Spire Healthcare Group Plc · LSE:SPI
Spire Healthcare — Investor Presentation (June 2025)
34 slides from Spire Healthcare's investor presentation, June 2025
Slide 1: Investor introduction
Investor introduction June 2025
Slide 2: Forward-looking statements
These materials contain certain forward-looking statements relating to the business of Spire Healthcare Group plc (the “Company”), including with respect to the progress, timing and completion of the Company’s development, the Company’s ability to treat, attract, and retain patients and customers, i
Slide 3: Company overview
Company overview QZ Spire Healthcare
Slide 4: Spire Healthcare – Leading independent healthcare group in the UK
Spire Healthcare – Leading independent healthcare group in the UK Integrated Spire network, leveraging brand power and cross-referrals ▪ UK’s largest independent integrated healthcare group by turnover Hospitals • 38 hospitals Primary care • #1 in talking therapies >1m people cared for ▪ 38 hospital
Slide 5: Strong financial and quality track record
Strong financial and quality track record Revenue 8% CAGR Highest ever EBITDA Strong conversion to Profit Before Tax £m £m £m 1,511.2 260.0 1,600 1,359.0 234.0 60 50.2 250 50 1,400 1,198.5 203.5 38.8 1,106.2 185.7 189.0 178.2 40 1,200 980.8 200 161.1 931.1 919.9 30 20.0 1,000 +11.2% 17.2% 12.8 14.1
Slide 6: Strong balance sheet further supported by £1.4bn of property freehold
Strong balance sheet further supported by £1.4bn of property freehold 6.6x 5.9x 5.5x 5.0x 4.8x Acquisition of Claremont Acquisition of The 3.9x Doctors Clinic Acquisition of Hospital Group Vita Health Group 2.3x 2.2x 2.2x 2.0x FY 2020 FY 2021 FY 2022 FY 2023 FY 2024 Leverage Ratio (Bank) Leverage Ra
Slide 7: Good progress delivering against our medium-term objectives
Good progress delivering against our medium-term objectives 2022 2024 Target/framework measure Hospital Growth +8.3% +5.5%1 >5% revenue CAGR Medium-term financial Hospital EBITDA margin 17.0% 18.0% EBITDA >21% objectives Hospital EBIT margin 8.8% 10.3% EBIT >13% ROCE 6.2% 8.2% >10% New Services reve
Slide 8: £12bn fast growing market opportunity
£12bn fast growing market opportunity Cross-referrals from Primary to Secondary care Primary care Hospital care Market value £6bn | Market growth 6% Market value c£6bn | Market growth 5% Diagnostics Market value £1-1.5bn | Market growth 2% Occupational Health (employers) Market value £1.5-2bn | Mark
Slide 9: Strategic update
Strategic update QZ Spire Healthcare
Slide 10: Our model for success – making a positive difference to people's lives
Group Our model for success – making a positive difference to people’s lives Build scale and access Invest in high return growth Focus on efficiency Lead on quality and experience Balance sheet strength supported by a highly valued property estate Deliver strong financial performance and investor re
Slide 11: Building scale and access in attractive sectors
Group Building scale and access in attractive sectors Integrated Spire network, leveraging brand power and cross-referrals Hospitals (1m patients) Primary Care (300k patients) Where we are Where we’re going Where we are Where we’re going • 38 hospitals • Infill hospitals where • Largest independent
Slide 12: Hospitals: a relentless focus on quality
pit Hos als Hospitals: a relentless focus on quality • Patient Incident Response Framework implemented Strong patient safety culture • Colleague and patient voice paramount • Strong Freedom to Speak Up culture • 23-hour hip and knee pathways Innovation driving the • Growing cardiology / cardiac prov
Slide 13: Hospitals: successfully accelerating efficiencies
