Spire Healthcare Group Plc · LSE:SPI
Spire Healthcare — FY2025 Earnings Presentation
37 slides from Spire Healthcare's earnings presentation, Mar 5, 2026
Slide 1: Full Year 2025 Results
Full Year 2025 Results 5 March 2026
Slide 2: Forward-looking statements disclaimer
This presentation contains inside information. 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
Slide 3: Strategic and operational update
Strategic and operational update Justin Ash, Group CEO
Slide 4: Our strategy addresses key market opportunities and responds to NHS uncertainty
Our strategy addresses key market opportunities and has enabled us to respond quickly to NHS uncertainty 1 2 3 + + Private focused Transformation Scaling multi-payor strategy and efficiency Primary Care 4 Maintaining focus on quality and innovation 4
Slide 5: FY25 trends: improving private patient and fast-growing primary care markets
FY25 trends: Improving private patient and fast-growing primary care markets, amid rising labour costs and NHS budget constraints + Improving private patient trends + Fast growing primary care market - Significant cost headwinds incl. rising labour costs - Exceptional NHS budget constraints 5
Slide 6: FY25 summary: Successful strategic delivery in an uncertain market
FY25 summary: Successful strategic delivery in an uncertain market 1 Grow 2 Drive transformation 3 Scale 4 Focus on private patients & efficiency Primary Care quality & innovation • Self-Pay momentum • £30m new savings • 5 new clinics. OP clinics • Reduced Avg Length of • Patient Support Centres gen
Slide 7: Effectively leveraging the self-pay opportunity
Effectively leveraging the self-pay opportunity Market leading brand scores in the private market1 Actions driving self-pay Marketing: Private-focused, targeted local plans Spontaneous 35% +3% awareness driving demand and conversion Prompted Pricing: AI price optimisation awareness 80% +7% 76% Patie
Slide 8: Market update: Private patient growth amid slowing NHS commissioning
Market update: Private patient growth encouraging amid a slowing NHS commissioning environment Expected Spire Q1 2026 Spire planning scenario Q2-Q4 2026 NHS commissioning resets Apr 26 (start of their new financial year) Expect improvement in Q2-Q4 y/y performance NHS revenue c.(25)% y/y relative to
Slide 9: Outlook: Focused on delivery of strategic priorities
Outlook: Focused on delivery of strategic priorities within our control to drive cash flow 1 Grow 2 3 Scale 4 Focus on Drive transformation private patients & efficiency Primary Care quality & innovation • Capture self-pay through • Increased savings to • Drive hospital referrals • Continuous qualit
Slide 10: Update on Strategic Review process
Update on Strategic Review process Commenced Sep 2025 Broad review of strategic options designed to drive long-term shareholder value The Company is considering a range of potential options, including, but not limited to, a Range of options potential sale of the Company, value generation from the Ho
Slide 11: Maintaining quality and experience through outstanding care
Maintaining quality and experience through outstanding care 98%Hospitals rated ‘Good’, ‘Outstanding’ or equivalent1 97% 84% Hospital patients consultants rated rated experience Hospital care ’very ‘good’/’very good’ good’/‘excellent’ 1. Refers to inspected hospitals that are rated ‘Good’ or ‘Outstan
Slide 12: Financial update
Financial update Harbant Samra, Group CFO
Slide 13: FY25 summary: Strong adjusted free cash flow growth
Group FY25 summary: Strong adjusted free cash flow growth driven by efficiencies and capex discipline FY25 outturn2 Private market improving +4.5%, of which Hospital +4.3% y/y NHS reduced commissioning Revenue growth Primary Care in strong growth Adj. EBITDA1 £268.6m, +3.2% y/y (margin 17.0%) Signif
