Spire Healthcare made a £11.5m loss after tax in the six months to the end of June, reversing the £7m profit it reported 12 months earlier.
The hospital and clinic operator was hit by ‘continued tighter claims authorisation’ from insurers.
Less NHS work, higher borrowing costs and depreciation were also factors.
But they were offset by higher private medical insurance (PMI), self-pay and primary care revenues.
Indeed, PMI revenue increased 3.1% to £355.4m, year-on-year, despite continued tighter claims authorisation and lower activity from one un-named insurer.
Previously agreed contracts helped primary care revenue to jump 8.1% to £72.1m, while there was a 4.5% rise in self-pay to £179.8m.
These results came during a period when the organisation’s board was waiting for a firm offer to buy the group.
Indeed, Spire was sold earlier this month for £1bn to a consortium led by Toscafund, which now controls its 38 hospitals and more than 55 clinics across England, Wales and Scotland.
A smaller piece of the pie
Higher PMI and self-pay helped the group to expand its share of the hospital market by 5% to 43.4% during the period.
They also helped offset a 14.3% decline in revenue from NHS patients but could not stop revenue from the hospital business falling 1.6% to £720.6m, year-on-year.
Group sales also slipped to £792.7m in the first half from £796.7m during the same period of 2025.
Lost value
Depreciation had a big impact totalling £60.4m, up from £56.6m a year earlier.
This breaks down as £58.4m wiped off the value of its hospitals and £2m from the primary care estate.
Strong visibility
Yet NHS revenue appears to be improving with a 24.9% decline in the first quarter, easing to a 3.2% decline in the following three months after commissioning plans were reset in April.
Spire also pointed to having strong visibility over NHS activity with 95% of indictive activity plan-related revenue for this financial year already agreed.
A new phase
Spire’s adjusted free cashflow leapt 35.3% to £20.7m, with cash conversion reaching 110% from 95% a year earlier, while expenditure fell by almost a third (30%) to £36.3m.
Following a period of sustained investment in the estate, the group has now entered a phase of lower capital intensity.
During the first half of the year, Spire also signed a four-year deal with Bupa to expand cancer, musculoskeletal and women’s healthcare.
Clear visibility
Spire’s interim chief executive, Sir David Sloman, pointed to the hospital operator’s results in self-pay and private medical insurance as areas of “strength”.
He added that NHS activity during the period was in line with expectations and there is clear visibility over future volumes.
“Meanwhile, robust cash generation, improving capital efficiency and disciplined capital allocation supported a significant increase in adjusted free cashflow.
“Our further enhancements to patient access, clinical capacity and service development are helping us to gain market share and meet the UK’s growing healthcare needs.
“Together, these factors provide momentum for the second half, focused on strengthening our private patient proposition and delivering our transformation programme.”
