Highlights

  • Spire reports 3.6% revenue growth for July–October 2025 and plans GBP 30 million in savings for FY25 amid cost pressures.
  • Full-year FY25 adjusted EBITDA expected near lower guidance range (GBP 270m–GBP 285m); FY26 EBITDA forecast broadly flat or slightly higher.
  • Banking facilities of GBP 425 million extended to August 2028 with unchanged terms, supporting financial stability and growth.

Spire Healthcare Group plc (LSE:SPI) has provided a trading update for the period ending 31 October 2025, alongside revised outlooks for the fiscal years 2025 and 2026. The Group also announced an extension of its GBP 425 million banking facilities to August 2028. Despite ongoing challenges in NHS commissioning, Spire reports growth in revenue and self-pay patient trends, with expectations for 2026 EBITDA to remain in line or slightly ahead of 2025 levels.

Trading Performance and Transformation Progress

Since its interim results in July, Spire Healthcare has recorded Group revenue growth of 3.6% y/y from July to October 2025. The company has managed inflationary pressures and rising employment costs through a transformation programme, targeted to generate GBP 30 million in new savings during the year. This includes an additional GBP 10 million saving identified early in 2025 to offset increased National Insurance and National Minimum Wage expenses.

The launch of Patient Support Centres (PSCs) in summer 2025 centralized patient booking and administrative functions from almost all hospitals, initially causing some disruption in private bookings that has since stabilized.

Market Trends and FY25 Earnings Outlook

Self-pay patient trends have improved, while private medical insurance (PMI) volumes are stable compared to the first half of 2025. However, NHS commissioning activity to the independent sector has slowed due to Integrated Care Board budget constraints. Spire continues to engage with local commissioners to address these challenges while ensuring quality patient care.

Given these factors, Spire expects full-year adjusted Group EBITDA for FY25 to be near the lower boundary of the previously guided range of GBP 270 million to GBP 285 million.

Strategy and Outlook for FY26

Looking forward, Spire anticipates continued improvements in self-pay and PMI patient volumes as PSCs reach operational maturity. Investments will focus on strengthening PMI partnerships, expanding self-pay marketing, and enhancing patient experience.

In Primary Care, Spire plans to grow through bolt-on mergers and acquisitions in faster-growing regions, which will also boost hospital referrals.

Spire expects to deliver a further GBP 30 million of new savings in FY26, supported by detailed planning.

The NHS sector remains uncertain, particularly in the first quarter, with a recent consultation on NHS Payment Scheme prices proposing tariff increases below inflation rates. Spire intends to actively participate in this consultation to support its partnership with the NHS and the independent sector.

Given current market visibility, Spire projects FY26 Group adjusted EBITDA will be broadly in line with or slightly above 2025 results. The Group remains confident in medium-term growth prospects, particularly from private patient volumes.

Extension of Debt Facilities and Shareholder Value Review

Spire has secured an 18-month maturity extension to its GBP 425 million banking facilities until August 2028, maintaining prior terms. The facilities consist of a GBP 325 million term loan and a GBP 100 million revolving credit facility with the same lender syndicate.

Following a September announcement, Spire is exploring options to enhance long-term shareholder value, including potential sales, leveraging hospital property assets, and focusing on private payors.