Slide 14: Hospitals: Transformation programme and ARPC growth protected EBITDA margin
pit Hos als Hospitals: Transformation programme and ARPC growth protected EBITDA margin in a year with significant cost headwinds £1,446.1m £ £258.8m + 3.9% y/y2 Revenue + 4.3% y/y2 Adj. EBITDA1 Margin 17.9% (FY24: 18.0%) Diversified payor mix provides multiple levers EBITDA grew >7% y/y excl NI & N
Slide 15: Self-pay: Improving activity supported by targeted marketing
pit Hos als Self-pay: Improving activity supported by targeted marketing y/y growth in self-pay admissions returned to positive by Q425 Self-pay y/y growth1 • Enquiries driven by marketing (1.1)% • PSCs’ positive contribution Revenue H1: (2.6)% | H2: +0.5% 0% (4.5)% Jan-25 Apr-25 Jul-25 Oct-25 Volum
Slide 16: PMI: Growth supported by mix management
pit Hos als PMI: Growth supported by mix management in a broadly stable volume environment PMI admissions y/y growth trend largely stable through FY25 PMI y/y growth1 Revenue +3.1% H1: +2.5% | H2: +3.8% 0% Volume (0.9)% H1: (1.0)% | H2: (0.7)% Jan-25 Apr-25 Jul-25 Oct-25 ARPC +5.3% 1. All growth rat
Slide 17: NHS: Strong full year growth, reduced commissioning in H2
pit Hos als NHS: Strong growth for the full year, followed by reduced commissioning in H2, as previously announced High acuity focus amid slowing y/y admissions growth NHS patient y/y growth1 30% Revenue +11.4% Maintained H1: +16.2% | H2: +6.8% 20% >60% mix orthopaedics Volume +9.8% H1: +13.0% | H2:
Slide 18: Primary Care: Strong organic revenue performance with new clinics
ary car rim e Primary Care: Strong organic revenue performance with new clinics P enhancing future referral potential to Hospitals £133.7m £ £9.8m + 7.4% y/y2 (13.6)% y/y2 Revenue Adj. EBITDA1 Margin 7.3% Strong organic revenue growth EBITDA growth impacted by new clinics • Driven by organic and new
Slide 19: Transformation savings and price & mix optimisation underpin EBITDA delivery
Group Transformation savings and price & mix optimisation underpin EBITDA delivery £m 260.0 c.50/50 staff salary Mitigated c. two thirds 268.6 and direct cost/ of cost inflation overheads, with salary +3.6%, in line with inflation FY24 Cost inflation One-offs: Transformation Hospital FY25 EBITDA NI/
Slide 20: Adjusting items driven by transformation and Strategic Review fees
Group Adjusting items driven by transformation restructuring and professional fees associated with the Strategic Review £m FY24 FY25 Adjusted EBITDA 260.0 268.6 Adjusted profit before tax 50.2 46.5 Driven by: Total adjusting items (11.9) (27.9) (1) Transformation c.£13m (2) Strategic Review c.£7m Re
Slide 21: Strong cash flow generation, up 65% y/y
Group Strong cash flow generation, up 65% y/y, reflects capex discipline and transformation savings £m 33.6 Cash rental payments 8.6 higher than usual due to timing 64.3 Transformation savings and differences 39.0 rigorous capex management drove adj. FCF growth of c.65% y/y FY24 Adj. EBITDA Capex Re
Slide 22: Sustained estate investment enabled capex reduction to 5% of revenue
Group Sustained investment in the estate over a number of years has enabled us to reduce capex outlay to 5% of Group revenue FY25 capex £78.5m: (30)% y/y and below guidance Capex as % of revenue 8% Primary Care 7% 7% c.£8m 7m 6% 5% Growth c.£3 Trans- Hospitals formation Mainte c.£50m c.£21m More pat
Slide 23: Consistent ROCE improvement on a strong balance sheet
Group Consistent ROCE improvement on a strong balance sheet backed by a valuable portfolio of 19 freehold hospital properties Bank leverage ratio Return on Capital Employed2 8.5% • Two bolt-on M&As in Primary Care (ex NI & NMW) 8.2% • Extended £425m bank facilities 7.5% with terms unchanged1 8.0% 6.
