Welcome to the Careium Q4 presentation for 2022. For the first part of the conference call, the participants will be in listen-only mode. During the questions and answer session, participants are able to ask questions by dialing star five on their telephone keypad. Now, I will hand the conference over to CEO Maria Khorsand and CFO Mathias Carlsson. Please go ahead.
Thank you very much. It is a pleasure for us to present our quarter four report. Strongest quarter both on sales and operating profit. We demonstrate continued success in winning and implementing new contracts in Sweden, and our product sales in U.K. increased by 131%, reflecting transformation from analog to digital. We launched the alarm-triggered Elis, which is designed as a piece of jewelry to minimize stigma. The rollout in Norway of digital keys for home care is ongoing. Our action program to get back to profit is in place and has given results. Careium now is well-equipped to capitalize on growth opportunities in the care sector. We demonstrate strong sales development of 29.9% supported by growth in all regions.
The continued organic growth of 20.9% in the quarter and 16.6% in the full year. Services sales have gone up to SEK 145.1 million. That's an increase of 14.4% compared to Q4 2021. Our product sales amounted to SEK 51.1 million, which is an increase of 43.9%. We delivered a gross margin of 39.4% in the quarter despite this cost of components. During the quarter, we began the rollout in Norway of digital keys for home care. That's a system which simplifies the process for both caregivers and users. The new alarm-triggered Elis was launched in Q4. Elis is designed as a piece of jewelry.
It is a piece of jewelry with the aim of minimizing the stigma as a way of increasing usage and safety. In the Nordic market, we increased the sales by 16% compared to quarter four 2021. Of course, we have several new contract implemented in the quarter. We have good performance in service delivery despite high risk of sick leave towards the end of the year in our alarm receiving centers. We are proud of that. We are very proud of that. The number of connections at the end of the period equals to 134,700. That's an increase of 10.5% compared to quarter four 2021. In U.K., we increased sales by 33.5% compared to quarter four 2021.
Our product sales went up to 131% compared to Q4 2021, and 88% for the full year. The digital transformation has gained momentum during 2022, and the continued work of the restructuring of the region is leading it to lower costs for both service delivery and administration. In Central Europe, we increased sales up to 13.6% compared to Q4 2021. The service sales increased mainly to increase of number of connections in the Netherlands. The number of connections at the end of the period went up to 29,700, which is an increase of 9.5%. Other markets, mainly represented by product sales in France, have showed a decrease of 35.2%, that's mainly due to accounting error last year. Now to the profitability of Q4 2022.
We are really proud of that. Adjusted EBITDA amounted to SEK 35.1 million compared to 18.4 same period last year. Including the restructuring cost, EBITDA amounted to SEK 31.5 million, and that's compared to 17 for the same period last year. Adjusted EBIT amounted to SEK 16.5 million compared to one same period last year. Including the restructuring cost, EBIT amounted to SEK 13.2 million compared to -0.4 last year. The improved profitability is mainly explained by growth in sales and measures taken to decrease operating costs. The results include SEK 7.2 million of income from reversal of provisions for earnouts. Operating profit, excluding affecting comparability, amounted to SEK 9.3 million for the quarter.
The most impressive part of this picture, this slide, is actually the journey that we've had, that we've been to from minus SEK 18 million of the EBIT in Q3 2022 to plus SEK 16 million in Q4 in the EBIT for 2022. We are really proud of that. Of course, the action program to get to profit is completed, and it included restructuring of the U.K. operations, including the closing of offices, increased efficiency in contact center, field services, implementation of common system for service delivery, implementation of new systems for private pay billing, and increased efficiency in administration. We streamlined our sales organization by joining other regions and markets and creating a bigger Nordic region, which is really good. We merged our product management and our technology development to strengthen our portfolio going forward.
Most of all, we created smaller, more unified, stronger, and a very committed management team that we are extremely happy about. The action program is expected to increase operating profit by SEK 60 million-SEK 80 million on annual basis. The total transformation cost in 2022 amounted to around SEK 25 million. To our cash flow Q4. The cash flow from current activities during the Q4 amounted to SEK -32.7 million. The negative change in the working capital compared to Q4 2021 is explained mainly for temporary increase working capital balance as high sales towards the end of the quarter tied up capital account receivables and also by accounts payable paid down during the quarter, thereby a negative cash flow for the right reasons. That's important to note.
The free cash flow went up then to SEK 153.4 million, and the cash totaled to SEK 39.9 million at the end of the year. In addition, the bank overdraft facility showed available cash of SEK 20.8 million compared to zero same period last year. Net debt amounted to SEK 253.6 million at the end of the fourth quarter, compared with net debt of SEK 204.8 million at the end of the previous quarter and a net debt of SEK 149.7 million at the end of the fourth quarter 2021. At the end of the quarter, Careium complies with agreed bank covenant waivers, which is very important to note. A few concluding remarks.
