition agreement, 
the Board-approved acquisition model and a risk-free discount rate of 2.5%. The maximum contingent consideration is $85m. The provisional fair 
values of assets acquired and liabilities assumed are set out below:

Intangible assets
Property, plant & equipment and inventory
Trade and other receivables
Trade and other payables
Net deferred tax assets
Net assets
Goodwill
Consideration (net of $nil cash acquired)

$ million

 61 
 3 
 2 
 (3)
 1 
 64 
 132 
 196 

The goodwill is attributable to the control premium, the acquired workforce and the synergies that can be expected from integrating Rotation 
Medical, Inc. into the Group’s existing business. The goodwill is not expected to be deductible for tax purposes.

During the year ended 31 December 2017, the contribution to revenue and attributable profit from this acquisition is immaterial. If the acquisition had 
occurred at the beginning of the year, its contribution to revenue and attributable profit would have also been immaterial.

Year ended 31 December 2016
During the year ended 31 December 2016, the Group acquired two medical technology businesses deemed to be business combinations within the 
scope of IFRS 3 Business Combinations. The acquisition accounting was completed during 2017 with no measurement adjustments made.

On 4 January 2016, the Group completed the acquisition of 100% of the share capital of Blue Belt Holdings Inc., a business specialising in robotic 
technologies. The acquisition secures a leading position in the fast growing area of Orthopaedic robotics-assisted surgery. The fair value of 
consideration is $265m and includes $51m deferred consideration. The fair values of assets acquired were:

Aggregate identifiable assets acquired and liabilities assumed
Intangible assets
Property, plant & equipment and inventory
Trade and other payable
Provisions
Deferred tax assets
Net assets
Goodwill
Consideration (net of $3m cash acquired)

$ million

70
13
(11)
(10)
16
78
184
262

The goodwill is attributable to the revenue synergies of providing a full robotic surgery offering and future applications of the technological 
expertise. The goodwill is not expected to be deductible for tax purposes.

On 8 January 2016 the Group completed the acquisition of BST-CarGel, a first-line cartilage repair product from Piramal Healthcare (Canada) 
Limited. The fair value of the consideration is $42m and included $37m of deferred and contingent consideration. The fair values of net assets 
acquired are: product intangible assets of $15m, inventory of $1m, and a deferred tax liability of $1m. The goodwill, which is expected to be 
deductible for tax purposes, arising on the acquisition is $27m, is attributable to the future penetration into new markets expected from 
the transaction.

During the year ended 31 December 2016, the contribution to revenue and attributable profit from these acquisitions is immaterial. If the 
acquisitions had occurred at the beginning of the year, their contribution to revenue and attributable profit would have also been immaterial.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 161

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21 ACQUISITIONS AND DISPOSALS continued 
Year ended 31 December 2015
During the year ended 31 December 2015, the Group acquired its distributor in Colombia and its distributor and a manufacturer in Russia. 
The acquisitions are deemed to be business combinations within the scope of IFRS 3 Business Combinations. The aggregated total fair value of 
the consideration was $68m and included $23m of contingent consideration and $13m through the settlement of working capital commitments. 
The acquisition accounting was completed in 2016 with no measurement adjustments being made. 

The following table summarises the aggregate consideration transferred and the aggregate fair value amounts of assets acquired and liabilities 
assumed at the acquisition date:

Identifiable assets acquired and liabilities assumed
Intangible assets
Other assets1
Liabilities
Net assets
Goodwill
Consideration (net of $1m cash acquired)

1 

Including net cash of $1m.

$ million

19
29
(14)
34
34
68

The aggregated goodwill arising on the acquisitions is $34m. This is attributable to the additional economic benefits expected from the 
transactions, including the assembled workforces, which have been transferred as part of the acquisitions. The goodwill recognised is not 
deductible for tax purposes. The contribution to revenue and attributable profit from these acquisitions for the year ended 31 December 2015 was 
immaterial. If the acquisitions had occurred at the beginning of the year, their contributions to revenue and attributable profit for the year ended 
31 December 2015 would also have been immaterial.

21.2 Disposal of business
During the year ended 31 December 2016 the Group disposed of its Gynaecology business for cash consideration of $350m. The net assets 
disposed included $6m plant and equipment, and $4m inventory. Disposal related costs of $7m and liabilities of $7m resulted in a pre-tax gain on 
disposal of $326m.

For the years ended 31 December 2015 and 31 December 2017, the Group did not dispose of any businesses.

22 OPERATING LEASES

Accounting policy
Leases are classified as finance leases when the terms of the lease transfer substantially all the risks and rewards of ownership to the Group. 
All other leases are classified as operating leases.

Payments under operating leases are expensed in the income statement on a straight-line basis over the term of the lease. Lease incentives 
received are recognised as an integral part of the total lease expense, over the term of the lease.

Future minimum lease payments under non-cancellable operating leases fall due as follows:

Land and buildings:
Within one year
After one and within two years
After two and within three years
After three and within four years
After four and within five years
After five years

Other assets:
Within one year
After one and within two years
After two and within three years
After three and within four years

2017  
$ million

2016  
$ million

 40
 35 
 27 
 23 
 19 
 56 
 200 

 17 
 11 
 5 
 1 
 34 

33
27
23
16
13
41
153

15
11
6
2
34

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 162

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23 OTHER NOTES TO THE ACCOUNTS
23.1 Share-based payments

Accounting policy
The Group operates a number of equity-settled executive and employee share plans. For all grants of share options and awards, the fair value 
at the grant date is calculated using appropriate option pricing models. The grant date fair value is recognised over the vesting period as an 
expense, with a corresponding increase in retained earnings.

The Group operates the following equity-settled executive and employee share plans: Smith & Nephew 2001 US Share Plan, Smith & Nephew 
Global Share Plan 2010, Smith & Nephew ShareSave Plan (2012), Smith & Nephew International ShareSave Plan (2012) and the Smith & Nephew 
France ShareSave plan (2012). At 31 December 2017, 5,277,000 options (2016: 5,780,000, 2015: 7,235,000) were outstanding with a range of exercise 
prices from 535 to 1,092 pence.

At 31 December 2017, the maximum number of shares that could be awarded under the Group’s long-term incentive plans was 5,854,000 
(2016: 5,807,000, 2015: 6,402,000). These include conditional share awards granted to senior employees and equity and performance share 
awards granted to senior executives under the Global Share Plan 2010.

The expense charged to the income statement for share-based payments for the year is $31m (2016: $27m, 2015: $30m). 

23.2 Related party transactions
Trading transactions
In the course of normal operations, the Group traded with its associates detailed in Note 11. The aggregated transactions, which have not been 
disclosed elsewhere in the financial statements are $nil (2016: $nil, 2015: $nil).

Key management personnel
The remuneration of executive officers (including Non-Executive Directors) during the year is summarised below:

Short-term employee benefits
Share-based payments expense
Pension and post-employment benefit entitlements
Compensation for loss of office

Directors’ remuneration disclosures are included on pages 83 to 93.

2017 
$ million

2016  
$ million

2015  
$ million

15
7
1
3
26

15
7
1
–
23

16
8
1
–
25

24 POST BALANCE SHEET EVENTS
Subsequent to the year end the Group announced its Accelerating Performance and Execution (APEX) programme. This is a five-year effort to make 
key enhancements to the Group’s business and ways of working in Manufacturing, Warehousing and Distribution, General and Administrative 
Expenses and Commercial Effectiveness. The programme is expected to require a one-off cash cost of $240m of which a charge of around $100m 
is expected in 2018. No provisions have been recorded in respect of this programme as at 31 December 2017. A constructive obligation in relation 
to this programme had not arisen at 31 December 2017 as the Group had not announced the main features of the programme nor raised a valid 
expectation in those employees affected by the programme.

NOTES TO THE GROUP ACCOUNTS continuedSMITH & NEPHEW ANNUAL REPORT 2017 163

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COMPANY FINANCIAL STATEMENTS
COMPANY BALANCE SHEET

Fixed assets:
Investments
Current assets:
Debtors
Cash and bank

Creditors: amounts falling due within one year:
Borrowings
Other creditors

Net current liabilities
Total assets less current liabilities
Creditors: amounts falling due after one year:
Borrowings
Total assets less total liabilities

Equity shareholders’ funds:
Called up equity share capital
Share premium account
Capital redemption reserve
Capital reserve
Treasury shares
Exchange reserve
Profit and loss account
Shareholders’ funds

At 31 December  
2017 
$ million

At 31 December 
2016 
$ million

Notes

2

3
5

5
4

5

 7,092 

5,322

 1,084 
 88 
 1,172 

 (4)
 (1,202)
 (1,206)
 (34)
 7,058 

 (1,423)
 5,635 

 178 
 605 
 17 
 2,266 
 (257)
 (52)
 2,878 
 5,635 

824
14
838

(41)
(814)
(855)
(17)
5,305

(1,559)
3,746

180
600
15
2,266
(432)
(52)
1,169
3,746

The accounts were approved by the Board and authorised for issue on 22 February 2018 and signed on its behalf by:

Roberto Quarta 
Chairman  

Olivier Bohuon 
Chief Executive Officer 

Graham Baker
Chief Financial Officer

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COMPANY FINANCIAL STATEMENTS
STATEMENT OF CHANGES IN EQUITY

Share 
capital 
$ million

Share 
premium 
$ million

Capital 
redemption 
reserve 
$ million

Capital 
reserves 
$ million

Treasury 
shares 
$ million

Exchange 
reserves 
$ million

Profit and 
loss account 
$ million

Total 
shareholders’ 
funds 
$ million

At 1 January 2016
Attributable profit for the year
Net gain on cash flow hedges
Exchange adjustments
Equity dividends paid in the year
Share-based payments recognised1
Cost of shares transferred to beneficiaries
New shares issued on exercise of share options
Cancellation of treasury shares
Treasury shares purchased
At 31 December 2016
Attributable profit for the year
Net gain on cash flow hedges
Exchange adjustments
Equity dividends paid in the year
Share-based payments recognised1
Cost of shares transferred to beneficiaries
New shares issued on exercise of share options
Cancellation of treasury shares
Treasury shares purchased
At 31 December 2017

183
–
–
–
–
–
–
–
(3)
–
180
–
–
–
 – 
 – 
 – 
 – 
 (2)
 – 
 178 

590
–
–
–
–
–
–
 10
 –
 –
600 
– 
 –
 – 
 – 
 – 
 – 
 5 
 – 
 – 
 605 

12
–
–
–
–
–
–
 – 
 3 
 – 
15
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 2 
 – 
 17 

2,266
–
–
–
–
–
 –
–
–
–
2,266
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 2,266 

(294)
–
–
–
–
–
 40 
 –
190 
(368)  
 (432) 
 – 
 – 
 – 
 – 
 – 
 26 
 – 
 201 
 (52)
 (257)

(52)
–
–
–
–
–
 – 
 – 
 – 
 – 
 (52)
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 (52)

1,589
58
1
(3)
(279)
27
 (34)
 – 
 (190)
 – 
 1,169 
 2,167 
 1 
 1 
 (269)
 31 
 (21)
 – 
 (201)
 – 
 2,878 

4,294
58
1
(3)
(279)
27
 6 
 10
 – 
 (368)
3,746 
 2,167 
 1 
 1 
 (269)
 31 
 5 
 5 
 – 
 (52)
 5,635 

1  The Company operates a number of equity-settled executive and employee share plans. For all grants of share options and awards, the fair value as at the date of grant is calculated using an appropriate option 

pricing model and the corresponding expense is recognised over the vesting period. Subsidiary companies are recharged for the fair value of share options that relate to their employees. The disclosure relating to 
the Company is detailed in Note 23.1 of the Notes to the Group accounts.

Further information on the share capital of the Company can be found in Note 19.1 of the Notes to the Group accounts.

The total distributable reserves of the Company are $2,569m (2016: $685m). In accordance with the exemption permitted by Section 408 of the 
Companies Act 2006, the Company has not presented its own profit and loss account. The attributable profit for the year dealt with in the accounts 
of the Company is $2,167m (2016: $58m).

Fees paid to KPMG LLP for audit and non-audit services to the Company itself are not disclosed in the individual accounts because Group financial 
statements are prepared which are required to disclose such fees on a consolidated basis. The fees for the consolidated Group are disclosed in 
Note 3.2 of the Notes to the Group accounts.

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NOTES TO THE COMPANY ACCOUNTS

1 BASIS OF PREPARATION
Smith & Nephew plc (the Company) is a public limited company incorporated in England and Wales.

The separate accounts of the Company are presented as required by the Companies Act 2006. On 1 January 2015, the Company transitioned 
from previously extant UK Generally Accepted Accounting Practices to Financial Reporting Standard 101 Reduced Disclosure Framework (‘Reduced 
Disclosure Framework’). These financial statements and accompanying notes have been prepared in accordance with the Reduced Disclosure 
Framework for all periods presented. There were no transitional adjustments required on adoption of the new standard. The financial information for the 
Company has been prepared on the same basis as the consolidated financial statements, applying identical accounting policies as outlined throughout 
the Notes to the Group accounts. The Directors have determined that the preparation of the Company financial statements on a going concern basis is 
appropriate as the Company receives dividend cash receipts from its subsidiary undertakings which enable it to meet its liabilities as they fall due.

In applying these policies, management is required to make estimates and assumptions that affect the reported amounts of assets and liabilities 
and disclosure of contingent assets and liabilities at the date of the accounts and the reported amounts of revenues and expenses during the 
reporting period. Although these estimates are based on management’s best knowledge of current events and actions, actual results ultimately 
may differ from those estimates.

In these financial statements, the Company has applied the exemptions available under FRS 101 in respect of the following disclosures:

 – A Cash Flow Statement and related notes; 

 – Comparative period reconciliations for share capital and tangible fixed assets;

 – Disclosures in respect of transactions with wholly-owned subsidiaries;

 – Disclosures in respect of capital management;

 – The effects of new but not yet effective IFRSs; and 

 – Disclosures in respect of the compensation of key management personnel.

As the consolidated financial statements include the equivalent disclosures, the Company has also taken the exemptions under FRS 101 available in 
respect of the following disclosures:

 – IFRS 2 Share Based Payments in respect of group settled share based payments; and

 – Certain disclosures required by IFRS 13 Fair Value Measurement and the disclosures required by IFRS 7 Financial Instrument Disclosures.

The Company proposes to continue to adopt the reduced disclosure framework of FRS 101 in its next financial statements.

2 INVESTMENTS

ACCOUNTING POLICY
Investments in subsidiaries are stated at cost less provision for impairment.

At 1 January
Additions
At 31 December

2017 
$ million

 5,322
1,770
7,092

2016 
$ million

5,322
 –
5,322

Investments represent holdings in subsidiary undertakings. In 2017, the Company increased its investment in Smith & Nephew (Overseas) Limited.

In accordance with Section 409 of the Companies Act 2006, a listing of all entities invested in by the consolidated Group is provided in Note 9. 

3 DEBTORS

Amounts falling due within one year:
Amounts owed by subsidiary undertakings
Prepayments and accrued income
Current asset derivatives – forward foreign exchange contracts
Current asset derivatives – forward foreign exchange contracts – subsidiary undertakings
Current asset derivatives – currency swaps
Current taxation

2017 
$ million

2016 
$ million

 1,007 
 3 
 25 
 45 
 3 
 1 
 1,084 

735
3
45
36
1
4
824

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NOTES TO THE COMPANY ACCOUNTS continued

4 OTHER CREDITORS 

Amounts falling due within one year:
Amounts owed to subsidiary undertakings
Other creditors
Current liability derivatives – forward foreign exchange contracts
Current liability derivatives – forward foreign exchange contracts – subsidiary undertakings
Current liability derivatives – currency swaps
Current liability derivatives – interest rate swaps

2017 
$ million

2016 
$ million

 1,119 
 10 
 45 
 25 
 1 
 2 
 1,202 

715
17
36
45
–
1
814

5 CASH AND BORROWINGS

ACCOUNTING POLICY
Financial instruments
Currency swaps are used to match foreign currency net assets with foreign currency liabilities. They are initially recorded at fair value and then 
for reporting purposes remeasured to fair value at exchange rates and interest rates at subsequent balance sheet dates.

Changes in the fair value of derivative financial instruments are recognised in the profit and loss account as they arise.

Bank loans and overdrafts due within one year or on demand
Borrowings due after one year
Borrowings 
Cash and bank
(Debit)/credit balance on derivatives – currency swaps
Credit/(debit) balance on derivatives – interest rate swaps
Net debt

2017 
$ million

 4 
 1,423 
 1,427 
 (88)
 (2) 
 2
 1,339

2016 
$ million

41
1,559
1,600
(14)
1
(1)
1,586

All currency swaps are stated at fair value. Gross US Dollar equivalents of $388m (2016: $449m) receivable and $386m (2016: $448m) payable have 
been netted. Currency swaps comprise foreign exchange swaps and were used in 2017 and 2016 to hedge intra-group loans. 

6 CONTINGENCIES

Guarantees in respect of subsidiary undertakings

2017 
$ million

1

2016 
$ million

–

The Company gives guarantees to banks to support liabilities and cross guarantees to support overdrafts. 

The Company operated defined benefit pension plans in 2004 but at the end of 2005 its pension plan obligations were transferred to Smith & 
Nephew UK Limited. The Company has provided guarantees to the trustees of the pension plans to support future amounts due from participating 
employers (see Note 18 of the Notes to the Group accounts).

7 DEFERRED TAXATION
The Company has gross unused capital losses of $90m (2016: $100m) available for offset against future chargeable gains. No deferred tax asset 
has been recognised on these unused losses as they are not expected to be realised in the foreseeable future. 

8 RESULTS FOR THE YEAR
As permitted by Section 408(4) of the Companies Act 2006, the Company has not presented its own profit and loss account. Profit for the year was  
$2,167m (2016: $58m).

