Spire Healthcare Group (SPI) H2 2025 earnings summary

Executive summary

• Delivered resilient performance in FY25 despite significant cost inflation, NHS commissioning changes, and rising labor costs, focusing on private growth, transformation, and efficiency.

• Strategic priorities included expanding private multi-payer strategy, transformation for efficiency, primary care growth, and care quality, with successful delivery of £30m in cost savings and new clinic openings.

• NHS volumes slowed sector-wide in H2 2025 due to budgetary constraints, but self-pay volumes returned to growth by year-end.

• Ongoing strategic review may include a potential sale, property value generation, or operational adjustments.

• Maintained high quality of care, with 98% of sites rated good or outstanding and high patient and consultant satisfaction.

Financial highlights

• Total revenue grew 4.5% year-over-year; hospital revenue up 4.3%.

• Adjusted EBITDA increased 3.2% to £268.6m; adjusted profit before tax down 7.4% to £46.5m.

• Adjusted free cash flow rose 64.9% to £64.3m; CapEx reduced 30% to £78.5m, now 5% of group revenue.

• ROCE was 8% (8.5% excluding National Insurance and minimum wage increases).

• Statutory profit after tax declined to £17.2m, impacted by cost inflation and one-off items.

Outlook and guidance

• Expecting mid to high single-digit private revenue growth in 2026; self-pay up ~6% in Q1.

• NHS revenue expected down ~25% in Q1 2026, with Q2–Q4 NHS revenue down 5–10% year-over-year.

• Adjusted EBITDA for 2026 targeted broadly in line with 2025.

• CapEx guidance for FY26 at ~£80m, with continued focus on cash flow and lower capex as % of revenue.

• Effective tax rate expected between 25%–35%.