pit Hos als Hospitals: successfully accelerating efficiencies >£80m New in-year Automation / digitalisation Prior year continuation • Digitalising patient booking/ check-ins • Optimising back-office processes Our guidance / initial plan (e.g. Pharmacy procurement) >£50m One best way • Implementing s
Slide 14: Hospitals: investing for growth and efficiency
pit Hos als Hospitals: investing for growth and efficiency Hospital capex FY24: Hospital capex £99m Growth c£40m Maintenance c£59m • Minor operations unit at Spire • Ongoing hospital refurbs = Total Hospital capex as % of Hospital revenue Claremont • IT infrastructure • Five new MRIs • Automation /
Slide 15: Primary Care: incremental market segments driving synergies into the Hospital business
Primary Primary Care: incremental market segments driving synergies into care the Hospital business Targeting new healthcare segments with lower capex that enhances Hospital referrals and capacity utilisation Clinics Vita for the NHS Spire for Business Outpatient GP Physio led • Small format • Small
Slide 16: Primary Care: balanced levers to deliver £40m EBITDA ambition
Primary Primary Care: balanced levers to deliver our ambition of a £40m EBITDA care business in the medium term £40m Primary Care grows 6% annually in a highly EBITDA fragmented market Balanced levers to reach £40m EBITDA: organic growth, rollout and small M&A Lower capex than Hospitals – services d
Slide 17: 2024 Results Highlights
2024 Results Highlights QZ Spire Healthcare
Slide 18: FY24: strong growth and strategic progress in a dynamic market
FY24: strong growth and strategic progress in a dynamic market • Revenue growth 6.2%2 y/y (Hospitals 5.5%2 y/y) Strong growth • EBITDA margins1 expanded in Hospitals and Primary Care • Adj. EBITDA1 £260m +9.0%2 and Adj. PBT1 £50.2m +29.4% y/y • NHS revenue accelerated +8.8%2 y/y Dynamic environment
Slide 19: Positive outlook driven by growth, efficiency and new services
Positive outlook driven by growth, efficiency and new services • FY25 EBITDA impact £(30)m from NI/NMW, energy, payor mix Accelerate efficiency • FY25 efficiencies >£30m, £10m above prior plan • FY26 efficiencies £80m cumulative, £20m above prior guidance • Hospitals >5% revenue growth • Primary Car
Slide 20: Good hospital performance and margin improvement
Hospital Good hospital performance and margin improvement Revenue Adjusted EBITDA1 Adjusted EBIT £1.39bn £249.7m £143.3m + 5.5%2 Margin 18.0% Margin 10.3% FY 23: £1.33bn FY 23: £233.8m FY 23: £131.2m On target revenue growth 5.5%2 EBITDA margin1 expansion 30bps2 EBIT margin1 expansion 40bps2 • Volum
Slide 21: Private: PMI in faster growth and will continue
Hospital Private: PMI in faster growth and will continue Private admissions and OP procedures Private admissions ARPC/£ Private revenue/£’000 350,000 +1.0%1 4,000 +3.9%1 1,200,000 3,500 +4.3%1 300,000 1,000,000 3,000 250,000 800,000 2,500 200,000 2,000 600,000 150,000 1,500 400,000 100,000 1,000 50,
Slide 22: NHS accelerating, with our focus on margin
Hospital NHS accelerating, with our focus on margin NHS admissions and OP procedures NHS admissions ARPC/£ NHS revenue/£’000 140,000 +4.4%1 4,000 +5.0%1 400,000 +8.8%1 120,000 3,500 350,000 3,000 300,000 100,000 2,500 250,000 80,000 2,000 200,000 60,000 1,500 150,000 40,000 1,000 100,000 20,000 500
Slide 23: Primary Care ahead of expectations and very strong margin expansion
Primary care Primary Care ahead of expectations and very strong margin expansion Revenue Adjusted EBITDA1 Adjusted EBIT £121.0m £10.3m £6.1m + 15.0%2 Margin 8.5% Margin 5.0% FY 23: £31.4m FY 23: £0.2m FY 23: £(0.8)m, Strong revenue growth 15.0%2 EBITDA margin1 expansion 340bps2 EBIT margin1 expansio
Slide 24: Strong flow through from EBITDA to PBT