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OVERVIEW

OUR BUSINESS  
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OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

NOTES TO THE COMPANY ACCOUNTS continued

9 GROUP COMPANIES
In accordance with Section 409 of the Companies Act 2006, a full list of subsidiaries, associates, joint arrangements, joint ventures and 
partnerships are listed below, including their country of incorporation. All companies are 100% owned, unless otherwise indicated. Unless otherwise 
stated, the share capital disclosed comprises ordinary shares which are indirectly held by Smith & Nephew plc.

Country of  
operation and 
incorporation

Registered 
Office

Company name

Country of  
operation and 
incorporation

Registered 
Office

Company name
UK
Blue Belt Technologies UK Limited2

Michelson Diagnostic Limited3 (13.4%)

Neotherix Limited3 (24.9%)

Plus Orthopedics (UK) Limited2

Smith & Nephew (Overseas) Limited1

Smith & Nephew ARTC Limited

Smith & Nephew Beta Limited2

Smith & Nephew China Holdings UK 
Limited1

Smith & Nephew Employees Trustees 
Limited2

England & Wales

London

England & Wales

England & Wales

England & Wales

England & Wales

England & Wales

England & Wales

England & Wales

Kent

York

London

London

London

London

London

England & Wales

London

Smith & Nephew ESN Limited2

England & Wales

Smith & Nephew Extruded Films Limited2

England & Wales

Smith & Nephew Finance2

Smith & Nephew Finance Oratec2

Smith & Nephew Healthcare Limited2

Smith & Nephew Investment Holdings 
Limited1

England & Wales

England & Wales

England & Wales

England & Wales

Smith & Nephew Medical Fabrics Limited2

England & Wales

Smith & Nephew Medical Limited2

Smith & Nephew Nominee Company 
Limited2

Smith & Nephew Nominee Services 
Limited2

England & Wales

England & Wales

Rest of Europe
Smith & Nephew GmbH

ArthroCare Belgium SPRL2

Smith & Nephew S.A.-N.V

Smith & Nephew A/S

A2 Surgical2

Smith & Nephew France SAS1

Smith & Nephew S.A.S.

Smith & Nephew Oy

Smith & Nephew Business Services 
GmbH & Co. KG1

Smith & Nephew Business Services 
Verwaltungs GmbH1

Smith & Nephew Deutschland (Holding) 
GmbH1

Smith & Nephew GmbH

Smith & Nephew Orthopaedics GmbH

Plus Orthopedics Hellas SA2

Smith & Nephew Hellas S.A.2

Smith & Nephew Limited

England & Wales

London

Smith & Nephew Finance Ireland Limited2

Smith & Nephew S.r.l.

Smith & Nephew Orthopaedics Limited2

England & Wales

Smith & Nephew Pensions Nominees 
Limited2

England & Wales

London

London

ArthroCare Luxembourg Sarl2

Smith & Nephew Finance S.a.r.l.2

Smith & Nephew International S.A.1

Smith & Nephew Pharmaceuticals Limited2

England & Wales

Hull

Smith & Nephew (Europe) B.V.1

Smith & Nephew Raisegrade Limited2

Smith & Nephew Rareletter Limited2

England & Wales

England & Wales

Smith & Nephew Trading Group Limited1

England & Wales

Smith & Nephew UK Executive Pension 
Scheme Trustee Limited2

Smith & Nephew UK Limited1

Smith & Nephew UK Pension Fund 
Trustee Limited2

Smith & Nephew USD Limited1

Smith & Nephew USD One Limited1

T.J. Smith and Nephew, Limited

The Albion Soap Company Limited2

TP Limited1

England & Wales

England & Wales

England & Wales

England & Wales

England & Wales

England & Wales

England & Wales

Scotland

Edinburgh

Smith & Nephew B.V.1

Smith & Nephew Management B.V.1

Smith & Nephew Nederland CV

Smith & Nephew Optics B.V.4

Smith & Nephew A/S

Smith & Nephew sp. z.o.o.

Smith & Nephew Lda

D-Orthopaedics LLC

DC LLC

Smith & Nephew LLC

Smith & Nephew S.A.U

Smith & Nephew Aktiebolag

Lumina Adhesives AB3 (11%)

Plus Orthopedics Holding AG1

Smith & Nephew Manufacturing AG

Smith & Nephew Orthopaedics AG

Smith & Nephew Schweiz AG

Smith & Nephew AG

London

Hull

London

London

Hull

London

London

Hull

London

London

London

London

London

London

London

London

London

Hull

London

Austria

Belgium

Belgium

Vienna

Zaventem

Zaventem

Denmark

Hoersholm

France

France

France

Neuilly-sur-
Seine

Neuilly-sur-
Seine

Neuilly-sur-
Seine 

Finland

Helsinki

Germany

Hamburg

Germany

Hamburg

Germany

Hamburg

Germany

Germany

Hamburg

Tuttlingen

Greece

Greece

Ireland

Ireland

Italy

Athens 

Athens

Dublin 2

Dublin 1

Milan

Luxembourg

Luxembourg

Luxembourg

Luxembourg

Luxembourg

Luxembourg

Netherlands

Amsterdam

Netherlands

Amsterdam

Netherlands

Amsterdam

Netherlands

Amsterdam

Netherlands

Amsterdam

Norway

Poland

Portugal

Oslo

Warsaw

Lisbon

Russian Federation

Moscow 

Russian Federation

Puschino

Russian Federation

Moscow 2

Spain

Barcelona

Sweden

Molndal

Sweden

Gothenburg

Switzerland

Switzerland

Switzerland

Switzerland

Switzerland

Baar

Aarau

Baar

Baar

Baar

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FINANCIAL  
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ACCOUNTS

GROUP AND OTHER 
INFORMATION

NOTES TO THE COMPANY ACCOUNTS continued

Country of  
operation and 
incorporation

Registered 
Office

Company name

9 GROUP COMPANIES continued

Company name
US
Arthrocare Corporation1

Bioventus LLC3 (49%)

Blue Belt Holdings, Inc.1

Blue Belt Technologies, Inc.

Delphi Ventures V, L.P.3 (6.9%)

Healicoil, Inc.

Hipco, Inc.

Leaf Healthcare Inc.3 (11%)

Memphis Biomed Ventures I, LP3 (4.61%)

Oratec Interventions, Inc.

Orthopaedic Biosystems Ltd., Inc.

OsteoBiologics, Inc.

Plus Orthopedics LLC

Rotation Medical, Inc.

Sinopsys Surgical, Inc.3 (12.4%)

Smith & Nephew Consolidated, Inc.1

Smith & Nephew OUS, Inc.1

Smith & Nephew, Inc.

ArthroCare (Australasia) Pty Ltd2

Smith & Nephew Pty Limited

Smith & Nephew Surgical Holdings 
Pty Limited2

Smith & Nephew Surgical Pty Limited2

Smith & Nephew Comercio de Produtos 
Medicos LTDA

Smith & Nephew (Alberta) Inc.2

Smith & Nephew Inc.

Tenet Medical Engineering, Inc.

Smith & Nephew Finance Holdings 
Limited2

ArthoCare Medical Devices (Beijing) Co. 
Limited⁴

Plus Orthopedics (Beijing) Co. Limited⁴

Plus Trading (Beijing) Co Limited⁴

Smith & Nephew Medical 
(Shanghai) Limited

United States

San Jose

United States

Wilmington

United States Minneapolis

United States

Pittsburgh 

United States

San Mateo

United States

Wilmington

United States

Wilmington

United States

United States

United States

United States

United States

United States

United States

United States

Delaware

Delaware

Concord

Phoenix 

Dallas 

Andover

Andover

Boulder

United States

Wilmington

United States

Wilmington

United States

Wilmington

Argentina Buenos Aires

Australia

North Ryde 

Australia

North Ryde 

Australia

North Ryde

Australia

North Ryde

Brazil

São Paulo

Canada

Canada

Canada

Calgary 

Toronto

Calgary

Cayman Islands South Church  
Street, 
George Town

China

China

China

China

Chao Yang 
District, 
Beijing

Shunyi 
District, 
Beijing

East City, 
Beijing

Shanghai 
Free Trade 
Test Zone

Surgical Frontiers Series I, LLC3 (32%)

United States

Dover

Trice Medical Inc.3 (6%)

United States

Delaware

Africa, Asia, Australasia and Other America
Smith & Nephew Argentina S.R.L.2

Smith & Nephew Orthopaedics (Beijing) 
Co., Ltd

S&N Holdings SAS1

Smith & Nephew Colombia S.A.S

ArthroCare Costa Rica Srl

Smith & Nephew Curaçao N.V.

Country of  
operation and 
incorporation

China

Registered 
Office

Beijing 
Economic 
and Technical 
Development 
Area

Colombia

Colombia

Bogota

Bogota

Costa Rica

Costa Rica

Curaçao

Willemstad

Smith & Nephew Beijing Holdings Limited1

Hong Kong

Hong Kong

Smith & Nephew Limited

Hong Kong

Hong Kong

Smith & Nephew Suzhou Holdings Limited1

Hong Kong

 Hong Kong

Adler Mediequip Private Limited

ArthoCare India Medical Device  
Private Limited2

India

India

Pune

Mumbai

Smith & Nephew Healthcare Private Limited

India Mumbai-59

Ortho-Space Ltd.3 (16.8%)

Smith & Nephew KK

Israel

Japan

Smith & Nephew Chusik Hoesia

Korea, Republic of

Caesarea

Tokyo

Seoul

Smith & Nephew Healthcare Sdn Berhad

Malaysia Kuala Lumpur

Smith & Nephew S.A. de C.V.

Smith & Nephew Limited

Smith & Nephew Superannuation  
Scheme Limited

Smith & Nephew, Inc.

Smith & Nephew Pte Limited

Smith & Nephew (Pty) Limited

Smith & Nephew Pharmaceuticals 
(Proprietary) Limited2

Smith & Nephew Limited

Mexico Mexico City

New Zealand

Auckland

New Zealand

Auckland 2

Puerto Rico

San Juan

Singapore

Singapore

South Africa

South Africa

Westville

Westville

Thailand Huai Khwang 
District, 
Bangkok

Sri Siam Medical Limited1,3 (48.99%)

Thailand

Smith ve Nephew Medikal Cihazlar Ticaret 
Limited Sirketi

Smith & Nephew FZE

Turkey

United Arab 
Emirates

Lumpini 
Phatumwan, 
Bangkok

Sariyer,  
Istanbul

Jebel Ali,  
Dubai

1  Holding company.

2  Dormant company.

3  Not 100% owned by Smith & Nephew Group.

4 

In liquidation.

Smith & Nephew Medical (Suzhou) Limited

China

Suzhou City

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OUR BUSINESS  
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OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

NOTES TO THE COMPANY ACCOUNTS continued

9 GROUP COMPANIES continued

Registered Office addresses
UK
London

Kent

York

Hull

15 Adam Street, London, WC2N 6LA

Ground Floor, Eclipse House, Eclipse Park, 
Sittingbourne Road, Maidstone, Kent, ME14 3EN

25 Carr Lane, York, YO26 5HT

101 Hessle Road, Hull, HU3 2BN

Edinburgh

4th Floor, 115 George Street, Edinburgh, EH2 4JN

Rest of Europe
Vienna

Zaventem

Hoersholm

Neuilly-sur-Seine

Concorde Business Park, 1/C/3 2320, 
Schwechat, Austria

Hector Heenneaulaan 366,  
1930 Zaventem, Belgium

Slotsmarken 14, Hoersholm, DK-2970, Denmark

40, Boulevard du Parc, 92200 Neuilly-sur-Seine, 
France

Helsinki

Hamburg

Tuttlingen

Athens

Dublin 1

Dublin 2

Milan

Luxembourg

Amsterdam

Oslo

Warsaw

Lisbon

Moscow

Moscow 2

Puschino

Barcelona

Molndal

Baar

Aarau

Ayritie 12 C, 01510, Vantaa, Finland

Friesenweg 4, Haus 21, 22763,  
Hamburg, Germany

Alemannenstrasse 14, 78532,  
Tuttlingen, Germany

Protopappa Street 43, GR 16346,  
Ilioupoli, Athens, Greece

3rd Floor, Kilmore House, Park Lane, 
Spencer Dock, Dublin 1, Ireland

Molyneux House, Bride Street, 
Dublin 2, Ireland

Via de Capitani 2A, 20864,  
Agrate Brianza (MI), Italy

163, Rue de Kiem, L-8030 Strassen, Luxembourg

Kruisweg 637, 2132 NB Hoofddorp,  
The Netherlands

Nye Vakas vei 64, 1395, Hvalsted, Norway

Ul Osmanska 12, 02-823, Warsaw, Poland

Estrada Nacional no 10 ao Km. 131,  
Parque Tejo – Bloco C, 2625-445 Forte de Casa,  
Vila Franca de Xira, Portugal

9a, Bld, 10, 2nd Sinichkina Street,  
Moscow 111020, Russian Federation

2nd Syromyatnichesky lane, Moscow, 105120, 
Russian Federation

8/1 Stroiteley Street, 142290, City of Puschino, 
Moscow Region, Russian Federation

Edificio Conata I, c/ Fructuos Gelabert 2 y 4, 
San Joan Despi – 08970, Barcelona, Spain

PO Box 143, S-431 22 Molndal, Sweden

Oberneuhofstr 10d, Baar, 6340

Schachenallee 29, 5000, Aarau, Switzerland

Gothenburg

Varbergsgatan 2A / 412 65 Göteborg / Sweden

Registered Office addresses
US
San Jose

Minneapolis

Pittsburgh

Boulder

Wilmington

Concord

Phoenix

Dallas

Andover

San Mateo

Memphis

Tustin

Dover

595 North Pastoria Avenue, Sunnyvale, 
California, 94086, USA

2905 Northwest Blvd, Suite 40,  
Plymouth MN 55441, USA

2828 Liberty Ave, Suite 100,  
Pittsburgh PA 15222, USA

5480 Valmont Road, Suite 215, Boulder,  
Colorado, 80301, USA

CT Corporation, 1209 Orange Street,  
Wilmington DE 19801, USA

C T Corporation, 9 Capitol Street, Concord, 
New Hampshire, 03301, USA

CT Corporation System, 3225 North Central 
Avenue, Phoenix AZ 85012, USA

CT Corporation System, 350 North St. Paul Street, 
Dallas TX 75201, USA

150 Minuteman Road, Andover,  
MA, 01810, USA

160 Bovet Road, Suite 408, San Mateo,  
CA 94402, USA

6075 Poplar Avenue, Suite 335,  
Memphis, Tennessee, 38119, USA

3002 Dow Avenue, Building 100,  
Unit 138, Tustin, California, 92780, USA

160 Greentree Drive, Suite 101,  
Dover, Delaware, 19904, USA

Africa, Asia, Australasia and Other America
Maipu 1300, 13th Floor,  
Buenos Aires
City of Buenos Aires, Argentina

North Ryde

São Paulo

Calgary

Toronto

85 Waterloo Road, North Ryde NSW 2113, Australia

Avenida do Cafe, 277, Centro Empresarial do 
Aco, Centro Empresarial do Aco, Torre B, 4 andar, 
conjuto, CEP 04311-000, São Paulo 403,  
Jabaquara, Brazil

3500-855-2 Street SW,  
Calgary AB AB T2P 4J8, Canada

199, Bay Street, 4000, Toronto,  
Ontario M5L 1A9, Canada

South Church Street, 
Georgetown

c/o M&C Corporate Services Limited, Ugland 
House, South Church Street, P.O. Box 309, George 
Town, Grand Cayman, Cayman Islands

Chao Yang District, Beijing Room 17-021, Internal B17 floor, B3-24th floor,  
No 3 Xin Yuan South Rd, Chao Yang District,  
Beijing, China

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OPERATIONAL 
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FINANCIAL  
REVIEW

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GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

NOTES TO THE COMPANY ACCOUNTS continued

9 GROUP COMPANIES continued

Av. Insurgentes Sur, numero 1602, Piso No.7, Oficina 
702, Colonia Credito, Constructor,  
Delegacion Benito Juarez, C.P. 03940, Mexico

621 Rosebank Road, Avondale,  
Auckland 6, New Zealand

36a Hillside Road, Wairau Valley, Auckland, 0627 
NZ, New Zealand

Edificio Cesar Castillo, Calle Angel Buonomo  
#361, Hato Rey, 00917, Puerto Rico

50 Raffles Place, #32-01 Singapore Land Tower, 
048623, Singapore

30 The Boulevard, Westway Office Park,  
Westville, 3629, South Africa

16th Floor Building A, 9th Tower Grand Rama 9,  
33/4 Rama 9 Road, Huai Khwang District,  
Bangkok, 10310, Thailand

16th Floor, GPF Witthayu Tower A, 
93/1 Wireless Road, Lumpini, Phatumwan, 
Bangkok, 10330, Thailand

Bahcekoy Mah., Orkide Sok.,  
No:8/E Bahcekoy, Sariyer Istanbil, Turkey

PO Box 16993 LB02016, Jebel Ali,  
Dubai, United Arab Emirates

Registered Office addresses

Shunyi District, Beijing

East City, Beijing

Guangzhou

Shanghai

Registered Office addresses

22 Linhe Avenue, Linhe Economic Development 
Zone, Shunyi District, Beijing, 101300, China

Mexico City

No. B-D, Floor 2, A Building, Beijing East Gate Plaza, 
No. 9, Dong Zhong Street, East City, Beijing, China

Auckland

Room 2502 No 33, 6th Jian She Rd, Yue Xiu District, 
Guangzhou, China

Auckland 2

Room 1208-1209, No 168 Middle Xi Zang Rd, 
Shanghai, China

Shanghai Free Trade Test 
Zone

Part B, 4th Floor, Tong Yong Building,  
No 188 Ao Na Rd, Shanghai Free Trade Test Zone, 
Shanghai, China

Dong Cheng District, 
Beijing

Chengdu

Unit B1, 2/F, Tower A, East Gate Plaza No.9, 
Dongshong Street, Dong Cheng District,  
Beijing, China

No 5. 15th Floor, Unit 1, Building, 
1 Li Bao Building, No 62 North Ke Hua Rd,  
Wu Hou District, Chengdu, China

Middle Xi Zang Rd, 
Shanghai

Room 1201-1207, No168 Middle Xi Zang Rd, 
Shanghai, China

San Juan

Singapore

Westville

Huai Khwang District, 
Bangkok

Lumpini Phatumwan, 
Bangkok

Suzhou City

12, Wuxiang Road, West Area of Comprehensive 
Bonded Zone, Suzhou Industrial Park, Suzhou City, 
SIP, Jiangsu Province, China

Sariyer, Istanbul

Jebel Ali, Dubai

Beijing Economic and 
Technical Development 
Area

No. 98 Kechuang Dongliujie,  
Beijing Economic and Technical Development Area,  
Beijing, China

Bogota

Costa Rica

Willemstad

Hong Kong

Pune

Mumbai

Mumbai-59

Caesarea

Tokyo

Seoul

Kuala Lumpur

Calle 100 No. 7 – 33 to 1 P3,  
Bogota D.C., 0, Colombia

Building B32, 50 meters South of Revisión Téchnica 
Vehicular, Province de Alajuela, Canton Alajuela, 
Coyol Free Zone, District San José, Costa Rica

Pietermaai 15, PO Box 4905, Curaçao

Unit 813 – 816, 8/F, Delta House, 3 On Yiu Street, 
Shatin, New Territories, Hong Kong

Sushrut House, Survey no.288,  
Phase II next to MIDC, Hinjewadi, at Mann, 
Taluka Mulshi, Pune, 411057, India

5A, Bakhtawar, 5th Floor, behind The Oberoi, 
Nariman Point, Mumbai, Maharashtra, 400021, 
India

501-B – 509-B Dynasty Business Park, 
Andheri Kurla Road, Andheri East, Mumbai-59, 
Maharashtra, India

7 Halamarish, Caesarea, 3088900, Israel

2-4-1, Shiba -Koen, Minato-Ku,  
Tokyo 105-0011, Japan

13th Floor, ASEM Tower, Gangnam-gu 13th Floor, 
ASEM Tower, 159-1 Samsung-dong, Seoul, Korea

Unit 10-02(A), Level 10, Menara TJB, 9, Jalan Syed 
Mohd Mufti, Johor Bahru, Johor 8000, Malaysia

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GROUP AND OTHER 
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GROUP INFORMATION

BUSINESS OVERVIEW AND GROUP HISTORY
Smith & Nephew’s operations are organised into geographical selling regions and product franchises within the medical technology industry.

