New York City’s Hospital for Special Surgery Engages in Second Knowledge Transfer to Improve Healthcare in British Hospitals

New York, NY—April 18, 2005

Manhattan's Hospital for Special Surgery (HSS), a world leader in orthopedic surgery and research, today announced an alliance with U.K.-based Tribal Group plc (Tribal) to transfer knowledge of its best practices in orthopedic patient care and treatment protocols to Tribal's wholly owned subsidiary, Mercury Health. Mercury won a £214 million contract in 2004 from Great Britain's National Health Service (NHS) to design, set up and manage a regional network of five treatment centers in the south of England. HSS will work with Mercury Health to develop a center in Brighton, located in mid-Sussex.

This alliance is the second knowledge transfer HSS has undertaken with the British public health service in its efforts to improve health care in hospitals across England by incorporating HSS best practices for hip and knee replacement surgery. Last March, after a three-year knowledge transfer consulting program with HSS, the NHS opened a new center, the Southwest London Elective Orthopedic Center (SWLEOC), which has experienced significantly improved patient outcomes.

Under this knowledge transfer with Mercury Health, HSS will help Mercury's new centers perform a range of inpatient and elective surgery and diagnostic procedures. Through an exchange program between Mercury Health staff and HSS staff, HSS will provide Mercury Health with advisory services and best practices in orthopedics focusing on patient education, care pathways, infection control and physical therapy. HSS also will provide access to operating processes and protocols, as well as clinical operating data.

Henry Pitman, chief executive of Tribal, said: "The strategic agreement with HSS enhances the capabilities of our healthcare business, Mercury Health, in the delivery of elective surgery and diagnostic procedures in the U.K."

HSS Chief Executive Officer and President John Reynolds, who will lead the HSS team working with and advising Mercury Health, said: "At HSS, we perform more than 16,000 orthopedic surgeries a year. We've developed protocols that improve outcomes and simultaneously decrease the length of patient stays and reduce costs. We look forward to working with Mercury Health and Tribal Group."

HSS's first knowledge transfer was initiated after a study conducted by the Royal College of Surgeons and the British Orthopaedic Association in 2000 on outcomes for hip replacement surgery in the U.K. found patients experienced long waiting times followed by lengthy hospital stays for hip and knee replacements. Furthermore, a quarter of the patients left the hospital with severe walking restrictions. The NHS designated HSS as a resource partner for knowledge transfer with four NHS trusts in Southwest London and HSS began working with the trusts in 2000 to replicate the HSS patient-focused system of care at every level by transferring its quality models of infection control, patient education and patient "throughput" and rehabilitation protocols.

After instituting HSS' best practices, SWLEOC began conducting elective hip and knee replacements in January 2004, performed by surgeons from each of these four NHS trusts. The center has seen a significant reduction in costs, improved outcomes and increased patient satisfaction. Length of stay rates have decreased by more than 50% with the average length of stay dropping from an average of more than 12 days to 6.2 days. As a result, the waiting times for hip surgery are expected to decrease to an average of six months compared to the current wait of 12 to 18 months. In England, cutting the length of stay to six days will translate into an estimated savings of £1,500 per patient according to the Health Service Journal.

About Tribal Group plc
Tribal Group plc provides a range of consultancy, support and managed services to the UK public sector. The group's core markets are in education; local government, housing and regeneration; health and social care; and central government. The group employs 1,900 staff in the UK. Tribal is quoted on the London Stock Exchange (TRB.L) with forecast revenues for 2006 of over £260 million.