Slide 24: FY26 outlook: Private revenue growth, efficiencies and free cash flow
Group FY26 outlook: Focused on private revenue growth, efficiencies and free cash flow generation Targeting FY26 adj. EBITDA broadly in line with FY25 Hospital Private revenue Q1: c.4% y/y (c.70% of Hospital rev) Q2-Q4: Mid to high single digit % growth Hospital NHS revenue Q1: c.(25)% y/y (c.30% of
Slide 25: Closing remarks
Closing remarks Justin Ash, Group CEO
Slide 26: Key takeaways: Targeting sustainable growth in cash flow
Group Key takeaways: Targeting sustainable growth in cash flow FY25 results demonstrate a resilient performance against a backdrop of increased employment costs, combined with NHS commissioning uncertainty Responded effectively: £30m savings, improved cash generation, maintained care quality, optimi
Slide 27: Spire Healthcare
QZ Spire Healthcare
Slide 28: Appendix
Appendix QZ Spire Healthcare
Slide 29: FY26 technical guidance
Group FY26 technical guidance Technical guidance for FY26 Hospital Property lease payments c.£110m (FY25: £104.4m) Depreciation and amortisation c.£125m – £130m (FY25: £119.6m) Capex1 c.£80m (FY25: £78.5m) Net financing costs c.£110m (FY25: £104.0m) Tax2 Effective corporation tax rate between 25% –
Slide 30: Payor group volumes, ARPC and revenue
pit Hos als Payor group volumes, ARPC and revenue PMI Self-pay NHS1 FY22 FY23 FY24 FY25 FY22 FY23 FY24 FY25 FY22 FY23 FY24 FY25 Admissions and OP Procedures (‘000s) 190.6 209.8 218.4 215.9 112.5 105.4 98.1 93.5 117.2 123.8 128.2 140.3 ARPC (£) 2,756 2,896 3,032 3,193 3,955 4,356 4,637 4,822 3,129 3,
Slide 31: Cash and borrowings
Group Cash and borrowings £m 31 Dec 21 31 Dec 22 31 Dec 23 31 Dec 24 31 Dec 25 £m 31 Dec 21 31 Dec 22 31 Dec 23 31 Dec 24 31 Dec 25 Bank borrowings 427.5 324.3 365.3 367.1 367.1 Bank borrowings 427.5 324.4 365.3 367.1 367.1 Lease liabilities Cash 202.6 74.2 49.6 41.2 34.7 837.8 866.5 891.7 912.8 948
Slide 32: Primary Care: Strong underlying growth continues as clinics mature
ary car rim e Primary Care: Strong underlying growth continues as clinics follow P typical maturity profile while driving referrals • 2/3 large outpatient clinics now profitable • Clinics drove c.£3m EBITDA referrals to Hospitals • Opening 1-2 more large clinics in 2026 FY24 EBITDA Underlying Underl
Slide 33: Growth investments focused on returns and strategic alignment
Group Growth investments focused on returns and strategic alignment Patient Support Centres AI software on MRI scanners Solar panels Key platform for private patient Software installation with Our investment in solar power revenue growth, offering speed productivity improvement delivered >£1m annual
Slide 34: Spire has gained share in the private market
pit Hos als Spire has gained share in the private market Spire growing greatest share of private admission volumes to H1 20251 50% Spire: +0.8% vs 2021 40% 30% Competitor A: (1.3)% vs 2021 Competitor B: +0.4% vs 2021 20% FY21 FY22 FY23 FY24 H125 1. PHIN data. Share of all private admissions in the U
Slide 35: Spire continues to lead in the high acuity hip and knee market
pit Hos als Spire continues to lead in the high acuity hip and knee market 35
Slide 36: 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 37: 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 — FY2025 Earnings Presentation on 6ix