The Group has a history dating back 160 years to the family enterprise of Thomas James Smith who opened a small pharmacy in Hull,  
UK in 1856. Following his death in 1896, his nephew Horatio Nelson Smith took over the management of the business.

By the late 1990s, Smith & Nephew had expanded into being a diverse healthcare conglomerate with operations across the globe, producing 
various medical devices, personal care products and traditional and advanced wound care treatments. In 1998, Smith & Nephew announced a 
major restructuring to focus management attention and investment on three global business units – Advanced Wound Management, Endoscopy 
and Orthopaedics – which offered high growth and margin opportunities. In 2011, the Endoscopy and Orthopaedics businesses were brought 
together to create an Advanced Surgical Devices division. In 2015, the Advanced Wound Management and Advanced Surgical Devices divisions 
were brought together to form a global business across nine product franchises, managed as three geographical selling regions with global 
functions for operations, R&D and corporate support functions.

Smith & Nephew was incorporated and listed on the London Stock Exchange in 1937 and in 1999 the Group was also listed on the New York Stock 
Exchange. In 2001, Smith & Nephew became a constituent member of the FTSE 100 index in the UK. This means that Smith & Nephew is included 
in the top 100 companies traded on the London Stock Exchange measured in terms of market capitalisation.

Today, Smith & Nephew is a public limited company incorporated and headquartered in the UK and carries out business around the world.

PROPERTIES
The table below summarises the main properties which the Group uses and their approximate areas.

Approximate area (square feet 000’s) 

Group head office in London, UK
UK office and surgical training facility in Watford, UK
Manufacturing and office facilities in Memphis, Tennessee, US 
Wound management manufacturing, research and office facility in Hull, UK 
Manufacturing facility in Suzhou, China
Manufacturing facility in Alajuela, Costa Rica
Distribution facility in Memphis, Tennessee, US
Manufacturing facility in Beijing, China
Bioactives headquarters and laboratory space in Fort Worth, Texas, US
Manufacturing, research and office facility in Austin, Texas, US 
Manufacturing facility in Oklahoma City, Oklahoma, US
Regional headquarters in Andover, Massachusetts, US 
Manufacturing facility in Aarau, Switzerland
Manufacturing facility in Mansfield, Massachusetts, US
Manufacturing facility in Devrukh, India
Regional headquarters and distribution facility in Baar, Switzerland
Manufacturing facility in Tuttlingen, Germany

13
60
968
473
288
265
248
192
165
157
155
144
121
98
74
71
50

The Group Global Operations strategy includes ongoing assessment of the optimal facility footprint. The Orthopaedics manufacturing facilities in 
Memphis, Tennessee are largely freehold, a portion of Tuttlingen and the Advanced Wound Management facilities in Hull are freehold while other 
principal locations are leasehold. The Group has freehold and leasehold interests in real estate in other countries throughout the world, but no other 
is individually significant to the Group. Where required, the appropriate governmental authorities have approved the facilities.

OFF-BALANCE SHEET ARRANGEMENTS
Management believes that the Group does not have any off-balance sheet arrangements, as defined by the SEC in item 5E of Form 20-F, that have 
or are reasonably likely to have a current or future effect on the Group’s financial condition, changes in financial condition, revenues or expenses, 
results of operations, liquidity, capital expenditures or capital resources that is material to investors.

RELATED PARTY TRANSACTIONS
Except for transactions with associates (see Note 23.2 of Notes to the Group accounts), no other related party had material transactions or loans 
with Smith & Nephew over the last three financial years.

GROUP AND OTHER 
INFORMATION

SMITH & NEPHEW ANNUAL REPORT 2017 172

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FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

GROUP INFORMATION continued

RISK FACTORS
There are known and unknown risks and uncertainties relating to Smith & Nephew’s business. The factors listed on pages 172–175 could cause  
the Group’s business, financial position and results of operations to differ materially and adversely from expected and historical levels. In addition, 
other factors not listed here that Smith & Nephew cannot presently identify or does not believe to be equally significant could also materially 
adversely affect Smith & Nephew’s business, financial position or results of operations.

Highly competitive markets
The Group competes across a diverse range of geographic and product markets. Each market in which the Group operates contains a number of 
different competitors, including specialised and international corporations. Significant product innovations, technical advances or the intensification 
of price competition by competitors could adversely affect the Group’s operating results.

Some of these competitors may have greater financial, marketing and other resources than Smith & Nephew. These competitors may be able 
to initiate technological advances in the field, deliver products on more attractive terms, more aggressively market their products or invest larger 
amounts of capital and research and development (R&D) into their businesses.

There is a possibility of further consolidation of competitors, which could adversely affect the Group’s ability to compete with larger companies 
due to insufficient financial resources. If any of the Group’s businesses were to lose market share or achieve lower than expected revenue growth, 
there could be a disproportionate adverse impact on the Group’s share price and its strategic options.

Competition exists among healthcare providers to gain patients on the basis of quality, service and price. There has been some consolidation in the 
Group’s customer base and this trend is expected to continue. Some customers have joined group purchasing organisations or introduced other 
cost containment measures that could lead to downward pressure on prices or limit the number of suppliers in certain business areas, which could 
adversely affect Smith & Nephew’s results of operations and hinder its growth potential.

Continual development and introduction of new products 
The medical devices industry has a rapid rate of new product introduction. In order to remain competitive, the Group must continue to develop 
innovative products that satisfy customer needs and preferences or provide cost or other advantages. Developing new products is a costly, lengthy 
and uncertain process. The Group may fail to innovate due to low R&D investment, a R&D skills gap or poor product development. A potential 
product may not be brought to market or not succeed in the market for any number of reasons, including failure to work optimally, failure to receive 
regulatory approval, failure to be cost-competitive, infringement of patents or other intellectual property rights and changes in consumer demand. 
The Group’s products and technologies are also subject to marketing attack by competitors. Furthermore, new products that are developed and 
marketed by the Group’s competitors may affect price levels in the various markets in which the Group operates. If the Group’s new products do not 
remain competitive with those of competitors, the Group’s revenue could decline.

The Group maintains reserves for excess and obsolete inventory resulting from the potential inability to sell its products at prices in excess of 
current carrying costs. Marketplace changes resulting from the introduction of new products or surgical procedures may cause some of the Group’s 
products to become obsolete. The Group makes estimates regarding the future recoverability of the costs of these products and records a provision 
for excess and obsolete inventories based on historical experience, expiration of sterilisation dates and expected future trends. If actual product life 
cycles, product demand or acceptance of new product introductions are less favourable than projected by management, additional inventory write-
downs may be required.

Dependence on government and other funding
In most markets throughout the world, expenditure on medical devices is ultimately controlled to a large extent by governments. Funds may be 
made available or withdrawn from healthcare budgets depending on government policy. The Group is therefore largely dependent on future 
governments providing increased funds commensurate with the increased demand arising from demographic trends.

Pricing of the Group’s products is largely governed in most markets by governmental reimbursement authorities. Initiatives sponsored by 
government agencies, legislative bodies and the private sector to limit the growth of healthcare costs, including price regulation, excise taxes and 
competitive pricing, are ongoing in markets where the Group has operations. This control may be exercised by determining prices for an individual 
product or for an entire procedure. The Group is exposed to government policies favouring locally sourced products. The Group is also exposed 
to changes in reimbursement policy, tax policy and pricing which may have an adverse impact on revenue and operating profit. Provisions in US 
healthcare legislation which previously imposed significant taxes on medical device manufacturers have been suspended for two years but may 
be reinstated. There may be an increased risk of adverse changes to government funding policies arising from deterioration in macro-economic 
conditions from time to time in the Group’s markets.

The Group must adhere to the rules laid down by government agencies that fund or regulate healthcare, including extensive and complex rules in 
the US. Failure to do so could result in fines or loss of future funding.

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GROUP INFORMATION continued

RISK FACTORS continued
World economic conditions
Demand for the Group’s products is driven by demographic trends, including the ageing population and the incidence of osteoporosis and obesity. 
Supply of, use of and payment for the Group’s products are also influenced by world economic conditions which could place increased pressure 
on demand and pricing, adversely impacting the Group’s ability to deliver revenue and margin growth. The conditions could favour larger, better 
capitalised groups, with higher market shares and margins. As a consequence, the Group’s prosperity is linked to general economic conditions and 
there is a risk of deterioration of the Group’s performance and finances during adverse macro-economic conditions.

During 2017, economic conditions worldwide continued to create several challenges for the Group, including deferrals of joint replacement 
procedures, heightened pricing pressure, significant declines in capital equipment expenditures at hospitals and increased uncertainty over the 
collectability of government debt, particularly those in the Emerging Markets and the oil-dependent Gulf States. These factors tempered the overall 
growth of the Group’s global markets and could have an increased impact on growth in the future.

Political uncertainties
The Group operates on a worldwide basis and has distribution channels, purchasing agents and buying entities in over 100 countries. 
Political upheaval in some of those countries or in surrounding regions may impact the Group’s results of operations. Political changes in a country 
could prevent the Group from receiving remittances of profit from a member of the Group located in that country or from selling its products or 
investments in that country. Furthermore, changes in government policy regarding preference for local suppliers, import quotas, taxation or other 
matters could adversely affect the Group’s revenue and operating profit. War, economic sanctions, terrorist activities or other conflict could also 
adversely impact the Group. These risks may be greater in Emerging Markets, which account for an increasing portion of the Group’s business. 

In June 2016 the UK voted to leave the European Union. The UK’s withdrawal will be effective from 29 March 2019 at 11pm GMT. As negotiations 
regarding the terms of the withdrawal continue, the nature of the trade agreements and the closeness of the economic ties between the UK and 
the EU beyond the withdrawal date remains uncertain. We continue to monitor the situation. Among the potential impacts of Brexit, the regulatory 
framework for medical devices could be affected, as it is unclear whether the UK will ascribe to the new Medical Devices Regulation which will 
become applicable in May 2020. 

Currency fluctuations
Smith & Nephew’s results of operations are affected by transactional exchange rate movements in that they are subject to exposures arising from 
revenue in a currency different from the related costs and expenses. The Group’s manufacturing cost base is situated principally in the US, the 
UK, China and Switzerland, from which finished products are exported to the Group’s selling operations worldwide. Thus, the Group is exposed 
to fluctuations in exchange rates between the US Dollar, Sterling and Swiss Franc and the currency of the Group’s selling operations, particularly 
the Euro, Australian Dollar and Japanese Yen. If the US Dollar, Sterling or Swiss Franc should strengthen against the Euro, Australian Dollar and the 
Japanese Yen, the Group’s trading margin could be adversely affected.

The Group manages the impact of exchange rate movements on revenue and cost of goods sold by a policy of transacting forward foreign currency 
commitments when firm purchase orders are placed. In addition, the Group’s policy is for forecast transactions to be covered between 50% and 
90% for up to one year. However, the Group is exposed to medium to long-term adverse movements in the strength of currencies compared to the 
US Dollar.

The Group uses the US Dollar as its reporting currency. The US Dollar is the functional currency of Smith & Nephew plc. The Group’s revenues, 
profits and earnings are also affected by exchange rate movements on the translation of results of operations in foreign subsidiaries for financial 
reporting purposes. See ‘Liquidity and capital resources’ on page 39.

Manufacturing and supply
The Group’s manufacturing production is concentrated at main facilities in Memphis, Mansfield and Oklahoma City in the US, Hull and Warwick 
in the UK, Aarau in Switzerland, Tuttlingen in Germany, Devrukh in India, Suzhou and Beijing in China, Alajuela in Costa Rica, Puschino in Russia 
and Curaçao, in Dutch Caribbean. If major physical disruption took place at any of these sites, it could adversely affect the results of operations. 
Physical loss and consequential loss insurance is carried to cover such risks but is subject to limits and deductibles and may not be sufficient to 
cover catastrophic loss. Management of orthopaedic inventory is complex, particularly forecasting and production planning. There is a risk that 
failures in operational execution could lead to excess inventory or individual product shortages.

The Group is reliant on certain key suppliers of raw materials, components, finished products and packaging materials or in some cases on a single 
supplier. These suppliers must provide the materials and perform the activities to the Group’s standard of quality requirements. 

A supplier’s failure to meet expected quality standards could create liability for the Group and adversely affect sales of the Group’s related products. 

The Group may be forced to pay higher prices to obtain raw materials, which it may not be able to pass on to its customers in the form of increased 
prices for its finished products. In addition, some of the raw materials used may become unavailable, and there can be no assurance that the 
Group will be able to obtain suitable and cost effective substitutes. Any interruption of supply caused by these or other factors could negatively 
impact Smith & Nephew’s revenue and operating profit.

The Group will, from time to time including as part of the APEX programme, outsource or insource the manufacture of components and finished 
products to third parties and will periodically relocate the manufacture of product and/or processes between existing and/or new facilities. 
While these are planned activities, with these transfers there is a risk of disruption to supply.

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GROUP INFORMATION continued

RISK FACTORS continued
Attracting and retaining key personnel
The Group’s continued development depends on its ability to hire and retain highly-skilled personnel with particular expertise. This is critical, 
particularly in general management, research, new product development and in the sales forces. If Smith & Nephew is unable to retain key 
personnel in general management, research and new product development or if its largest sales forces suffer disruption or upheaval, its revenue 
and operating profit would be adversely affected. Additionally, if the Group is unable to recruit, hire, develop and retain a talented, competitive 
workforce, it may not be able to meet its strategic business objectives.

Proprietary rights and patents
Due to the technological nature of medical devices and the Group’s emphasis on serving its customers with innovative products, the Group has 
been subject to patent infringement claims and is subject to the potential for additional claims.

Claims asserted by third parties regarding infringement of their intellectual property rights, if successful, could require the Group to expend time 
and significant resources to pay damages, develop non-infringing products or obtain licences to the products which are the subject of such 
litigation, thereby affecting the Group’s growth and profitability. Smith & Nephew attempts to protect its intellectual property and regularly opposes 
third party patents and trademarks where appropriate in those areas that might conflict with the Group’s business interests. If Smith & Nephew fails 
to protect and enforce its intellectual property rights successfully, its competitive position could suffer, which could harm its results of operations.

Product liability claims and loss of reputation
The development, manufacture and sale of medical devices entail risk of product liability claims or recalls. Design and manufacturing defects with 
respect to products sold by the Group or by companies it has acquired could damage, or impair the repair of, body functions. The Group may 
become subject to liability, which could be substantial, because of actual or alleged defects in its products. In addition, product defects could lead 
to the need to recall from the market existing products, which may be costly and harmful to the Group’s reputation.

There can be no assurance that customers, particularly in the US, the Group’s largest geographical market, will not bring product liability or related 
claims that would have a material adverse effect on the Group’s financial position or results of operations in the future, or that the Group will be 
able to resolve such claims within insurance limits. As at 31 December 2017, a provision of $157m is recognised relating to the present value of the 
estimated costs to resolve all unsettled known and unknown anticipated metal-on-metal hip implant claims.

Regulatory standards and compliance in the healthcare industry
Business practices in the healthcare industry are subject to regulation and review by various government authorities. In general, the trend in many 
countries in which the Group does business is towards higher expectations and increased enforcement activity by governmental authorities. 
While the Group is committed to doing business with integrity and welcomes the trend to higher standards in the healthcare industry, the Group 
and other companies in the industry have been subject to investigations and other enforcement activity that have incurred and may continue 
to incur significant expense. Under certain circumstances, if the Group were found to have violated the law, its ability to sell its products to certain 
customers could be restricted.

International regulation
The Group operates across the world and is subject to extensive legislation, including anti-bribery and corruption and data protection, in each 
country in which the Group operates. Our international operations are governed by the UK Bribery Act and the US Foreign Corrupt Practices 
Act which prohibit us or our representatives from making or offering improper payments to government officials and other persons or accepting 
payments for the purpose of obtaining or maintaining business. Our international operations in the Emerging Markets which operate through 
distributors increase our Group exposure to these risks. 