Of course, we are so happy about the strong sales and the good organic growth in quarter four. The action program to get back to profit is in place and has given a lot of good results. The growth margin, we managed to maintain it despite the increased cost of components. We launched Eliza, our jewelry, and the digital keys for home care, which are very important. Of course, we dealt with challenges. Challenges fulfilled service delivery and field services in U.K. You know what? We performed really good. We turned it around, and our performance now is fantastic. The negative cash flow that we've shown due to temporary increase in working capital are for the right reasons.
Going forward, the priorities and the opportunities we see, if I could elaborate a little bit on them, we of course will continue to improve in U.K. our service delivery. We put competence, our employees, our leadership, our culture high up our agenda. We will build strong relationship with our customers. We will continue doing that, and we broaden our product and services offering. We want to take a market leader position for care sector in Europe. Now, to conclude my presentation, I would like to thank our employees. You're just fantastic and you're great. Our partners and our customers who give us confidence and trust. We will do our best to deliver to you. By these words, I hand over to you for question and answers, which Mathias Carlsson and I are gonna do our best to answer. With that over.
If you wish to ask a question, please dial star five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial star five again on your telephone keypad. The next question comes from Oskar Räftegård from ABG. Please go ahead.
Hi, Maria and Mathias. Thank you for taking my questions. First of all, I just want to hear your thoughts on the cash flow again. Inventory levels came down a little bit from Q3, supporting the cash flow, actually. As you mentioned, you had accounts receivables coming up, I don't know, like SEK 15 million, SEK 16 million, I think. It seems like the working capital effect is largely driven by the paid payables. Is that how to assume it, or is it anything else that I'm missing here?
Before I hand over to Mathias, just a couple of words on it. There are actually two major components which impact the cash flow. At the end of the year, mainly in December, we've had fantastic product sales. We did a great job on that. Then on top of that, we paid for the components that we have. These two in combination impact the cash flow at short term in a negative way. Can you please handle?
Yeah. It's exactly as Maria explains, that we had quite a lot of accounts payable at the end of Q3 due to building up the inventories. Those we have paid off to a large extent during Q4 and not done as much purchases as we did in Q3, consequently lowering the inventories at the same time. In my or in our view, we have a negative free cash flow, yes, but, and the working capital is negative, but it's not bad working capital build-up. It is related to us paying our bills and selling on a high level at the end of the quarter.
All right. I see. Brilliant. Just a follow-up. Would you expect the working capital rebound to occur already in Q1, or should we expect that to, like, gradually come in 2020? Because you built up quite a lot of working capital during the entire 2022, right? Should we expect, like, a massive rebound Q1, Q2? Anything you can elaborate?
Yeah. We don't really like to do forecasts if you say so, but, I don't expect that we need to build up more working capital. I wouldn't dare to say that it will decrease radically in Q1, but, I don't expect that we will see the same build-up of working capital also in Q1. It will be probably be much less effect.
As I mentioned before, it was a short-term impact in quarter four.
Understood. Understood. Yeah. Sorry for my sort of negative comments in this quarter. Let's see. Also one, just one question on, related to cash flow. Just the CapEx came up, it was SEK 21 million in the quarter. Is that sort of seasonality effect, or do you expect that to be sort of the run rate going forward? Should it be more like SEK 13 million, SEK 14 million, like Q2, Q3?
You say that the part of the CapEx coming up is related also to the demand of our product, because it's not only that we have good product sales, we also deliver a lot of hardware or products on our rental contracts. When we rent a lot of new products, we will also have higher CapEx. It is, yeah. It's related to the demand of our products, you could say.
Understood. I have just one question on sort of the relationship with the bank now, because obviously you say that you comply with the waiver that the bank gave you. Are there any concerns from your side about the relationship with the bank and the bank waiver? Do you have, like, tough KPIs to meet here? Are you feeling pretty comfortable with the bank's financing situation?
We feel confident.
Yeah. Yeah.
Perfect. Clear. Clear message. Just the final one, I have just a question on the margin going forward, because the margin improvement was, I mean, very steep in the quarter between Q3 and in Q4. Just, I mean, in terms of the run rate, both on... I mean, the gross margin came up quite a bit, and then obviously the adjusted EBIT margin and EBITDA margin as well. The gross margin, we say that, I mean, is it fair to assume that that's going to come up a bit further? Do you have, like, any sort of normalized gross margin where you expect it to arrive at?
Yeah. I would say that the gross margin reflects a bit also the sales, because even though, of course, you could say that the cost in gross margin is variable, it is not totally variable. If we have high sales, we will get better gross margin also. The cost for the alarm receiving centres, those are recorded as within the gross margin, and they are of course variable, but not variable in a very short sense, you say. Yeah. It's a little bit related to how much sales we manage in that quarter.
All right. Understood. I think that was all for me. Thank you very much for taking my questions.
Thank you very much.
Thank you.
There are no more questions at this time from the telephone, so I hand the conference back to the speakers.
Thank you very much. Thank you very much for being part of this meeting and listening to us and taking part of our presentation. Look forward to cooperation with all of you going forward. Thank you.