Spire Healthcare plc is the largest listed healthcare group by revenue in the UK$.$ The group operates approximately $40$ private hospitals units.

Below is the summary of Spire's Statement of Cash Flows during the period $20152018.$

$\backslash$table$[[,\backslash$table$[[\backslash$table$[[2018],[($fM$)]]]],\backslash$table$[[\backslash$table$[[2017],[($fM$)]]]],\backslash$table$[[\backslash$table$[[2016],[($M$)]]]],\backslash$table$[[\backslash$table$[[2015],[($fM$)]]]]],[$Net cash from operating activities,$116\mathrm{.}3,124\mathrm{.}0,177\mathrm{.}4,155\mathrm{.}3],[$Net cash from investing activities,$(68),(118\mathrm{.}3),(149\mathrm{.}9),(109\mathrm{.}6)],[$Net cash from financing activities,$(39\mathrm{.}8),(34\mathrm{.}4),(38\mathrm{.}5),(41\mathrm{.}3)],[$Net increase$/$decrease in cash,$8\mathrm{.}5,(28\mathrm{.}7),(11\mathrm{.}0),4\mathrm{.}4]]$

Required:

Comment on the trends that you observe across the three types of activities. What do these trends tell you about Spire's strategy? Are there any encouraging or worrying signs that warrant closer attention? What type of additional information might you want to review from the other financial statements to corroborate your findings?