The Group will also be required to comply with the requirements of the EU General Data Protection Regulation (GDPR) concerning personal data of 
data subjects residing in the EU when it comes into force in May 2018.  

Enforcement of such legislation has increased in recent years with significant fines and penalties being imposed on companies and individuals 
where breaches are found to have occurred.

Regulatory approval
The international medical device industry is highly regulated. Regulatory requirements are a major factor in determining whether substances and 
materials can be developed into marketable products and the amount of time and expense that should be allotted to such development.

National regulatory authorities administer and enforce a complex series of laws and regulations that govern the design, development, approval, 
manufacture, labelling, marketing and sale of healthcare products. They also review data supporting the safety and efficacy of such products. 
Of particular importance is the requirement in many countries that products be authorised or registered prior to manufacture, marketing or sale 
and that such authorisation or registration be subsequently maintained. The major regulatory agencies for Smith & Nephew’s products include 
the Food and Drug Administration (FDA) in the US, the Medicines and Healthcare products Regulatory Agency in the UK, the Ministry of Health, 
Labour and Welfare in Japan, the China Food and Drug Administration and the Australian Therapeutic Goods Administration. At any time, the 
Group is awaiting a number of regulatory approvals which, if not received, could adversely affect results of operations. In 2017, the European Union 
reached agreement on a new set of Medical Device Regulations which entered into force on 25 May 2017. These have a three-year transition period; 
therefore will fully apply in EU Member States from 26 May 2020.

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GROUP INFORMATION continued

RISK FACTORS continued
The trend is towards more stringent regulation and higher standards of technical appraisal. Such controls have become increasingly demanding to 
comply with and management believes that this trend will continue. 

Regulatory requirements may also entail inspections for compliance with appropriate standards, including those relating to Quality Management 
Systems or Good Manufacturing Practices regulations. All manufacturing and other significant facilities within the Group are subject to regular 
internal and external audit for compliance with national medical device regulation and Group policies.

Payment for medical devices may be governed by reimbursement tariff agencies in a number of countries. Reimbursement rates may be set 
in response to perceived economic value of the devices, based on clinical and other data relating to cost, patient outcomes and comparative 
effectiveness. They may also be affected by overall government budgetary considerations. The Group believes that its emphasis on innovative 
products and services should contribute to success in this environment.

Failure to comply with these regulatory requirements could have a number of adverse consequences, including withdrawal of approval to sell a 
product in a country, temporary closure of a manufacturing facility, fines and potential damage to Company reputation.

Failure to make successful acquisitions
A key element of the Group’s strategy for continued growth is to make acquisitions or alliances to complement its existing business. Failure to 
identify appropriate acquisition targets or failure to conduct adequate due diligence or to integrate them successfully would have an adverse 
impact on the Group’s competitive position and profitability. This could result from the diversion of management resources towards the acquisition 
or integration process, challenges of integrating organisations of different geographic, cultural and ethical backgrounds, as well as the prospect of 
taking on unexpected or unknown liabilities. In addition, the availability of global capital may make financing less attainable or more expensive and 
could result in the Group failing in its strategic aim of growth by acquisition or alliance.

Relationships with healthcare professionals
The Group seeks to maintain effective and ethical working relationships with physicians and medical personnel who assist in the research and 
development of new products or improvements to our existing product range or in product training and medical education. If we are unable to 
maintain these relationships our ability to meet the demands of our customers could be diminished and our revenue and profit could be materially 
adversely affected.

Reliance on sophisticated information technology
The Group uses a wide variety of information systems, programmes and technology to manage our business. Our systems are vulnerable to a 
cyber attack, malicious intrusion, loss of data privacy or any other significant disruption. Our systems have been and will continue to be the target 
of such threats. We have systems in place to minimise the risk and disruption of these intrusions and to monitor our systems on an ongoing basis 
for current or potential threats. There can be no assurance that these measures will prove effective in protecting Smith & Nephew from future 
interruptions and as a result the performance of the Group could be materially adversely affected.

Other risk factors
Smith & Nephew is subject to a number of other risks, which are common to most global medical technology groups and are reviewed as part of 
the Group’s Risk Management process. 

FACTORS AFFECTING SMITH & NEPHEW’S RESULTS OF OPERATIONS
Government economic, fiscal, monetary and political policies are all factors that materially affect the Group’s operation or investments of 
shareholders. Other factors include sales trends, currency fluctuations and innovation. Each of these factors is discussed further in the ‘Our 
Marketplace’ on pages 16–17, ‘Financial review’ on pages 38–39 and ‘Taxation information for shareholders’ on pages 190–191.

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OTHER FINANCIAL INFORMATION

SELECTED FINANCIAL DATA 

Income statement
Revenue
Cost of goods sold
Gross profit
Selling, general and administrative expenses
Research and development expenses
Operating profit1
Net interest (payable)/receivable
Other finance costs
Share of results of associates
Profit on disposal of business
Profit before taxation
Taxation
Attributable profit for the year
Earnings per ordinary share
Basic earnings per share
Diluted earnings per share
Average number of shares used in basic earnings per share (millions)
Average number of shares used in diluted earnings per share (millions)
Adjusted attributable profit2
Attributable profit for the year
Acquisition related costs
Restructuring and rationalisation expenses
Legal and other
Amortisation and impairment of acquisition intangibles
Profit on disposal of business
US tax reform
Taxation on excluded items
Adjusted attributable profit
Adjusted earnings per ordinary share (EPSA)3

2017  
$ million

2016  
$ million

2015  
$ million

2014  
$ million

2013  
$ million

 4,765 
 (1,248)
 3,517 
 (2,360)
 (223)
 934 
 (51)
 (10)
 6 
 – 
 879 
 (112)
 767 

 87.8¢ 
 87.7¢ 
874
875

 767 
 (10)
 – 
(13)
 140 
 – 
 (32)
 (26)
 826 
 94.5¢ 

4,669
(1,272)
3,397
(2,366)
(230)
801
(46)
(16)
(3)
326
1,062
(278)
784

88.1¢
87.8¢
890
893

784
9
62
(20)
178
(326)
–
48
735
82.6¢

4,634
(1,143)
3,491
(2,641)
(222)
628
(38)
(15)
(16)
–
559
(149)
410

45.9¢
45.6¢
894
899

410
25
65
187
204
–
–
(130)
761
85.1¢

4,617
(1,162)
3,455
(2,471)
(235)
749
(22)
(11)
(2)
–
714
(213)
501

56.1¢
55.7¢
893
899

501
125
61
(2)
129
–
–
(71)
743
83.2¢

4,351 
(1,100)
3,251 
(2,210)
(231)
810 
4 
(11)
(1)
–
802 
(246)
556 

61.7¢
61.4¢
901
906

556 
31 
58 
– 
88 
– 
–
(40)
693 
76.9¢

1  Reconciliation of operating to trading profit is presented below.

2  Non-IFRS financial measures are explained and reconciled to the most directly comparable financial measure prepared in accordance with IFRS on pages 178–181.

3  Adjusted earnings per ordinary share is calculated by dividing adjusted attributable profit by the basic weighted number of shares.

Reconciliation of operating profit to trading profit

Operating profit
Acquisition related costs
Restructuring and rationalisation costs
Amortisation and impairment of acquisition intangibles
Legal and other
Trading profit

2017  
$ million

 934 
 (10)
 – 
 140 
 (16)
 1,048 

2016  
$ million

2015  
$ million

2014  
$ million

2013  
$ million

801
9
62
178
(30)
1,020

628
12
65
204
190
1,099

749
118
61
129
(2)
1,055

810
31 
58
88
–
987

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OTHER FINANCIAL INFORMATION continued

SELECTED FINANCIAL DATA continued

Group balance sheet
Non-current assets
Current assets
Total assets
Share capital
Share premium
Capital redemption reserve
Treasury shares
Retained earnings and other reserves
Total equity
Non-current liabilities
Current liabilities
Total liabilities
Total equity and liabilities

Group cash flow statement
Cash generated from operations
Net interest paid
Income taxes paid
Net cash inflow from operating activities
Capital expenditure (including trade investments and net of disposals 
of property, plant and equipment)
Acquisitions and disposals
Proceeds on disposal of business (net of tax)
Investment in associate
Proceeds from associate loan redemption
Proceeds from own shares
Equity dividends paid
Issue of ordinary capital and treasury shares purchased
Net cash flow from operating, investing and financing activities
Termination of finance lease
Exchange adjustments
Opening net debt
Closing net debt
Selected financial ratios
Gearing (closing net debt as a percentage of total equity)
Dividends per ordinary share
Research and development costs to revenue
Capital expenditure (including intangibles but excluding goodwill  
and trade investments) to revenue

2017  
$ million

2016  
$ million

2015  
$ million

2014  
$ million

2013  
$ million

 5,135 
 2,731 
 7,866 
 178 
 605 
 17 
 (257)
 4,101 
 4,644 
 1,876 
 1,346 
 3,222 
 7,866 

 1,273 
 (48)
 (135)
 1,090 

 (384)
 (159)
 – 
 – 
 – 
 5 
 (269)
 (47)
 236 
5
28
 (1,550)
 (1,281)

27.6%
 35.0¢1 
4.7%

4,815
2,529
7,344
180
600
15
(432)
3,595
3,958
2,038
1,348
3,386
7,344

1,035
(45)
(141)
849

(394)
(214) 
225
–
–
6
(279)
(358)
(165)
–
(24)
(1,361)
(1,550)

39%
30.8¢
4.9%

4,692
2,475
7,167
183
590
12
(294)
3,475
3,966
1,857
1,344
3,201
7,167

1,203
(36)
(137)
1,030

(360)
(44)
–
(25)
–
5
(272)
(61)
273
–
(21)
(1,613)
(1,361)

34%
30.8¢
4.8%

4,866
2,440
7,306
184
574
11
(315)
3,586
4,040
2,104
1,162
3,266
7,306

961
(33)
(245)
683

(379)
(1,552)
– 
(2)
188
4
(250)
(35)
(1,343)
–
(17)
(253)
(1,613)

40%
29.6¢
5.1%

7.9%

8.4%

7.7%

8.1%

3,563 
2,256 
5,819 
184 
535 
10 
(322)
3,640 
4,047 
699 
1,073 
1,772 
5,819 

1,138 
(6)
(265)
867 

(340)
(67)
– 
– 
–
3 
(239)
(183)
41 
–
(6)
(288)
(253)

6%
27.4¢
5.3%

7.8%

1  The Board has proposed a final dividend of 22.7 US cents per share which together with the first interim dividend of 12.3 US cents makes a total for 2017 of 35.0 US cents.

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OTHER FINANCIAL INFORMATION continued

NON-IFRS FINANCIAL INFORMATION – ADJUSTED MEASURES
These Financial Statements include financial measures that are not prepared in accordance with International Financial Reporting Standards (IFRS).
These measures, which include trading profit, trading profit margin, tax rate on trading results, EPSA, ROIC, trading cash flow, free cash flow, trading 
profit to trading cash conversion ratio, and underlying growth, exclude the effect of certain cash and non-cash items that Group management 
believes are not related to the underlying performance of the Group. These non-IFRS financial measures are also used by management to make 
operating decisions because they facilitate internal comparisons of performance to historical results.

Non-IFRS financial measures are presented in these Financial Statements as the Group’s management believe that they provide investors with 
a means of evaluating performance of the business segment and the consolidated Group on a consistent basis, similar to the way in which the 
Group’s management evaluates performance, that is not otherwise apparent on an IFRS basis, given that certain non-recurring, infrequent, non-
cash and other items that management does not otherwise believe are indicative of the underlying performance of the consolidated Group may not 
be excluded when preparing financial measures under IFRS. These non-IFRS measures should not be considered in isolation from, as substitutes 
for, or superior to financial measures prepared in accordance with IFRS.

Underlying revenue growth
‘Underlying growth in revenue’ is used to compare the revenue in a given year to the previous year on a like-for-like basis. This is achieved by 
adjusting for the impact of sales of products acquired in material business combinations or disposed of and for movements in exchange rates. 

Underlying growth in revenue is considered by the Group to be an important measure of performance in terms of local functional currency since  
it excludes those items considered to be outside the influence of local management. The Group’s management uses this non-IFRS measure  
in its internal financial reporting, budgeting and planning to assess performance on both a business and a consolidated Group basis. 
Revenue growth at constant currency is important in measuring business performance compared to competitors and compared to the growth of  
the market itself.

The Group considers that revenue from sales of products acquired in material business combinations results in a step-up in growth in revenue  
in the year of acquisition that cannot be wholly attributed to local management’s efforts with respect to the business in the year of acquisition. 
Depending on the timing of the acquisition, there will usually be a further step change in the following year. A measure of growth excluding the 
effects of business combinations also allows senior management to evaluate the performance and relative impact of growth from the existing 
business and growth from acquisitions. The process of making business acquisitions is directed, approved and funded from the Group corporate 
centre in line with strategic objectives.

The material limitation of the underlying growth in revenue measure is that it excludes certain factors, described above, which ultimately have a 
significant impact on total revenues. The Group compensates for this limitation by taking into account relative movements in exchange rates in its 
investment, strategic planning and resource allocation. In addition, as the evaluation and assessment of business acquisitions is not within the 
control of local management, performance of acquisitions is monitored centrally until the business is integrated. 

The Group’s management considers that the non-IFRS measure of underlying growth in revenue and the IFRS measure of growth in revenue are 
complementary measures, neither of which management uses exclusively.

‘Underlying growth in revenue’ reconciles to growth in revenue reported, the most directly comparable financial measure calculated in accordance 
with IFRS by making two adjustments, the ‘constant currency exchange effect’ and the ‘acquisitions and disposals effect’, described below.

The ‘constant currency exchange effect’ is a measure of the increase/decrease in revenue resulting from currency movements on non-US Dollar 
sales and is measured as the difference between: 1) the increase/decrease in the current year revenue translated into US Dollars at the current year 
average exchange rate and the prior revenue translated at the prior year rate; and 2) the increase/decrease being measured by translating current 
and prior year revenues into US Dollars using the prior year closing rate.

The ‘acquisitions and disposals effect’ is the measure of the impact on revenue from newly acquired material business combinations and recent 
material business disposals. This is calculated by comparing the current year, constant currency actual revenue (which include acquisitions 
and exclude disposals from the relevant date of completion) with prior year, constant currency actual revenue, adjusted to include the results 
of acquisitions and exclude disposals for the commensurate period in the prior year. These sales are separately tracked in the Group’s internal 
reporting systems and are readily identifiable.

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FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OTHER FINANCIAL INFORMATION continued

NON-IFRS FINANCIAL INFORMATION – ADJUSTED MEASURES continued
Reported revenue growth, the most directly comparable financial measure calculated in accordance with IFRS, reconciles to underlying growth in 
revenue as follows:

2017
Consolidated revenue by franchise

Sports Medicine, Trauma & Other
Sports Medicine Joint Repair
Arthroscopic Enabling Technologies 
Trauma & Extremities
Other Surgical Businesses
Reconstruction
Knee Implants
Hip Implants
Advanced Wound Management
Advanced Wound Care
Advanced Wound Bioactives
Advanced Wound Devices
Total

2016
Consolidated revenue by franchise

Sports Medicine, Trauma & Other
Sports Medicine Joint Repair
Arthroscopic Enabling Technologies 
Trauma & Extremities
Other Surgical Businesses
Reconstruction
Knee Implants
Hip Implants
Advanced Wound Management
Advanced Wound Care
Advanced Wound Bioactives
Advanced Wound Devices
Total

Reported growth
%

Underlying growth
%

Acquisitions/disposals
%

Reconciling items

Currency impact
%

 1 
 7 
 (3)
 4 
 (11)
 4 
 6 
 – 
 2 
 – 
 – 
 13 
 2 

 3 
 6 
 (3)
 4 
 7 
 3 
 5 
 – 
 2 
 – 
 – 
 13 
 3 

 (2)
 – 
 – 
 – 
 (19)
 – 
 – 
 – 
 – 
 – 
 – 
 – 
 (1)

 – 
 1 
 – 
 – 
 1 
 1 
 1 
 – 
 – 
 – 
 – 
 – 
 – 

Reported growth
%

Underlying growth
%

Acquisitions/disposals
%

Reconciling items

Currency impact
%

1
7
–
(4)
5
3
6
(1)
(3)
(5)
(1)
3
1

3
8
2
(4)
15
2
4
(1)
(1)
(3)
–
5
2

(1)
–
–
1
(9)
2
3
–
–
–
–
–
–

(1)
(1)
(2)
(1)
(1)
(1)
(1)
–
(2)
(2)
(1)
(2)
(1)

Trading profit, trading profit margin, trading cash flow and trading profit to cash conversion ratio
Trading profit, trading profit margin (trading profit expressed as a percentage of revenue), trading cash flow and trading profit to cash conversion 
ratio (trading cash flow expressed as a percentage of trading profit) are trend measures, which present the long-term profitability of the Group 
excluding the impact of specific transactions that management considers affect the Group’s short-term profitability and cash flows. The Group has 
identified the following items, where material, as those to be excluded from operating profit and cash generated from operations when arriving at 
trading profit and trading cash flow, respectively: acquisition and disposal related items arising in connection with business combinations, including 
amortisation of acquisition intangible assets, impairments and integration costs; restructuring events; gains and losses resulting from legal disputes 
and uninsured losses. In addition to these items, gains and losses that materially impact the Group’s profitability or cash flows on a short-term or 
one-off basis and the cash cost to fund defined benefit pension schemes that are closed to future accrual are excluded from operating profit and 
cash generated from operations when arriving at trading profit and trading cash flow, respectively.

