Annual Report 2020: Positive results after a gruelling pandemic year

2020 was defined by the pandemic, which had a profound impact on the inhabitants of the county of Stockholm and for all operations in Region Stockholm. Despite the strain, the region can present a positive result which will be used to tackle the financial challenges that lie ahead. This is clear from the Region Stockholm’s Annual Report for 2020, adopted by the Regional Council.

The result for 2020 amounted to SEK 5,802 million, compared to the budgeted annual result of SEK 311 million. The result is SEK 4,305 million higher than 2019. The positive result can mainly be explained by one-off items such as lower pension costs, capital gains from property sales, as well as temporary pandemic-related contributions.

In connection with the adoption of the annual accounts, the surplus will be set aside in a profit equalisation reserve (RUR). It will act as an insurance, in order to be able to ensure continued high accessibility for the inhabitants of the county of Stockholm to public transport and healthcare.

- 2020 is unparalleled in Region Stockholm’s history. Regional operations faced perhaps the most difficult challenges ever, and they have adapted and shown their commitment in a tremendous manner. I want to direct our heartfelt gratitude to all employees in the region, to everyone who works for the region and to all its partners for your incredible hard work. Your contributions have meant that the region, in any given situation, could meet the needs of Stockholmers for both intensive care and regular care, and that we had both protective equipment for employees and drugs for patients. Buses and trains have run on schedule to reduce the spread of infection, and at the same time maintain the need for public transport. These tremendous efforts have saved lives, says Regional Chair for Finance, Irene Svenonius.

The healthcare service was completely defined by COVID-19
During the majority of 2020, virtually all operations have focused on dealing with the COVID-19 pandemic and its effects. Operations and resources in the healthcare service have been redirected. New forms of collaboration have been established and production coordination between healthcare providers has been strengthened. During the spring, capacity in intensive care quadrupled, from about 90 to 400 beds, including Capio S:t Görans.  In the late autumn and winter, when the second wave arrived, the need for ICU beds increased again, while there were still other patient groups requiring medical care, which increased demands on the healthcare service considerably, and just before the end of the year, the so called Emergency Agreement was reactivated.

COVID-19 has affected public health in a very tangible way. As of December 31 2020, a total of 121,874 people had been infected throughout the course of the year, of whom 3,452 died.

The pandemic also impacted healthcare consumption in the region. Doctor’s visits decreased by 18 percent compared to 2019. The number of other visits, such as nurse visits, physiotherapy, occupational therapy, speech therapy and podiatry decreased by nine percent. The greatest impact could be seen in the spring. At the same time, remote contacts increased dramatically, such as within general practitioner services, where they increased by 1,300 percent compared with 2019.

The number of medical care events in inpatient care declined by 2.8 percent, which corresponds to 9,000 medical care events, primarily within somatic specialist care. In emergency care, the number of medical care events fell by 1.7 percent from the previous year. In 2020, 16.1 visits to doctors and other healthcare providers, which was a decrease by 12.8 percent compared to the previous year. The number of doctor’s visits was 5.9, million, a decrease of 18.0 percent. The number of visits to other healthcare providers was 10.2 million, which was a decrease of 9.4 percent.

At the same time, Region Stockholm received a positive validation of the high quality of its healthcare services. According to a ranking published in Newsweek in early March, Karolinska University Hospital was ranked the tenth most distinguished hospital in the world. The ranking included hospitals in 20 countries and was based on a weighting of medical results, patient-reported quality/experience, and recommendations from employees in the healthcare sector in 2020.

COVID-19 led to a dramatic decrease in the use of public transport.
For the public transport system, the pandemic meant that the number of passengers halved overnight and revenue fell sharply, while all services ran ran on schedule to reduce the risk of congestion and thereby prevent the spread of infection. Communication campaigns have been carried out to urge passengers not to travel unless they have to. Where the risk of congestion was greatest, extra services were added.

Travel fell drastically during the year but despite the challenges brought about by the pandemic, the Transport Committee has maintained consistent levels of production and operation. In January and February 2020, passenger volumes were normal and unaffected by the pandemic. From mid-April, travel decreased by up to 50 percent, and at the end of the year was at 64.5 percent of the level of terrestrial public transport in 2019.

Other significant events for public transport in 2020:

  • The new Underground train, C30, was put into service on the Underground's Red Line.
  • Delivery and commissioning of the new A35 train for the Light Rail network.
  • Upgrades to the C20 Underground trains are approved for serial production
  • Roslagsbanan's new Vallentuna depot had its final inspection.
  • Kista and Solnagren on the Light Rail network have been connected.
  • The number 83 boat line, the new commuter route between Vaxholm and Strömkajen commenced. 
  • A new version of the SL app and the website was launched.

Regional development

Steps were taken within the scope of the region's mandate to mitigate the effects of the pandemic on the business community. There has been extensive collaboration with the municipalities, as well as with the County Administrative Board, state agencies, academia, other regions, organisations and the business community, to create the best possible conditions in difficult times. The pandemic led to a sharp economic downturn that has affected large parts of the business community, in the Stockholm region, nationally and globally. The crisis impacted the businesses in the region in different ways. In some industries, demand has fallen sharply, with furloughing and notifications of redundancy as a result. In Sweden, more than 120,000 people have been given notice of redundancy since the beginning of March 2020. Notifications of redundancy increased most in Region Stockholm, which accounts for just under 50 percent of all redundancies in the country.

During the pandemic, Region Stockholm has worked actively to support the regional business community and the labour market. Meetings are being held regularly with business stakeholders in the region in which both politicians and officials participate. During the year, a web service was developed where companies that need work or have manpower available, can post what they can offer. In the same way, companies that need manpower can post their requirements.


COVID-19 has also had a major impact on the cultural life of the county. Above all, it is the restriction of public gatherings that has had far-reaching consequences for the stakeholders, which has only been partially offset by various support measures. Steps were therefore taken within the scope of the region's mandate to mitigate the effects on the culture sector. In the spring of 2020, it was decided that funds intended for cancelled events would not be reclaimed.

Stockholm has the potential to grow as an attractive film region in Europe, and in 2020, the partnership with the City of Stockholm in this respect has been intensified, with the aim of making the Stockholm region film-production friendly and that more stories from the region should be presented. The Culture Committee decided in their June meeting to propose to the Regional Executive Committee that in turn would propose to the Council that a regionally owned company be formed, with the task of supporting film production in the county. The decision to do so was made by the Council in December 2020.


The investments made by Region Stockholm amounted to SEK 10,916 million, which is SEK 4,018 million below budget. The deviation is due to the effects of the COVID-19 pandemic on property investments within healthcare, and the postponement of major investments within public transport.

Major investments will continue in the healthcare service  and public transport.

- It is positive to see that Region Stockholm continues to report a good financial result, not least considering the extensive investments in future healthcare services and public transport. Furthermore, there will be increasing costs for the transfer of tax revenue, decreasing general government grants over the coming years, as well as the prospect of the region not being fully compensated for the loss of ticket revenue within public transport, says Irene Svenonius, Regional Chair for Finance in Region Stockholm.

- The good result for the year gives us opportunities to manage risks in the future, but does not decrease the need to constantly improve and streamline regional operations in order to provide the inhabitants of the region with the best possible value for their tax money through good quality and accessibility.

Find out more in the Region Stockholm Annual Report

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