Spire Healthcare Group Plc · LSE:SPI
Spire Healthcare — FY2024 Earnings Presentation
36 slides from Spire Healthcare's earnings presentation, Mar 6, 2025
Slide 1: Full Year 2024 Results
Full Year 2024 Results 6 March 2025
Slide 2: Forward-looking statements disclaimer
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: 2024 highlights
2024 highlights Justin Ash, Group CEO of Spire Healthcare
Slide 4: 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 5: 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 6: Thank you to our colleagues, consultants and partners
Thank you to our colleagues, consultants and partners IRIS and DAISY awards Long service awards Ella May Barnes Clinic opening 6
Slide 7: Independent external recognition
Independent external recognition 7
Slide 8: Financial update
Financial update Harbant Samra, Group CFO Spire Healthcare
Slide 9: FY24: delivered against guidance
Group FY24: delivered against guidance FY24 outturn Our guidance for FY24 Hospitals revenue growth +5.5%2 >5% Hospitals margin1 Margin +30 bps2; savings >£20.0m Margin improvement + £15m cost savings Vita Revenue £107.4m, adj EBITDA1 £11.0m Revenue >£100m, adj EBITDA1 c.£10m Group adjusted EBITDA1 £
Slide 10: 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 11: 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 12: 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 13: 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 14: Cost savings accelerating with delivery ahead of plan
Group Cost savings accelerating with delivery ahead of plan >£80m New in-year Prior year continuation Automation / digitalisation Our guidance / initial plan >£50m One best way >£30m Patient Support Centres >£20m FY24 FY25 FY26 14
Slide 15: 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 16: Deploying capex to growth and efficiency
Group Deploying capex to growth and efficiency Hospital capex £99m Primary Care capex £13m Growth c£40m Maintenance c£59m • Spire Abergele • Minor operations unit at Spire Claremont • Ongoing hospital refurbs • Spire Harrogate Clinic • Five new MRIs • IT infrastructure • Spire Ella-May (Norwich) • A
Slide 17: Strong balance sheet further supported by £1.4bn of property freehold
Group 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) Lever
Slide 18: 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 19: Strategic update
Strategic update Justin Ash, Group CEO of Spire Healthcare
Slide 20: Our model for success – making a positive difference to people’s lives
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 returns
Slide 21: £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 22: Building scale and access in attractive sectors
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 Talkin
Slide 23: Clear plan to deliver medium term margin targets
Clear plan to deliver medium term margin targets FY25: Net impact £(20)m FY26: Net impact £(10)m FY27: Neutralised Efficiencies Efficiencies Optimise capacity utilisation Optimise capacity utilisation Primary Care Faster Primary Care Referrals efficiencies referrals Three year path to EBITDA margin1
Slide 24: Maintain our focus on quality: everyone, everywhere, every day
Maintain our focus on quality: everyone, everywhere, every day • 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 / ca
Slide 25: In conclusion
In conclusion FY24 results: Good performance in a dynamic environment Market backdrop strong: Growing private demand and continued partnership with the NHS Growth and efficiency: Leverage hospital scale, Primary Care expansion, accelerate efficiencies Outlook: Strategy delivering. Medium term margin
Slide 26: Appendix
Appendix QZ Spire Healthcare
Slide 27: Technical guidance
Group Technical guidance Technical guidance for 2025 Property lease payments c.£102m – £108m (FY24: £99.2m) Depreciation and amortisation c.£115m – £122m (FY24: £112.2m) Capex1 c.£90m – £100m (FY24: £99.1m) Net financing costs c.£103m – £108m (FY24: £99.2m) Tax2 Effective corporation tax rate betwee
Slide 28: 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 29: Group adjusting items of £10.1m
Group Group adjusting items of £10.1m £m FY 23 FY 24 Profit after tax before adjusting items 32.4 36.6 Adjusting items Business reorganisation and restructuring 2.0 4.3 Net profit on sale of Tunbridge Wells – (4.5) Remediation of Paterson malpractice issues (0.9) 6.9 Integration costs for DCG and Vi
Slide 30: Cash and borrowings
Group Cash and borrowings £m 31 Dec 20 31 Dec 21 31 Dec 22 31 Dec 23 31 Dec 24 £m 31 Dec 20 31 Dec 21 31 Dec 22 31 Dec 23 31 Dec 24 Bank borrowings 420.8 427.5 324.3 365.3 367.1 Bank borrowings 420.8 427.5 324.4 365.3 367.1 Lease liabilities Cash 106.3 202.6 74.2 49.6 41.2 749.5 837.8 866.5 891.7 91
Slide 31: 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 32: 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 33: Private patients: Self-Pay and PMI increasingly becoming one segment
Private patients: Self-Pay and PMI increasingly becoming one segment Evidence of Self-Pay to PMI switching in working age patients (H2 24 data, repeating trends highlighted in H1) Self-Pay PMI 28% 18% 16% 1% 2% -5% -9% -9% u 25s 25-44 45-64 65+ 33
Slide 34: NHS waiting lists stood at 7.46 million in December 2024
Group NHS waiting lists stood at 7.46 million in December 2024 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 Dec-09 Dec-10 Dec-11 Dec-12 Dec-13 Dec-14 Dec-15 Dec-16 Dec-17 Dec-18 Dec-19 De
Slide 35: 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 EBITDA
Slide 36: 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
Spire Healthcare Group — FY2024 Earnings Presentation on 6ix