Adjusted earnings per ordinary share (EPSA)
EPSA is a trend measure, which presents the long-term profitability of the Group excluding the post-tax impact of specific transactions that 
management considers affect the Group’s short-term profitability and the one-off impact of US tax reform. The Group presents this measure to 
assist investors in their understanding of trends. Adjusted attributable profit is the numerator used for this measure and is determined by adjusting 
attributable profit for the items that are excluded from operating profit when arriving at trading profit and items that are recognised below operating 
profit that affect the Group’s short-term profitability. The most directly comparable financial measure calculated in accordance with IFRS is basic 
earnings per ordinary share (‘EPS’).

SMITH & NEPHEW ANNUAL REPORT 2017 180

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OUR BUSINESS  
& MARKETPLACE

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REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OTHER FINANCIAL INFORMATION continued

NON-IFRS FINANCIAL INFORMATION – ADJUSTED MEASURES continued

2017 Reported 
Acquisition-related costs and profit on 
disposal
Restructuring and rationalisation costs 
Amortisation and impairment of acquisition 
intangibles 
Legal and other 7
US tax reform
Capital expenditure 
2017 Adjusted

Operating
profit1
$ million

 934 

Profit before 
tax2
$ million

 879

Attributable
profit4
$ million

Cash generated 
from operating
activities5
$ million

 767 

 1,273 

Taxation3
$ million

 (112)

Earnings
per share6
¢

 87.8 

 (10)
 – 

 140 
 (16)
 – 
 – 
 1,048 

 (10)
 –

 140
 (13)
 –
 –
 996

 2 
 – 

 (40)
 12 
 (32)
 – 
 (170)

 (8)
 – 

 100 
 (1)
 (32)
 – 
 826 

 3 
 15 

 – 
 25 
 – 
 (376)
 940 

 (0.9)
 – 

 11.4 
 (0.1)
 (3.7)
 – 
 94.5 

Revenue 
$ million

 4,765 

 – 
 – 

 – 
 – 
 – 
 – 
 4,765 

Acquisition-related costs and cash flows: For the year to 31 December 2017 the credit relates to a remeasurement of contingent consideration 
for a prior year acquisition partially offset by costs associated with the acquisition of Rotation Medical, Inc. 

Restructuring and rationalisation costs: There were no restructuring and rationalisation costs in the year to 31 December 2017. The restructuring 
and rationalisation cash flows relate to the implementation of the Group Optimisation plan that was announced in May 2014 and completed at the 
end of 2016.

Amortisation and impairment of acquisition intangibles: For the year to 31 December 2017 the charge relates to the amortisation of intangible 
assets acquired in material business combinations and an impairment charge of $10m.

Legal and other: For the year to 31 December 2017 the charge relates primarily to legal expenses for patent litigation with Arthrex, ongoing metal-
on-metal hip claims and an increase of $10m in the provision that reflects the present value of the estimated costs to resolve all other known 
and anticipated metal-on-metal hip claims. A $54m credit has been recognised in the year to 31 December 2017 following a settlement payment 
received from Arthrex relating to patent litigation. For the year to 31 December 2017 $44m of cash funding to closed defined benefit pension 
schemes is excluded from trading cash flow following the closure of the UK scheme to future accrual in December 2016.

2016 Reported 
Acquisition-related costs and profit on disposal
Restructuring and rationalisation costs 
Amortisation and impairment of acquisition 
intangibles 
Legal and other 
Capital expenditure 
2016 Adjusted

Operating
profit1
$ million

Profit before
tax2
$ million

Taxation3
$ million

Attributable
profit4
$ million

Cash generated 
from operating
activities5
$ million

Earnings
per share6
¢

801
9
62

178
(30)
–
1,020

 1,062
 (317)
 62

 178
 (20)
– 
 965

(278)
120
(14)

(59)
1
–
(230)

784
(197)
48

119
(19)
–
735

1,035
24
62

–
36
(392)
765

88.1
(22.2)
5.4

13.4
(2.1)
–
82.6

Revenue 
$ million

4,669
–
–

–
–
–
4,669

Acquisition-related costs and cash flows: For the year to 31 December 2016 these costs relate to the costs associated with the integration of 
Blue Belt Technologies and other acquisitions. Taxation and attributable profit include the effect of the disposal of the Gynaecology business. 

Restructuring and rationalisation costs: For the year to 31 December 2016 these costs primarily relate to the ongoing implementation of the 
Group Optimisation plan that was announced in May 2014. 

Amortisation and impairment of acquisition intangibles: For the year to 31 December 2016 these charges relate to the amortisation of 
intangible assets acquired in material business combinations and a total impairment of $48m including $32m relating to Oasis, a product acquired 
with the Healthpoint acquisition in 2013.

Legal and other: For the year to 31 December 2016 the net credit of $30m primarily relates to a $44m curtailment credit on post-retirement benefits 
in the UK pension scheme partially offset by legal expenses incurred for patent litigation with Arthrex. Also included is a net $1m credit in respect of 
insurance recoveries of $24m and legal expenses of $23m, relating to the ongoing metal-on-metal hip claims.

1  Represents a reconciliation of operating profit to trading profit.

2  Represents a reconciliation of reported profit before tax to trading profit before tax.

3  Represents a reconciliation of reported tax to trading tax.

4  Represents a reconciliation of reported attributable profit to adjusted attributable profit.

5   Represents a reconciliation of cash generated from operations to trading cash flow.

6   Represents a reconciliation of basic earnings per ordinary share to adjusted earnings per ordinary share (EPSA).

7  From 1 January 2017, the ongoing funding of closed defined benefit pension schemes is not included in management’s definition of trading cash flow as there is no defined benefit service cost for these schemes.

SMITH & NEPHEW ANNUAL REPORT 2017 181

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

OTHER FINANCIAL INFORMATION continued

NON-IFRS FINANCIAL INFORMATION – ADJUSTED MEASURES continued
Free cash flow
Free cash flow is a measure of the cash generated for the Group to use after capital expenditure according to its capital allocation framework, it is 
defined as the net cash flow from operating activities less: capital expenditure and cash flows from interest and income taxes. A reconciliation from 
net cash flow from operating activities, the most comparable IFRS measure, to free cash flow is set out below:

Net cash flow from operating activities
Capital expenditure
Interest received
Interest paid
Income taxes paid
Free cash flow

2017 
$ million

1,273
(376)
2
(50)
(135)
714

2016 
$ million

1,035
(392)
3
(48)
(141)
457

2015
$ million

1,203
(358)
8
(44)
(137)
672

Return on invested capital (ROIC)
Return on invested capital (ROIC) is a measure of the return generated on capital invested by the Group. It provides a metric for long-term value 
creation and encourages compounding reinvestment within the business and discipline around acquisitions with low returns and long payback. 
ROIC is defined as: Net Operating Profit less Adjusted Taxes/((Opening Net Operating Assets + Closing Net Operating Assets)/2). 

Operating profit
Taxation
Taxation adjustment1  
Net operating profit less adjusted taxes

Total equity
Retirement benefit asset
Investments 
Investments in associates
Cash at bank
Long term borrowings
Retirement benefit obligation
Bank overdrafts and loans
Net operating assets
Average net operating assets
Return on invested capital

1  Being the taxation on interest income, interest expense, other finance costs, share of results of associates and profit on disposal of business.

2017 
$ million

934
(112)
(10)
812

4,644
(62)
(21)
(118)
(169)
1,423
131
27
5,855
5,695
14.3%

2016
$ million

801
(278)
107
630

3,958
–
(25)
(112)
(100)
1,564
164
86
5,535
5,452
11.5%

2015 
$ million

3,966
(13)
(13)
(115)
(120)
1,434
184
46
5,369

SMITH & NEPHEW ANNUAL REPORT 2017 182

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FINANCIAL  
REVIEW

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ACCOUNTS

GROUP AND OTHER 
INFORMATION

OTHER FINANCIAL INFORMATION continued

CONTRACTUAL OBLIGATIONS
Contractual obligations at 31 December 2017 were as follows:

Debt obligations

Private placement notes
Operating lease obligations
Retirement benefit obligation
Purchase obligations
Capital expenditure
Other

Less than  
one year  
$ million

One to  
three years  
$ million

Payments due by period

Three to 
five years  
$ million

More than  
five years  
$ million

27

36
57
25
164
26
81
416

300

194
78
50
7
–
74
703

–

443
43
25
–
–
45
556

–

647
56
–
–
–
5
708

Other contractual obligations represent $45m of foreign exchange contracts and $160m of acquisition consideration. Provisions that do not relate to 
contractual obligations are not included in the above table.

The agreed contributions for 2018 in respect of the Group’s defined benefits plans are $25m for the UK Plan. 

There are a number of agreements that take effect, alter or terminate upon a change in control of the Company or the Group following a takeover, 
such as bank loan agreements and Company share plans. None of these are deemed to be significant in terms of their potential impact on the 
business of the Group as a whole. In addition, there are service contracts between the Company and its Executive Directors which provide for the 
automatic payment of a bonus following loss of office or employment occurring because of a successful takeover bid. Further details are set out on 
page 102.

The Company does not have contracts or other arrangements which individually are essential to the business.

EXCHANGE RATES
The Group publishes its consolidated financial statements expressed in US Dollars. The following tables provide certain information concerning the 
exchange rates between Sterling and US Dollars based on the Bank of England rate.

Year ended 31 December 
Year end
Average1
High
Low

1 The average of the Bank of England rates in effect on the last day of each month during the relevant period.

2017 

1.35
1.30
1.36
1.21

2016 

1.23
1.35
1.48
1.21

2015 

1.48
1.53
1.59
1.46

2014 

1.56
1.65
1.72
1.55

2013

1.66
1.56
1.66
1.48

High
Low

February
20181

January
2018

December
2017

November 
2017

October
2017

September
2017

1.42
1.38

1.43
1.35

1.35
1.33

1.35
1.31

1.33
1.31

1.36
1.30

1  Up to 16 February 2018, the latest practicable date for this Annual Report.

On 16 February 2018, the latest practicable date for this Annual Report, the Bank of England rate was US$1.40 per £1.00.

SMITH & NEPHEW ANNUAL REPORT 2017 183

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

2016 FINANCIAL HIGHLIGHTS

COMMENTARY ON THE INCOME STATEMENT
 – Group revenue increased by $35m, 1% on a reported basis, from $4,634m in 2015 to $4,669m in 2016. The underlying increase is 2%, after 

adjusting for 1% attributable to the unfavourable impact of currency movements.

 – Cost of goods sold increased by $129m, 11% on a reported basis, from $1,143m in 2015 to $1,272m in 2016. The movement is primarily due to 

underlying trading.

 – Selling, general and administrative expenses decreased by $275m (10% on a reported basis) from $2,641m in 2015 to $2,366m in 2016. In 2016, 

administrative expenses included amortisation of software and other intangible assets of $61m (2015: $66m), $62m of restructuring and 
rationalisation expenses (2015: $65m), an amount of $178m relating to amortisation and impairment of acquired intangibles (2015: $204m), $9m 
of acquisition related costs (2015: $12m) and $30m net credit primarily related to a $44m curtailment credit on UK post-retirement benefits (2015: 
$190m charge for legal and other charges). Excluding the above items, selling, general and administrative expenses were $2,086m in 2016, a 
decrease of $18m from $2,104m in 2015.

 – Research and development expenditure as a percentage of revenue remained broadly consistent at 4.9% in 2016 (2015: 4.8%). Expenditure  
was $230m in 2016 compared to $222m in 2015. The Group continues to invest in innovative technologies and products to differentiate it 
from competitors.

 – Operating profit increased by $173m from $628m in 2015 to $801m in 2016. This movement in 2016 was primarily driven by the absence of costs 

recognised in 2015 relating to anticipated and settled metal-on-metal hip claims.

 – Net interest expense increased by $8m from a net $38m expense in 2015 to a net $46m expense in 2016. This movement is primarily due to an 

increase in the effective interest rate and the increase in net debt due to the acquisition of Blue Belt Technologies.

 – Other finance costs in 2016 increased by $1m and principally relates to costs associated with the Group’s retirement benefit schemes.

 – The taxation charge increased by $129m to $278m from $149m in 2015 principally due to the tax charge on the disposal of the Gynaecology 

business. Our reported tax rate of 26.2% (2015: 26.7%) includes the one-off benefit of a US tax settlement which is partly offset by the tax rate on 
the disposal of the predominantly US Gynaecology business. 

COMMENTARY ON THE GROUP BALANCE SHEET
Non-current assets increased by $123m to $4,815m in 2016 from $4,692m in 2015. This is principally attributable to the following:

 – Property, plant and equipment increased by $50m from $932m in 2015 to $982m in 2016. There were $320m of additions together with $2m 

acquired with the Blue Belt acquisition which was partially offset by $21m of assets disposed. Depreciation of $224m was charged during 2016 
and there were unfavourable currency movements of $27m.

 – Goodwill increased by $176m from $2,012m in 2015 to $2,188m in 2016. This movement relates to additions of $211m from the acquisition of Blue 

Belt and BST-CarGel. This was partially offset by unfavourable currency movements of $35m.

 – Intangible assets decreased by $91m from $1,502m in 2015 to $1,411m in 2016. There were additions of $72m in 2016 relating to intellectual 

property, distribution rights and software acquired together with $85m acquired with the Blue Belt and BST-CarGel acquisitions. Amortisation and 
impairment during 2016 was $239m and there were unfavourable currency movements of $9m.

 – Investments increased to $25m from $13m in 2015. The increase was attributable to additions of $2m and fair value remeasurement of $10m.

 – Deferred tax assets decreased by $8m in the year from $105m in 2015 to $97m in 2016. The net deferred tax asset position is $3m (2015: asset of 
$28m). The decrease of $25m is due to tax accrual to tax return adjustments and current year utilisation of net deferred tax assets offset by the 
impact of acquisitions of $15m.

Current assets increased by $54m to $2,529m from $2,475m in 2015. The movement relates to the following:

 – Inventories rose by $27m to $1,244m in 2016 from $1,217m in 2015. This movement is driven by inventory increases in distribution hubs and 

general increase across the Emerging Markets. This was offset by unfavourable currency movements of $26m.

 – The level of trade and other receivables increased by $47m to $1,185m in 2016 from $1,138m in 2015. The movement primarily relates to increased 

trade receivables of $39m and $10m decrease in the bad debt provision as well as unfavourable currency movements.

 – Cash at bank has decreased by $20m from $120m in 2015 to $100m in 2016. 

Current liabilities increased by $4m from $1,344m in 2015 to $1,348m in 2016. This movement is attributable to:

 – Bank overdrafts and loans increased by $40m from $46m in 2015 to $86m in 2016.

 – Trade and other payables increased by $42m from $842m in 2015 to $884m in 2016 primarily due to deferred consideration for acquisitions 

made in 2016.

 – Provisions decreased by $46m from $193m in 2015 to $147m in 2016 primarily due to utilisation of the legal provision for known and anticipated 

metal-on-metal hip claims.

 – Current tax payables decreased by $32m from $263m in 2015 to $231m, mainly attributable to differences in the timing of cash tax payments 

year-on-year.

SMITH & NEPHEW ANNUAL REPORT 2017 184

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OUR BUSINESS  
& MARKETPLACE

OPERATIONAL 
REVIEW

FINANCIAL  
REVIEW

RISK

GOVERNANCE

ACCOUNTS

GROUP AND OTHER 
INFORMATION

INFORMATION FOR SHAREHOLDERS

FINANCIAL CALENDAR
Annual General Meeting

First quarter Trading Report
Payment of 2017 final dividend
Half year results announced
Third quarter Trading Report
Payment of 2018 interim dividend
Full year results announced
Annual Report available
Annual General Meeting

1  Dividend declaration dates.

12 April 2018

3 May 2018
9 May 2018
26 July 20181
1 November 2018
November 2018
February 20191
February/March 2019
April 2019

Annual General Meeting
The Company’s Annual General Meeting (‘AGM’) will be held on Thursday, 12 April 2018 at 2pm at No.11 Cavendish Square, London W1G 0AN. 
Registered shareholders have been sent either a Notice of Annual General Meeting or notification of availability of the Notice of Annual 
General Meeting.

Corporate headquarters and registered office
The corporate headquarters is in the UK and the registered office address is: Smith & Nephew plc, 15 Adam Street, London WC2N 6LA, UK.  
Registered in England and Wales No. 324357. Tel. +44 (0)20 7401 7646 website: www.smith-nephew.com.

SMITH & NEPHEW ANNUAL REPORT 2017 185

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OPERATIONAL 
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FINANCIAL  
REVIEW

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ACCOUNTS

GROUP AND OTHER 
INFORMATION

INFORMATION FOR SHAREHOLDERS continued

ORDINARY SHAREHOLDERS
Registrar
All general enquiries concerning shareholdings, dividends, changes to shareholders’ personal details and the AGM should be addressed to:

Computershare Investor Services plc, The Pavilions, Bridgwater Road, Bristol, BS99 6ZZ.

Tel: 0370 703 0047 
Tel: +44 (0) 117 378 5450 from outside the UK 
Website: www.investorcentre.co.uk

* 

 Lines are open from 8:30am to 5:30pm Monday to Friday, excluding public holidays in England and Wales.

SHAREHOLDER COMMUNICATIONS
We make quarterly financial announcements, which are made available through Stock Exchange announcements and on the Group’s website 
(www.smith-nephew.com). Copies of recent Annual Reports, press releases, institutional presentations and audio webcasts are also available 
on the website.

We send paper copies of the Notice of Annual General Meeting and Annual Report only to those shareholders and ADS holders who have elected 
to receive shareholder documentation by post. Electronic copies of the Annual Report and Notice of Annual General Meeting are available on the 
Group’s website at www.smith-nephew.com. Both ordinary shareholders and ADS holders can request paper copies of the Annual Report, which 
the Company provides free of charge. The Company will continue to send to ordinary shareholders by post the Form of Proxy notifying them of the 
availability of the Annual Report and Notice of Annual General Meeting on the Group’s website. If you elect to receive the Annual Report and Notice 
of Annual General Meeting electronically you are informed by e-mail of the documents’ availability on the Group’s website. ADS holders receive the 
Form of Proxy by post, but will not receive a paper copy of the Notice of Annual General Meeting. 