Group Strong flow through from EBITDA to PBT FY23 FY24 Group adjusted EBITDA1 £234.0m £260.0m +9.0%2 Group adjusted profit before tax1 £38.8m £50.2m +29.4% Conversion from EBITDA to PBT 16.6% 19.3% Adjusting items £(4.2)m £(11.9)m Group profit before tax £34.6m £38.3m +10.7% Dividend per share 2.1p
Slide 25: Maintaining cash levels after supporting investment and returns
Group Maintaining cash levels after supporting investment and returns £m FY 24 Opening cash balance 49.6 Cash from operating activities 242.8 Vs £(83.9)m prior yr Capex (109.3) Working capital movement (7.0) Vs £(15.5)m prior yr Rent on leasehold property (99.2) Interest cost on debt (22.0) Proceeds
Slide 26: FY25 guidance delivers growth and cost mitigation
Group FY25 guidance delivers growth and cost mitigation Our guidance for FY25 Group revenue growth Mid-single digit % y/y Group adjusted EBITDA1 £270m – £285m ROCE1 Ahead of last year incl. absorbing NI, NMW, payor mix and energy - £(30)m impact Group bank debt leverage1 c2x (ahead of any M&A) at ye
Slide 27: Appendix
Appendix QZ Spire Healthcare
Slide 28: Managing capacity through targeted capex, space optimisation and savings programme
pit Hos als Managing capacity through targeted capex, space optimisation and savings programme driving further headroom Capacity is dependent upon many factors – for example Outpatient facilities Theatres Beds Acuity (imaging) 11 sites with less than 20% capacity headroom (the list of sites with <20
Slide 29: Payor group volumes, ARPC, revenue
pit Hos als Payor group volumes, ARPC, revenue PMI Self-pay NHS1 FY21 FY22 FY23 FY24 FY21 FY22 FY23 FY24 FY21 FY22 FY23 FY24 Admissions and OP Procedures (‘000s) 171.3 190.6 209.8 218.4 104.3 112.5 105.4 98.1 114.5 117.2 123.8 128.2 ARPC (£) 2,686 2,756 2,896 3,032 3,683 3,955 4,356 4,637 2,731 3,12
Slide 30: Portfolio management of payors and specialties by hospital
pit Hos als Portfolio management of payors and specialties by hospital Gross profit contribution index Hospital portfolio PMI Self-pay NHS +80% Private revenue • All payors and 16 hospitals selected specialties contribute a positive Orthopaedics 0.4 1.0 0.3 gross margin • Payor volume varies 60% – 8
Slide 31: Strong satisfaction with Hospital care quality
pit Hos als Strong satisfaction with Hospital care quality Consultants rating our Hospital care as ‘very good’/ ‘excellent’ Hospital patients rating their experience as ‘good’/ ‘very good’ 86% 98% 84% 84% 83% 97% 97% 82% 96% 96% 96% 96% 96% 96% 80% 96% 78% 78% 95% 76% 75% 74% 94% 2021 2022 2023 2024
Slide 32: NHS waiting lists stood at 7.42 million in March 2025
Group NHS waiting lists stood at 7.42 million in March 2025 8,000,000 Waiting >52 weeks 7,000,000 Wating 18-52 weeks Waiting <18 weeks 6,000,000 Size of Waiting List 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 Mar-15 Mar-11 Mar-12 Mar-13 Mar-14 Mar-16 Mar-17 Mar-18 Mar-19 Mar-20 Mar-21 Mar-2
Slide 33: Alternative performance measures definitions
Group Alternative performance measures definitions Performance measure Definition Purpose Adjusted operating profit; or, Operating profit, less adjusting items before interest and tax. Provides a comparable measure of operating profit performance over time. adjusted EBIT Conversion of adjusted EBITD
Slide 34: Alternative performance measures definitions (continued)
Group Alternative performance measures definitions (continued) Performance measure Definition Purpose Return on Capital Employed Adjusted EBIT divided by capital employed. Assess the efficiency in generating profits as a percentage of the total capital used. (ROCE) Earnings per share (EPS) Profit af
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