INVESTOR COMMUNICATIONS
The Company maintains regular dialogue with individual institutional shareholders, together with results presentations. To ensure that all members 
of the Board develop an understanding of the views of major investors, the Executive Directors review significant issues raised by investors with the 
Board. Non-Executive Directors are sent copies of analysts’ and brokers’ briefings. There is an opportunity for individual shareholders to question 
the Directors at the Annual General Meeting and the Company regularly responds to letters from shareholders on a range of issues. 

UK CAPITAL GAINS TAX
For the purposes of UK capital gains tax, the price of the Company’s ordinary shares on 31 March 1982 was 35.04p.

SMITH & NEPHEW SHARE PRICE
The Company’s ordinary shares are quoted on the London Stock Exchange under the symbol SN. The Company’s share price is available on 
the Smith & Nephew website www.smith-nephew.com and at www.londonstockexchange.com where the live financial data is updated with a 
15-minute delay.

AMERICAN DEPOSITARY SHARES (‘ADSS’) AND AMERICAN DEPOSITARY RECEIPTS (‘ADRS’)
In the USA, the Company’s ordinary shares are traded in the form of ADSs, evidenced by ADRs, on the New York Stock Exchange under the symbol 
SNN. Each American Depositary Share represents two ordinary shares. Deutsche Bank is the authorised depositary bank for the Company’s 
ADR programme.

ADS ENQUIRIES
All enquiries regarding ADS holder accounts and payment of dividends should be addressed to:

Deutsche Bank Shareholder Services 
American Stock Transfer and Trust Company 
Operations Centre 6201 15th Avenue 
Brooklyn, New York 
NY 11219

Tel: +1 866  249 2593 (toll free) 
E-mail: db@astfinancial.com 
Website: www.adr.db.com

The Deutsche Bank Global Direct Investor Services Program is available for US residents, enabling investment directly in ADSs with reduced 
brokerage commissions and service costs. For further information on Global Direct contact Deutsche Bank Shareholder Services (as above) or visit 
www.adr.db.com.

SMITH & NEPHEW ANNUAL REPORT 2017 186

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FINANCIAL  
REVIEW

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ACCOUNTS

GROUP AND OTHER 
INFORMATION

INFORMATION FOR SHAREHOLDERS continued

SMITH & NEPHEW ADS PRICE
The Company’s ADS price can be obtained from the official New York Stock Exchange website at www.nyse.com and the Smith & Nephew website 
www.smith-nephew.com where the live financial data is updated with a 15-minute delay, and is quoted daily in the Wall Street Journal. 

ADS PAYMENT INFORMATION
The Company hereby discloses ADS payment information for the year ended 31 December 2017 in accordance with the Securities and Exchange 
Commission rules 12.D.3 and 12.D.4 relating to Form 20-F filings by foreign private issuers. The depositary collects its fees for delivery and surrender 
of ADSs directly from investors depositing shares or surrendering ADSs for the purpose of withdrawal or from intermediaries acting for them. 
The depositary collects fees for making distributions to investors, including payment of dividends by the Company by deducting those fees from the 
amounts distributed or by selling a portion of distributable property to pay the fees. The depositary may collect its annual fee for depositary services 
by deductions from cash distributions or by directly billing investors or by charging the book-entry system accounts of participants acting for them. 
The depositary may generally refuse to provide fee-attracting services until its fee for those services are paid.

Persons depositing or withdrawing shares must pay

For

$5.00 (or less) per 100 ADSs (or portion of 100 ADSs)
$0.05 (or less) per ADS

$0.05 (or less) per ADS per calendar year
Registration or transfer fees

Taxes and other governmental charges the depositary or the  
custodian have to pay on any ADS or share underlying an ADS,  
for example, stock transfer taxes, stamp duty or withholding taxes
Any charges incurred by the depositary or its agents for servicing  
the deposited securities

Issuance of ADSs, including issuances resulting from a distribution  
of shares or rights or other property
Cancellation of ADSs for the purpose of withdrawal, including if the 
deposit agreement terminates
Any cash distribution to ADS registered holders, including payment  
of dividend
Depositary services
Transfer and registration of shares on our share register to or from  
the name of the depositary or its agent when shares are deposited  
or withdrawn
As necessary

As necessary

During 2017, a fee of one US cent per ADS was collected on the 2016 final dividend paid in May and a fee of one US cent per ADS was collected on 
the 2017 interim dividend paid in October. In the period 1 January 2017 to 16 February 2018, the total program payments made by Deutsche Bank 
Trust Company Americas were $599,992.

DIVIDEND HISTORY
Smith & Nephew has paid dividends on its ordinary shares in every year since 1937. Following the capital restructuring and dividend reduction in 
2000, the Group adopted a policy of increasing its dividend cover (the ratio of EPSA, as set out in the ‘Selected financial data’, to ordinary dividends 
declared for the year). This was intended to increase the financing capability of the Group for acquisitions and other investments. From 2000 to 
2004, the dividend increased in line with inflation and, in 2004, dividend cover stood at 4.1 times. Having achieved this level of dividend cover 
the Board changed its policy, from that of increasing dividends in line with inflation, to that of increasing dividends for 2005 and after by 10%. 
Following the redenomination of the Company’s share capital into US Dollars, the Board re-affirmed its policy of increasing the dividend by 10% a 
year in US Dollar terms.

On 2 August 2012, the Board announced its intention to pursue a progressive dividend policy, with the aim of increasing the US Dollar value  
of ordinary dividends over time broadly based on the Group’s underlying growth in earnings, while taking into account capital requirements and 
cash flows.

At the time of the full year results, the Board reviews the appropriate level of total annual dividend each year. The Board intends that the interim 
dividend will be set by a formula and will be equivalent to 40% of the total dividend for the previous year. Dividends will continue to be declared in 
US Dollars with an equivalent amount in Sterling payable to those shareholders whose registered address is in the UK, or who have validly elected 
to receive Sterling dividends.

An interim dividend in respect of each fiscal year is normally declared in July or August and paid in November. A final dividend will be 
recommended by the Board of Directors and paid subject to approval by shareholders at the Company’s Annual General Meeting.

Future dividends of Smith & Nephew will be dependent upon: future earnings; the future financial condition of the Group; the Board’s dividend 
policy; and the additional factors that might affect the business of the Group set out in ‘Special note regarding forward-looking statements’ and 
‘Risk Factors’.

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DIVIDENDS PER SHARE
The table below sets out the dividends per ordinary share in the last five years.

Pence per share:
Interim
Final
Total
US cents per share:
Interim
Final
Total

2017

2016

2015

2014

2013

Years ended 31 December

9.340
16.1831
25.523

12.300
22.700
35.000

10.080
14.420
24.500

12.300
18.500
30.800

8.533
14.300
22.833

13.111
19.000
32.111

7.578
13.574
21.152 

12.222
20.667
32.889

7.211
11.121 
18.332

11.556
18.889
30.445

1  Translated at the Bank of England rate on 16 February 2018.

From 6 April 2016 dividends below £5,000 per tax year became tax free and dividends above £5,000 per tax year became subject to personal 
income tax at the rate of 7.5% for basic rate taxpayers, 32.5% for higher rate taxpayers and 38.1% for additional rate taxpayers. A self-assessment 
form will therefore be required if your dividend income exceeds £5,000 per tax year. This will apply to both cash and dividend reinvestment plan 
(‘DRIP’) dividends, although dividends paid on shares held within pensions and ISAs will be unaffected, remaining tax free. Please note, with effect 
from 6 April 2018, the tax free allowance for dividend income will reduce from £5,000 to £2,000. This will impact the 2017 final dividend, which will 
be payable on 9 May 2018, subject to shareholder approval.

Dividends shown in the table above, prior to 6 April 2016, include the associated UK tax credit of 10%, but exclude the deduction of 
withholding taxes.

Since the second interim dividend for 2005, all dividends have been declared in US cents per ordinary share.

In respect of the proposed final dividend for the year ended 31 December 2017 of 22.7 US cents per ordinary share, the record date will be 6 April 
2018 and the payment date will be 9 May 2018. The Sterling equivalent per ordinary share will be set following the record date. Shareholders may 
elect to receive their dividend in either Sterling or US Dollars and the last day for election will be 20 April 2018. The ordinary shares will trade ex-
dividend on both the London and New York Stock Exchanges from 5 April 2018.

The proposed final dividend of 22.7 US cents per ordinary share, which together with the interim dividend of 12.3 US cents, makes a total for 2017  
of 35.00 US cents.

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SHARE PRICES
The table below sets out, for the periods indicated, the highest and lowest middle market quotations for the Company’s ordinary shares (as derived 
from the Daily Official List of the UK Listing Authority) and the highest and lowest sales prices of its ADSs (as reported on the New York Stock 
Exchange composite tape).

Year ended 31 December:
2013
20141
2015
2016
2017
Quarters in the year ended 31 December:
2016:
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
2017:
1st Quarter

2nd Quarter
3rd Quarter
4th Quarter
2018:
1st Quarter (to 16 February 2018)
Last six months:
August 2017
September 2017
October 2017
November 2017
December 2017
January 2018
February 2018 (to 16 February 2018)

High  
£

8.68
11.93
12.12
13.10
14.31

11.79
12.67
13.10
12.81

12.52

13.82
13.99
14.31

12.94

13.97
13.99
14.31
14.12
13.24
12.94
12.80

Ordinary shares

Low  
£

High  
US$

ADSs 

Low  
US$

6.80
8.57
10.60
10.51
11.70

10.51
11.12
12.11
10.67

11.70

12.16
12.94
12.79

12.15

13.16
13.08
13.59
13.10
12.79
12.31
12.15

71.85
97.27
37.78
35.06
38.50

34.80
34.97
35.06
32.97

31.71

35.71
37.17
38.50

37.20

36.40
37.17
38.50
37.42
36.13
37.20
36.54

52.90
29.39
32.48
27.11
29.90

30.55
31.43
32.37
27.11

29.90

30.98
33.87
34.62

34.12

34.99
35.53
36.10
35.50
34.62
34.58
34.12

1  On 14 October 2014, the ratio of ordinary shares per ADS changed from five ordinary shares per ADS to two ordinary shares per ADS. 

SHARE CAPITAL
The principal trading market for the ordinary shares is the London Stock Exchange. The ordinary shares were listed on the New York Stock Exchange 
on 16 November 1999, trading in the form of ADSs evidenced by ADRs. Each ADS represents two ordinary shares from 14 October 2014, before 
which time one ADS represented five ordinary shares. The ADS facility is sponsored by Deutsche Bank acting as depositary.

All the ordinary shares, including those held by Directors and Executive Officers, rank pari passu with each other. On 23 January 2006, the ordinary 
shares of 122/9p were redenominated as ordinary shares of US 20 cents (following approval by shareholders at the Extraordinary General Meeting in 
December 2005). The new US Dollar ordinary shares carry the same rights as the previous ordinary shares. The share price continues to be quoted 
in Sterling. In 2006, the Company issued £50,000 of shares in Sterling in order to comply with English law. These were issued as deferred shares, 
which are not listed on any stock exchange. They have extremely limited rights and therefore effectively have no value. These shares were allotted 
to the Chief Executive Officer, although the Board reserves the right to transfer them to another member of the Board should it so wish.

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SHARE CAPITAL continued
Shareholdings
As at 16 February 2018, to the knowledge of the Group, there were 14,877 registered holders of ordinary shares, of whom 96 had registered 
addresses in the USA and held a total of 207,045 ordinary shares (0.023% of the total issued). Because certain ordinary shares are registered in the 
names of nominees, the number of shareholders with registered addresses in the USA is not representative of the number of beneficial owners of 
ordinary shares resident in the USA.

As at 16 February 2018, 33,740,645 ADSs equivalent to 67,481,290 ordinary shares or approximately 7.7% of the total ordinary shares in issue, were 
outstanding and were held by 87 registered ADS holders.

Major shareholders
As far as is known to Smith & Nephew, the Group is not directly or indirectly owned or controlled by another corporation or by any Government and 
the Group has not entered into arrangements, the operation of which may at a subsequent date result in a change in control of the Group.

As at 16 February 2018, no persons are known to Smith & Nephew to have any interest (as defined in the Disclosure and Transparency Rules of 
the FCA) in 3% or more of the ordinary shares, other than as shown below. The following tables show changes over the last three years in the 
percentage and numbers of the issued share capital owned by shareholders holding 3% or more of ordinary shares, as notified to the Company 
under the Disclosure and Transparency Rules:

BlackRock, Inc.

BlackRock, Inc.

16 February 2018  
%

5.2

2017  
%

5.2

16 February 2018 
’000

46,427

2017  
’000

46,427

As at 31 December

2015  
%

5.2

2016  
%

5.2

2016  
’000

46,427

As at 31 December

2015  
’000

46,427

The Company is not aware of any person who has a significant direct or indirect holding of securities in the Company, and is not aware of 
any persons holding securities which may control the Company. There are no securities in issue which have special rights as to the control of 
the Company.

Purchase of ordinary shares on behalf of the Company
At the AGM, the Company will be seeking a renewal of its current permission from shareholders to purchase up to 10% of its own shares. In order to 
avoid shareholder dilution, shares allotted to employees through employee share schemes are bought back on a quarterly basis and subsequently 
cancelled by the Company. 

From 1 January 2017 to 16 February 2018, in the months listed below, the Company has purchased 2,907,586 ordinary shares at a cost of 
$50,112,844.04.

20-21 February 2017 (partial Q4 2016)
18-22 May 2017 (Q1 2017)
2 August 2017 (Q2 2017)
7-8 November 2017 (Q3 2017)
14-15 February 2018 (Q4 2017)

Total shares  
purchased  
000s

429
960
309
652
557

Average price  
paid per share  
pence

1,205.0589
1,324.2686
1,319.9881
1,384.7434
1,261.6308

Approximate US$ value  
of shares purchased  
under the plan

$6,451,301
$16,520,793
$5,410,073
$11,837,805
$9,892,872

The shares were purchased in the open market by J.P. Morgan Securities plc and Merrill Lynch International on behalf of the Company.

Exchange controls and other limitations affecting security holders
There are no UK governmental laws, decrees or regulations that restrict the export or import of capital or that affect the payment of dividends, 
interest or other payments to non-resident holders of Smith & Nephew’s securities, except for certain restrictions imposed from time to time by Her 
Majesty’s Treasury of the United Kingdom pursuant to legislation, such as the United Nations Act 1946 and the Emergency Laws Act 1964, against 
the Government or residents of certain countries.

There are no limitations, either under the laws of the UK or under the Articles of Association of Smith & Nephew, restricting the right of non-UK 
residents to hold or to exercise voting rights in respect of ordinary shares, except that where any overseas shareholder has not provided to the 
Company a UK address for the service of notices, the Company is under no obligation to send any notice or other document to an overseas 
address. It is, however, the current practice of the Company to send every notice or other document to all shareholders regardless of the country 
recorded in the register of members, with the exception of details of the Company’s dividend reinvestment plan, which are not sent to shareholders 
with recorded addresses in the USA and Canada.

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TAXATION INFORMATION FOR SHAREHOLDERS
The comments below are of a general and summary nature and are based on the Group’s understanding of certain aspects of current UK and 
US federal income tax law and practice relevant to the ADSs and ordinary shares not in ADS form. The comments address the material US and 
UK tax consequences generally applicable to a person who is the beneficial owner of ADSs or ordinary shares and who, for US federal income 
tax purposes, is a citizen or resident of the USA, a corporation (or other entity taxable as a corporation) created or organised in or under the laws 
of the USA (or any State therein or the District of Columbia), or an estate or trust the income of which is included in gross income for US federal 
income tax purposes regardless of its source (each a US Holder). The comments set out below do not purport to address all tax consequences of 
the ownership of ADSs or ordinary shares that may be material to a particular holder and in particular do not deal with the position of shareholders 
who directly or indirectly own 10% or more of the Company’s issued ordinary shares. This discussion does not apply to (i) persons whose holding of 
ADSs or ordinary shares is effectively connected with or pertains to either a permanent establishment in the UK through which a US Holder carries 
on a business in the UK or a fixed base from which a US Holder performs independent personal services in the UK, or (ii) persons whose registered 
address is inside the UK. This discussion does not apply to certain investors subject to special rules, such as certain financial institutions, tax-
exempt entities, insurance companies, broker-dealers and traders in securities that elect to use the mark-to-market method of tax accounting, 
partnerships or other entities treated as partnerships for US federal income tax purposes, US Holders holding ADSs or ordinary shares as part of 
a hedging, conversion or other integrated transaction or US Holders whose functional currency for US federal income tax purposes is other than 
the US Dollar. In addition, the comments below do not address the potential application of the provisions of the United States Internal Revenue 
Code known as the Medicare Contribution Tax, any alternative minimum tax consequences, any US federal tax other than income tax or any US 
state, local or non-US (other than UK) taxes. The summary deals only with US Holders who hold ADSs or ordinary shares as capital assets for tax 
purposes. The summary is based on current UK and US law and practice which is subject to change, possibly with retroactive effect. US Holders 
are recommended to consult their own tax advisers as to the particular tax consequences to them of the ownership of ADSs or ordinary shares. 
The Company believes, and this discussion assumes, that the Company was not a passive foreign investment company for its taxable year ended 
31 December 2017.

This discussion is based in part on representations by the depositary and assumes that each obligation under the deposit agreement and any 
related agreement will be performed in accordance with its terms. For purposes of US federal income tax law, US Holders of ADSs will generally 
be treated as owners of the ordinary shares represented by the ADSs. However, the US Treasury has expressed concerns that parties to whom 
depositary shares are released before shares are delivered to the depositary (pre-released) may be taking actions that are inconsistent with the 
claiming of foreign tax credits by owners of depositary shares. Such actions would also be inconsistent with the claiming of the reduced rate of 
tax, described below, applicable to dividends received by certain non-corporate US Holders. Accordingly, the availability of the reduced tax rate 
for dividends received by certain non-corporate US Holders of ADSs could be affected by actions that may be taken by parties to whom ADSs are 
pre-released.

Taxation of distributions in the UK and the USA
The UK does not currently impose a withholding tax on dividends paid by a UK corporation, such as the Company.

Distributions paid by the Company will generally be taxed as foreign source dividends to the extent paid out of the Company’s current or 
accumulated earnings and profits as determined for US federal income tax purposes. Because the Company does not maintain calculations of its 
earnings and profits under US federal income tax principles, it is expected that distributions generally will be reported to US Holders as dividends. 
Such dividends will not be eligible for the dividends-received deduction generally allowed to corporate US Holders.

Dividends paid to certain non-corporate US Holders of ordinary shares or ADSs may be subject to US federal income tax at lower rates than those 
applicable to other types of ordinary income if certain conditions are met. Non-corporate US Holders should consult their own tax advisers to 
determine whether they are subject to any special rules that limit their ability to be taxed at these favourable rates.

Taxation of capital gains
US Holders, who are not resident or ordinarily resident for tax purposes in the UK, will not generally be liable for UK capital gains tax on any capital 
gain realised upon the sale or other disposition of ADSs or ordinary shares unless the ADSs or ordinary shares are held in connection with a trade 
carried on in the UK through a permanent establishment (or in the case of individuals, through a branch or agency). Furthermore, UK resident 
individuals who acquire ADSs or ordinary shares before becoming temporarily non-UK residents may remain subject to UK taxation of capital gains 
on gains realised while non-resident.

For US federal income tax purposes, gains or losses realised upon a taxable sale or other disposition of ADSs or ordinary shares by US Holders 
generally will be US source capital gains or losses and will be long-term capital gains or losses if the ADSs or ordinary shares were held for more 
than one year. The amount of a US Holder’s gain or loss will be equal to the difference between the amount realised on the sale or other disposition 
and such holder’s tax basis in the ADSs, or ordinary shares, each determined in US Dollars.

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TAXATION INFORMATION FOR SHAREHOLDERS continued
Inheritance and estate taxes
The HM Revenue & Customs imposes inheritance tax on capital transfers which occur on death, and in the seven years preceding death. The HM 
Revenue & Customs considers that the US/UK Double Taxation Convention on Estate and Gift Tax applies to inheritance tax. Consequently, a US 
citizen who is domiciled in the USA and is not a UK national or domiciled in the UK will not be subject to UK inheritance tax in respect of ADSs and 
ordinary shares. A UK national who is domiciled in the USA will be subject to UK inheritance tax but will be entitled to a credit for any US federal 
estate tax charged in respect of ADSs and ordinary shares in computing the liability to UK inheritance tax. Special rules apply where ADSs and 
ordinary shares are business property of a permanent establishment of an enterprise situated in the UK.

US information reporting and backup withholding
Payments of dividends on, or proceeds from the sale of, ADSs or ordinary shares that are made within the USA or through certain US-related 
financial intermediaries generally will be subject to US information reporting, and may be subject to backup withholding, unless a US Holder is an 
exempt recipient or, in the case of backup withholding, provides a correct US taxpayer identification number and certain other conditions are met.

Any backup withholding deducted may be credited against the US Holder’s US federal income tax liability, and, where the backup withholding 
exceeds the actual liability, the US Holder may obtain a refund by timely filing the appropriate refund claim with the US Internal Revenue Service.

US Holders who are individuals or certain specified entities may be required to report information relating to securities issued by a non-US person 
(or foreign accounts through which the securities are held), subject to certain exceptions (including an exception for securities held in accounts 
maintained by US financial institutions). US Holders should consult their tax advisers regarding their reporting obligations with respect to the ADSs 
or ordinary shares.

UK stamp duty and stamp duty reserve tax
UK stamp duty is charged on documents and in particular instruments for the transfer of registered ownership of ordinary shares. Transfers of 
ordinary shares in certificated form will generally be subject to UK stamp duty at the rate of ½% of the consideration given for the transfer with the 
duty rounded up to the nearest £5.

UK stamp duty reserve tax (SDRT) arises when there is an agreement to transfer shares in UK companies ‘for consideration in money or money’s 
worth’, and so an agreement to transfer ordinary shares for money or other consideration may give rise to a charge to SDRT at the rate of ½% 
(rounded up to the nearest penny). The charge of SDRT will be cancelled, and any SDRT already paid will be refunded, if within six years of the 
agreement an instrument of transfer is produced to HM Revenue & Customs and the appropriate stamp duty paid.

Transfers of ordinary shares into CREST (an electronic transfer system) are exempt from stamp duty so long as the transferee is a member of CREST 
who will hold the ordinary shares as a nominee for the transferor and the transfer is in a form that will ensure that the securities become held in 
uncertificated form within CREST. Paperless transfers of ordinary shares within CREST for consideration in money or money’s worth are liable to 
SDRT rather than stamp duty. SDRT on relevant transactions will be collected by CREST at ½%, and this will apply whether or not the transfer is 
effected in the UK and whether or not the parties to it are resident or situated in the UK.

A charge of stamp duty or SDRT at the rate of 1½% of the consideration (or, in some circumstances, the value of the shares concerned) will arise 
on a transfer or issue of ordinary shares to the depositary or to certain persons providing a clearance service (or their nominees or agents) for the 
conversion into ADRs and will generally be payable by the depositary or person providing clearance service. In accordance with the terms of the 
Deposit Agreement, any tax or duty payable by the depositary on deposits of ordinary shares will be charged by the depositary to the party to 
whom ADRs are delivered against such deposits.

No liability for stamp duty or SDRT will arise on any transfer of, or agreement to transfer, an ADS or beneficial ownership of an ADS, provided 
that the ADS and any instrument of transfer or written agreement to transfer remains at all times outside the UK, and provided further that any 
instrument of transfer or written agreement to transfer is not executed in the UK and the transfer does not relate to any matter or thing done or to be 
done in the UK (the location of the custodian as a holder of ordinary shares not being relevant in this context). In any other case, any transfer of, or 
agreement to transfer, an ADS or beneficial ownership of an ADS could, depending on all the circumstances of the transfer, give rise to a charge to 
stamp duty or SDRT.

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ARTICLES OF ASSOCIATION
The following summarises certain material rights of holders of the Company’s ordinary shares under the material provisions of the Company’s 
Articles of Association and English law. This summary is qualified in its entirety by reference to the Companies Act and the Company’s Articles 
of Association. In the following description, a ‘shareholder’ is the person registered in the Company’s register of members as the holder of an 
ordinary share.

The Company is incorporated under the name Smith & Nephew plc and is registered in England and Wales with registered number 324357.

The Company’s ordinary shares may be held in certificated or uncertificated form. No holder of the Company’s shares will be required to make 
additional contributions of capital in respect of the Company’s shares in the future. In accordance with English law, the Company’s ordinary shares 
rank equally.

Directors
Under the Company’s Articles of Association, a Director may not vote in respect of any contract, arrangement, transaction or proposal in which 
he, or any person connected with him, has any material interest other than by virtue of his interests in securities of, or otherwise in or through, 
the Company. This is subject to certain exceptions relating to proposals (a) indemnifying him in respect of obligations incurred on behalf of the 
Company, (b) indemnifying a third party in respect of obligations of the Company for which the Director has assumed responsibility under an 
indemnity or guarantee, (c) relating to an offer of securities in which he will be interested as an underwriter, (d) concerning another body corporate 
in which the Director is beneficially interested in less than 1% of the issued shares of any class of shares of such a body corporate, (e) relating to an 
employee benefit in which the Director will share equally with other employees and (f) relating to any insurance that the Company is empowered to 
purchase for the benefit of Directors of the Company in respect of actions undertaken as Directors (and/or officers) of the Company.

A Director shall not vote or be counted in any quorum present at a meeting in relation to a resolution on which he is not entitled to vote.

The Directors are empowered to exercise all the powers of the Company to borrow money, subject to the limitation that the aggregate amount 
of all monies borrowed after deducting cash and current asset investments by the Company and its subsidiaries shall not exceed the sum 
of $6,500,000,000.

Any Director who has been appointed by the Directors since the previous Annual General Meeting of shareholders, either to fill a casual vacancy 
or as an additional Director holds office only until the conclusion of the next Annual General Meeting and then shall be eligible for re-election by 
the shareholders. The other Directors retire and are eligible for re-appointment at the third Annual General Meeting after the meeting at which they 
were last re-appointed. If not re-appointed, a Director retiring at a meeting shall retain office until the meeting appoints someone in his place, or if 
it does not do so, until the conclusion of the meeting. The Directors are subject to removal with or without cause by the Board or the shareholders. 
Directors are not required to hold any shares of the Company by way of qualification.

Under the Company’s Articles of Association and English law, a Director may be indemnified out of the assets of the Company against liabilities he 
may sustain or incur in the execution of his duties.

Rights attaching to ordinary shares
Under English law, dividends are payable on the Company’s ordinary shares only out of profits available for distribution, as determined in 
accordance with accounting principles generally accepted in the UK and by the Companies Act 2006. Holders of the Company’s ordinary shares 
are entitled to receive final dividends as may be declared by the Directors and approved by the shareholders in general meeting, rateable according 
to the amounts paid up on such shares, provided that the dividend cannot exceed the amount recommended by the Directors.

The Company’s Board of Directors may declare such interim dividends as appear to them to be justified by the Company’s financial position. 
If authorised by an ordinary resolution of the shareholders, the Board may also direct payment of a dividend in whole or in part by the distribution of 
specific assets (and in particular of paid up shares or debentures of the Company).

Any dividend unclaimed after 12 years from the date the dividend was declared, or became due for payment, will be forfeited and will revert to 
the Company.

There were no material modifications to the rights of shareholders under the Articles during 2017.

Voting rights of ordinary shares
Voting at any general meeting of shareholders is by a show of hands unless a poll, which is a written vote, is duly demanded and held. On a show 
of hands, every shareholder who is present in person at a general meeting has one vote regardless of the number of shares held. On a poll, every 
shareholder who is present in person or by proxy has one vote for each ordinary share held by that shareholder. A poll may be demanded by any of 
the following:

 – The chairman of the meeting;

 – At least five shareholders present or by proxy entitled to vote on the resolution;

 – Any shareholder or shareholders representing in the aggregate not less than one-tenth of the total voting rights of all shareholders entitled to vote 

on the resolution; or

 – Any shareholder or shareholders holding shares conferring a right to vote on the resolution on which there have been paid-up sums in aggregate 

equal to not less than one-tenth of the total sum paid up on all the shares conferring that right.

A Form of Proxy will be treated as giving the proxy the authority to demand a poll, or to join others in demanding one, as above.

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ARTICLES OF ASSOCIATION continued
The necessary quorum for a general meeting is two shareholders present in person or by proxy carrying the right to vote upon the business to 
be transacted.

Matters are transacted at general meetings of the Company by the processing and passing of resolutions of which there are two kinds; ordinary or 
special resolutions:

 – Ordinary resolutions include resolutions for the re-election of Directors, the approval of financial statements, the declaration of dividends (other 
than interim dividends), the appointment and re-appointment of auditors or the grant of authority to allot shares. An ordinary resolution requires 
the affirmative vote of a majority of the votes of those persons voting at the meetings at which there is a quorum.

 – Special resolutions include resolutions amending the Company’s Articles of Association, dis-applying statutory pre-emption rights or changing 
the Company’s name; modifying the rights of any class of the Company’s shares at a meeting of the holders of such class or relating to certain 
matters concerning the Company’s winding up. A special resolution requires the affirmative vote of not less than three-quarters of the votes of the 
persons voting at the meeting at which there is a quorum.

Annual General Meetings must be convened upon advance written notice of 21 days. Other general meetings must be convened upon advance 
written notice of at least 14 clear days. The days of delivery or receipt of notice are not included. The notice must specify the nature of the business 
to be transacted. Meetings are convened by the Board of Directors. Members with 5% of the ordinary share capital of the Company may requisition 
the Board to convene a meeting.

Variation of rights
If, at any time, the Company’s share capital is divided into different classes of shares, the rights attached to any class may be varied, subject to the 
provisions of the Companies Act, with the consent in writing of holders of three-quarters in nominal value of the issued shares of that class or upon 
the adoption of a special resolution passed at a separate meeting of the holders of the shares of that class. At every such separate meeting, all the 
provisions of the Articles of Association relating to proceedings at a general meeting apply, except that the quorum is to be the number of persons 
(which must be two or more) who hold or represent by proxy not less than one-third in nominal value of the issued shares of the class and at any 
such meeting a poll may be demanded in writing by any person or their proxy who hold shares of that class. Where a person is present by proxy or 
proxies, he is treated as holding only the shares in respect of which the proxies are authorised to exercise voting rights.

Rights in a winding up
Except as the Company’s shareholders have agreed or may otherwise agree, upon the Company’s winding up, the balance of assets available 
for distribution:

 – After the payment of all creditors including certain preferential creditors, whether statutorily preferred creditors or normal creditors; and

 – Subject to any special rights attaching to any other class of shares;

 – Is to be distributed among the holders of ordinary shares according to the amounts paid-up on the shares held by them. This distribution is 

generally to be made in US Dollars. A liquidator may, however, upon the adoption of any extraordinary resolution of the shareholders and any 
other sanction required by law, divide among the shareholders the whole or any part of the Company’s assets in kind.

Limitations on voting and shareholding
There are no limitations imposed by English law or the Company’s Articles of Association on the right of non-residents or foreign persons to hold or 
vote the Company’s ordinary shares or ADSs, other than the limitations that would generally apply to all of the Company’s shareholders.

Transfers of shares
The Board may refuse to register the transfer of shares held in certificated form which:

 – Are not fully paid (provided that it shall not exercise this discretion in such a way as to prevent stock market dealings in the shares of that class 

from taking place on an open and proper basis);

 – Are not duly stamped or duly certified or otherwise shown to the satisfaction of the Board to be exempt from stamp duty, lodged at the Transfer 
Office or at such other place as the Board may appoint and (save in the case of a transfer by a person to whom no certificate was issued in 
respect of the shares in question) accompanied by the certificate for the shares to which it relates, and such other evidence as the Board may 
reasonably require to show the right of the transferor to make the transfer and, if the instrument of transfer is executed by some other person on 
his behalf, the authority of that person so to do;

 – Are in respect of more than one class of shares; or

 – Are in favour of more than four transferees.

Deferred shares
Following the re-denomination of share capital on 23 January 2006, the ordinary shares’ nominal value became 20 US cents each. There were no 
changes to the rights or obligations of the ordinary shares. In order to comply with the Companies Act 2006, a new class of Sterling shares was 
created, deferred shares, of which £50,000 were issued and allotted in 2006 as fully paid to the Chief Executive Officer though the Board reserves 
the right to transfer them to another member of the Board should it so wish. These deferred shares have no voting or dividend rights and on 
winding up only are entitled to repayment at nominal value only if all ordinary shareholders have received the nominal value of their shares plus an 
additional US$1,000 each.

Amendments
The Company does not have any special rules about amendments to its Articles of Association beyond those imposed by law.

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CROSS REFERENCE TO FORM 20-F
This table provides a cross reference from the information included in this Annual Report to the requirements of Form 20-F. 

Part I
Item 1
Item 2
Item 3

Item 4

Item 4A
Item 5

Item 6

Item 7

Item 8

Item 9

Identity of Directors, Senior Management and Advisers
Offer Statistics and Expected Timetable
Key Information
A – Selected Financial Data
B – Capitalization and Indebtedness
C – Reason for the Offer and Use of Proceeds
D – Risk Factors
Information on the Company
A – History and Development of the Company
B – Business Overview
C – Organizational Structure
D – Property, Plant and equipment
Unresolved Staff Comments
Operating and Financial Review and Prospects
A – Operating results
B – Liquidity and Capital Resources
C – Research and Development, patents and licences, etc.
D – Trend information
E  – Off Balance Sheet Arrangements
F  – Tabular Disclosure of Contractual Obligations
G – Safe Harbor
Directors, Senior Management and Employees
A – Directors and Senior Management
B – Compensation
C – Board Practices
D – Employees
E  – Share Ownership
Major shareholders and Related Party Transactions
A – Major shareholders
  – Host Country shareholders
B – Related Party Transactions
C – Interests of experts and counsel
Financial information
A – Consolidated Statements and Other Financial Information
  – Legal Proceedings
  – Dividends
B – Significant Changes
The Offer and Listing
A – Offer and Listing Details
B – Plan of Distribution
C – Markets
D – Selling shareholders
E  – Dilution
F  – Expenses of the Issue

Page
n/a
n/a

176–177
n/a
n/a
172–175

165–171, 184
2–47, 121–124, 169–175, 183
7, 136–137, 167–168
131–132, 171
None

6–7, 36–39, 172–175, 183
39, 140–142, 158-159
3, 5, 13, 125
16–17, 38-39, 171–175
171
182
200

50–55
79–105
50–78
25–28, 126
91, 93, 162

189
189
162, 171
n/a

107–162
149–150
186-187
None

188–189
n/a
188
n/a
n/a
n/a

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CROSS REFERENCE TO FORM 20-F continued

Part I
Item 10

Item 11
Item 12

Part II
Item 13
Item 14
Item 15
Item 16

Part III
Item 17
Item 18
Item 19

Additional Information
A – Share capital
B – Memorandum and Articles of Association
C – Material Contracts
D – Exchange Controls
E  – Taxation
F  – Dividends and Paying Agents
G – Statement by Experts
H – Documents on Display
I  – Subsidiary Information
Quantitative and Qualitative Disclosure about Market Risk
Description of Securities other than Equity Securities
A – Debt securities
B – Warrants and rights
C – Other securities
D – American Depositary shares

Defaults, Dividend Arrearages and Delinquencies
Material Modifications to the Rights of Security Holders and Use of Proceeds
Controls and Procedures
(Reserved)
A – Audit Committee Financial Expert
B – Code of Ethics
C – Principal Accountant Fees and Services
D – Exemptions from the Listing Standards for Audit Committees
E  – Purchases of Equity Securities by the Issuer and Affiliated Purchasers
F  – Change in Registrant’s Certifying Accountant
G – Corporate Governance
H – Mine Safety Disclosure

Financial Statements
Financial Statements
Exhibits

Page

n/a
192–193
n/a
189
190–191
n/a
n/a
200
167–170
143–147, 171–175

n/a
n/a
n/a
185–186

None
None
71–78
n/a
71
78
75–76, 126
n/a
157, 189
n/a
56
n/a

n/a
107–162

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GLOSSARY OF TERMS
Unless the context indicates otherwise, the following terms have the meanings shown below: 

Term
ACL
ADR

ADS
Arthroscopic Enabling Technologies

Advanced Wound Bioactives

Advanced Wound Care

Advanced Wound Devices

AGM
Arthroscopy

Basis Point
Chronic wounds 

Company

Companies Act
Emerging Markets
EPSA

Endoscopy

Established Markets

Euro or €
FDA
Financial statements
FTSE 100
Group or Smith & Nephew

Health economics

Hip Implants
IFRIC

IFRS

Knee implants

LSE
MHRA

Meaning
The anterior cruciate ligament (ACL) is one of the four major ligaments in the human knee.
In the US, the Company’s ordinary shares are traded in the form of American Depositary Shares 
evidenced by American Depositary Receipts (ADRs).
In the US, the Company’s ordinary shares are traded in the form of American Depositary Shares (ADSs).
A product group which includes a variety of technologies such as fluid management equipment for 
surgical access, high definition cameras, digital image capture, scopes, light sources and monitors to 
assist with visualisation inside the joints, radio frequency, electromechanical and mechanical tissue 
resection devices, and hand instruments for removing damaged tissue.
A product group which includes biologics and other bioactive technologies that provide unique 
approaches to debridement and dermal repair/regeneration.
A product group which includes products for the treatment and prevention of acute and chronic wounds, 
including leg, diabetic and pressure ulcers, burns and post-operative wounds.
A product group which includes traditional and single-use Negative Pressure Wound Therapy and 
hydrosurgery systems.
Annual General Meeting of the Company.
Endoscopy of the joints is termed ‘arthroscopy’, with the principal applications being the knee 
and shoulder.
One hundredth of one percentage point.
Chronic wounds are those with long or unknown healing times including leg ulcers, pressure sores and 
diabetic foot ulcers.
Smith & Nephew plc or, where appropriate, the Company’s Board of Directors, unless the context 
otherwise requires.
Companies Act 2006, as amended, of England and Wales.
Emerging Markets include Greater China, India, Brazil and Russia.
EPSA (Adjusted earnings per ordinary share) is a trend measure, which presents the long-term 
profitability of the Group excluding the post-tax impact of specific transactions that management 
considers affects the Group’s short-term profitability. The Group presents this measure to assist investors 
in their understanding of trends. Adjusted attributable profit is the numerator used for this measure and 
is determined by adjusting attributable profit for the items that are excluded from operating profit when 
arriving at trading profit and items that are recognised below operating profit that affect the Group’s short-
term profitability.
Through a small incision, surgeons are able to see inside the body using a monitor and identify and 
repair defects.
Established Markets include United States of America, Europe, Australia, New Zealand, Canada 
and Japan.
References to the common currency used in the majority of the countries of the European Union.
US Food and Drug Administration.
Refers to the consolidated Group Accounts of Smith & Nephew plc.
Index of the largest 100 listed companies on the London Stock Exchange by market capitalisation.
Used for convenience to refer to the Company and its consolidated subsidiaries, unless the context 
otherwise requires.
A branch of economics concerned with issues related to efficiency, effectiveness, value and behaviour in 
the production and consumption of health and healthcare.
A product group which includes specialist products for reconstruction of the hip joint.
International Financial Reporting Interpretations as adopted by the EU and as issued by the International 
Accounting Standards Board.
International Financial Reporting Standards as adopted by the EU and as issued by the International 
Accounting Standards Board.
A product group which includes an innovative range of products for specialised knee replacement 
procedures.
London Stock Exchange.
The Medicines and Healthcare products Regulatory Agency in the UK.

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Parent Company
Pound Sterling, Sterling, £, pence or p References to UK currency. 1p is equivalent to one hundredth of £1.
SEC
Sports Medicine Joint Repair

GLOSSARY OF TERMS continued

Term
Negative Pressure Wound Therapy

NHS
NYSE
Orthopaedic products

Other Surgical Businesses

OXINIUM

Trading results

Trauma & Extremities

UK
Underlying growth

US
US Dollars, $ or cents or ¢

Meaning
A technology used to treat chronic wounds such as diabetic ulcers, pressure sores and post-operative 
wounds through the application of sub-atmospheric pressure to an open wound.
The UK National Health Service.
New York Stock Exchange.
Orthopaedic reconstruction products include joint replacement systems for knees, hips and shoulders 
and support products such as computer-assisted surgery and minimally invasive surgery techniques. 
Orthopaedic trauma devices are used in the treatment of bone fractures including rods, pins, screws, 
plates and external frames. Clinical therapies products include joint fluid therapy for pain reduction of the 
knee and an ultrasound treatment to accelerate the healing of bone fractures.
A product group which includes robotics-assisted surgery, various products and technologies to assist in 
surgical treatment of the ear, nose and throat, and gynaecological instrumentation, until the Gynaecology 
business disposal in August 2016.
OXINIUM material is an advanced load bearing technology. It is created through a proprietary 
manufacturing process that enables zirconium to absorb oxygen and transform to a ceramic on the 
surface, resulting in a material that incorporates the features of ceramic and metal. Management believes 
that OXINIUM material used in the production of components of knee and hip implants exhibits unique 
performance characteristics due to its hardness, low-friction and resistance to roughening and abrasion.
Smith & Nephew plc.

US Securities and Exchange Commission.
The Sports Medicine Joint Repair franchise includes instruments, technologies and implants necessary to 
perform minimally invasive surgery of joints. 
Trading profit, trading profit margin (trading profit expressed as a percentage of revenue), trading cash 
flow and trading profit to cash conversion ratio (trading cash flow expressed as a percentage of trading 
profit) are trend measures, which present the long-term profitability of the Group excluding the impact 
of specific transactions that management considers affect the Group’s short-term profitability and 
cash flows. The Group has identified the following items, where material, as those to be excluded from 
operating profit and cash generated from operations when arriving at trading profit and trading cash flow, 
respectively: acquisition and disposal related items arising in connection with business combinations, 
including amortisation of acquisition intangible assets, impairments and integration costs; restructuring 
events; gains and losses resulting from legal disputes and uninsured losses. In addition to these items, 
gains and losses that materially impact the Group’s profitability or cash flows on a short-term or one-off 
basis and the cash cost to fund defined benefit pension schemes that are closed to future accrual are 
excluded from operating profit and cash generated from operations when arriving at trading profit and 
trading cash flow, respectively.
A product group which includes internal and external devices used in the stabilisation of severe fractures 
and deformity correction procedures.
United Kingdom of Great Britain and Northern Ireland.
Growth after adjusting for the effects of currency translation and the inclusion of the comparative impact 
of acquisitions and exclusion of disposals.
United States of America.
References to US currency. 1 cent is equivalent to one hundredth of US$1.

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INDEX
2016 Financial highlights
Accounting Policies
Accounts Presentation
Acquisitions
Acquisition related costs
American Depositary Shares
Articles of Association
Audit fees
Board
Business overview
Business segment information
Cash and borrowings
Chairman’s statement
Chief Executive Officer’s review
Chief Financial Officer’s review
Company balance sheet
Company notes to the accounts
Contingencies
Contractual obligations
Corporate Governance Statement
Critical judgements and estimates
Cross Reference to Form 20-F
Currency fluctuations
Currency translation
Deferred taxation
Directors’ Remuneration Report
Directors’ responsibility statement
Dividends
Earnings per share
Employees/People
Employee share plans
Ethics and compliance
Executive Officers
Factors affecting results of operations
Financial instruments
Financial review
Glossary of terms
Goodwill
Group balance sheet
Group cash flow statement
Group companies
Group history
Group income statement
Group notes to the accounts
Group overview
Group statement of changes in equity
Group statement of comprehensive income
Independent auditor’s reports

Information for shareholders
Intangible assets
Intellectual property
Interest and other finance costs
Inventories
Investments
Investment in associates
Key Performance Indicators 
Leases 
Legal and other
Legal proceedings 
Liquidity and capital resources
Manufacturing and quality
New accounting standards
Off-balance sheet arrangements
Operating profit 
Other finance costs
Our marketplace
Outlook and trend information

Parent Company accounts
People/Employees 
Provisions 
Property, plant and equipment 
Regulation 
Related party transactions 
Research and development 
Restructuring and rationalisation expenses
Retirement benefit obligation 
Risk factors
Risk report 
Sales and marketing
Selected financial data 
Share based payments 
Share capital 
Strategic priorities 
Sustainability
Taxation
Taxation information for shareholders 
Total shareholder return
Trade and other payables
Trade and other receivables
Training and education
Treasury shares 

183
114, 119–120
199
15, 37, 159–161
123, 180
185–186
192–193
76, 126
50–53
6–7, 171–175
18–24, 121–124
140–142
2–3
4–5
36–37
163
165–170
148–150, 166
182
56
114
194–195
173
120
129
79–105
107
158, 186–187
3, 37, 38, 130–131
25–28
162
32, 69–70
54–55
175
143–147
38–39
196–197
133–134
116
117
167–168
171
115
119–162
6–7, 171
118
115
108–113

184–200
134–135
149–150
126
137
136
136–137
11–15, 39
142, 161
123, 180
149–150
39, 142
29–30
119–120
171
125–126
126
16–17
16–17, 38–39, 
171–175
163–170
25–28
148–150
131–132
17, 43
162, 171
28–29
123, 180
150–155
172–175
40–49
30–31
176–177
162
156–158, 188–189
10–15
33–35
127–129
190–191
94
139
138–139
32
157

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IRAN NOTICE
Section 13(r) of the Exchange Act requires issuers to make specific disclosure in their annual reports of certain types of dealings with Iran, including 
transactions or dealings with Iranian government-owned entities, as well as dealings with entities sanctioned for activities related to terrorism or 
proliferation of weapons of mass destruction, even when those activities are not prohibited by US law and do not involve US persons. The Group 
does not have a legal entity based in Iran, but in 2017 it exported certain medical devices to Iran, via sales by non-US entities, to a new privately 
owned Iranian distributor for sale in Iran. Prior to 2017, the Group had sold products via non-US entities to a privately owned distributor based in  
the UAE who sold products into Iran. In both cases, sales were to hospitals that we understand are owned or controlled by the Government of Iran. 

The Group’s direct and indirect sales of US origin medical devices into Iran are permitted pursuant to section 560.530(a)(3)(i) of the Iranian 
Transactions and Sanctions Regulations, and its indirect sales of non-US origin medical devices into Iran are made in accordance with applicable 
law. The Group also provides training to its distributor(s) and surgeons in Iran as necessary and ordinarily incident to the safe and effective use  
of the medical devices, which is also permitted by applicable law. In 2017, the Group’s gross revenues from sales to Iran were approximately $5.2m 
and net losses were approximately $4.0m, due in part to the transition to the new distributor. For prior years, approximate gross revenues and net 
profits of the Group from sales to Iran were: 2016: gross revenues $1.2m, net losses $0.4m; 2015: gross revenues $4.0m, net profits $0.8m; 2014: 
gross revenues $3.8m, net profits $1.1m; and 2013: gross revenues $3.5m, net profits $1.2m.

The Group is reporting the entire gross revenues and net profits for the activities described above, which figures include sales of US origin medical 
devices. The Group has included sales of US origin medical devices in the total gross revenue and net profit figures above as it does not separately 
break out revenues and profits by country of origin. The Group intends to continue to engage in the activities described above in accordance with 
applicable law.

ABOUT SMITH & NEPHEW 
The Smith & Nephew Group (the Group) is a global medical devices business operating in the markets for advanced surgical devices comprising 
orthopaedic reconstruction and trauma, sports medicine and advanced wound management, with revenue of approximately $4.8bn in 2017. Smith 
& Nephew plc (the Company) is the Parent Company of the Group. It is an English public limited company with its shares listed on the premium 
list of the UK Listing Authority and traded on the London Stock Exchange. Shares are also traded on the New York Stock Exchange in the form of 
American Depositary Shares (ADSs). 

This is the Annual Report of Smith & Nephew plc for the year ended 31 December 2017. It comprises, in a single document, the Annual Report 
and Accounts of the Company in accordance with UK requirements and the Annual Report on Form 20-F in accordance with the regulations of 
the United States Securities and Exchange Commission (SEC). 

Smith & Nephew operates on a worldwide basis and has distribution channels in over 100 countries. The Group is engaged in a single business 
activity, being the development, manufacture and sale of medical technology products and services. The Group is structured as two geographical 
selling regions: US and International; with a president for each who is responsible for the commercial view of that region. Research & Development, 
Manufacturing, Supply Chain and Central functions are managed globally for the Group as a whole. 

Smith & Nephew’s corporate website, www.smith-nephew.com, gives additional information on the Group, including an electronic version of this 
Annual Report. Information made available on this website, or other websites mentioned in this Annual Report, are not and should not be regarded 
as being part of, or incorporated into, this Annual Report. 

For the convenience of the reader, a Glossary of technical and financial terms used in this document is included on pages 196–197. The product 
names referred to in this document are identified by use of capital letters and the ◊ symbol (on first occurrence) and are trademarks owned by or 
licensed to members of the Group. 

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PRESENTATION 
The Group’s fiscal year end is 31 December. References to a particular year in this Annual Report are to the fiscal year, unless otherwise indicated. 
Except as the context otherwise requires, ‘Ordinary Share’ or ‘share’ refer to the ordinary shares of Smith & Nephew plc of 20 US cents each. 

The Group Accounts of Smith & Nephew in this Annual Report are presented in US Dollars. Solely for the convenience of the reader, certain parts 
of this Annual Report contain translations of amounts in US Dollars into Sterling at specified rates. These translations should not be construed as 
representations that the US Dollar amounts actually represent such Sterling amounts or could be converted into Sterling at the rate indicated. 

Unless stated otherwise, the translation of US Dollars and cents to Sterling and pence in this Annual Report has been made at the Bank of England 
exchange rate on the date indicated. On 16 February 2018, the latest practicable date for this Annual Report, the Bank of England rate was US$1.40 
per £1.00.

The results of the Group, as reported in US Dollars, are affected by movements in exchange rates between US Dollars and other currencies. 
The Group applied the average exchange rates prevailing during the year to translate the results of companies with functional currency other than 
US Dollars. The currencies which most influenced these translations in the years covered by this report were Sterling, Swiss Franc and the Euro. 

The Accounts of the Group in this Annual Report are presented in millions (m) unless otherwise indicated. 

SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS 
The Group’s reports filed with, or furnished to, the US Securities and Exchange Commission (SEC), including this document and written information 
released, or oral statements made, to the public in the future by or on behalf of the Group, contain ‘forward-looking statements’ within the meaning 
of the US Private Securities Litigation Reform Act of 1995, that may or may not prove accurate. For example, statements regarding expected revenue 
growth and trading profit margins discussed under ‘Outlook’ and ‘Strategic Priorities’, market trends and our product pipeline are forward-looking 
statements. Phrases such as ‘aim’, ‘plan’, ‘intend’, ‘anticipate’, ‘well-placed’, ‘believe’, ‘estimate’, ‘expect’, ‘target’, ‘consider’ and similar expressions 
are generally intended to identify forward-looking statements. Forward-looking statements involve known and unknown risks, uncertainties and 
other important factors that could cause actual results, to differ materially from what is expressed or implied by the statements. 

For Smith & Nephew, these factors include: economic and financial conditions in the markets we serve, especially those affecting healthcare 
providers, payers and customers; price levels for established and innovative medical devices; developments in medical technology; regulatory 
approvals, reimbursement decisions or other government actions; product defects or recalls; litigation relating to patent or other claims; legal 
compliance risks and related investigative, remedial or enforcement actions; strategic actions, including acquisitions and dispositions and our 
success in performing due diligence, valuing and integrating acquired businesses; disruption that may result from transactions or other changes we 
make in our business plans or organisation to adapt to market developments and numerous other matters that affect us or our markets, including 
those of a political, economic, business, competitive or reputational nature; relationships with healthcare professionals; reliance on information 
technology. Specific risks faced by the Group are described under ‘Risk factors’ on pages 172–175 of this Annual Report. Any forward-looking 
statement is based on information available to Smith & Nephew as of the date of the statement. All written or oral forward-looking statements 
attributable to Smith & Nephew are qualified by this caution. Smith & Nephew does not undertake any obligation to update or revise any forward-
looking statement to reflect any change in circumstances or in Smith & Nephew’s expectations. 

PRODUCT DATA 
Product data and product share estimates throughout this report are derived from a variety of sources including publicly available competitors’ 
information, internal management information and independent market research reports. 

DOCUMENTS ON DISPLAY 
It is possible to read and copy documents referred to in this Annual Report at the Registered Office of the Company. Documents referred to in this 
Annual Report that have been filed with the Securities and Exchange Commission in the US may be read and copied at the SEC’s public reference 
room located at 450 Fifth Street, NW, Washington DC 20549. Please call the SEC at 1-800-SEC-0330 for further information on the public reference 
rooms and their copy charges. The SEC also maintains a website at www.sec.gov that contains reports and other information regarding registrants 
that file electronically with the SEC. This Annual Report and some of the other information submitted by the Group to the SEC may be accessed 
through the SEC website.

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The inks used are renewable, biodegradable and emit 
fewer Volatile Organic Compounds (VOCs) than mineral-
oil inks. They are based on high levels of renewable raw 
materials such as vegetable oils and naturally occurring 
resin. The inks do not contain any toxic heavy metals 
and therefore, do not pose a problem if placed in landfill.

Designed and Produced by Radley Yeldar.

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Smith & Nephew plc 
15 Adam Street 
London WC2N 6LA 
United Kingdom

T  +44 (0) 20 7401 7646

enquiries@smith-nephew.com 

www.smith-nephew.com