Spire Healthcare shares fall as profit warning issued amid NHS slowdown

Shares in Spire Healthcare, one of the largest private hospital groups in Britain, fell sharply following an unexpected profit warning centred on a deceleration in NHS commissioning. The FTSE 250 group reported that uncertainty regarding NHS activity across the private sector had undermined confidence, pushing Spire shares down by 16 percent in late trading to their lowest level since April.

The trading update revealed that while self-pay business has shown continued improvement and private medical insurance activity has remained largely steady, these positive developments have been outweighed by a reduction in NHS referrals to the private sector. The company attributed this slowdown to budgetary constraints within the NHS, which has reduced the volume of work commissioned from private providers.

Spire expects full-year adjusted earnings to reach the lower end of its previously stated guidance of £270 million to £285 million, compared with the consensus analyst forecast of £275.5 million. The outlook for 2026 remains subdued, with management forecasting adjusted earnings to remain broadly in line with, or only slightly above, 2025 levels. This misses consensus estimates, which had suggested earnings of around £311 million for next year.

The profit warning arrives during a period of strategic review for Spire and could complicate ongoing discussions regarding the company’s future direction. Following shareholder discontent concerning its stock market valuation, Spire announced in September that it had engaged Rothschild to facilitate talks with several parties, including those exploring a potential sale of the business. The review also encompasses value generation from Spire’s property estate and a greater strategic focus on private payors. Discussions are ongoing with the process still at an early stage.

RBC analysts highlighted the significance of the profit warning and the implication of greater uncertainty for 2026 than previously anticipated, referencing a recent NHS consultation that proposed a tariff uplift notably lower than inflation. Despite these challenges, major investors maintain that the company is underpinned by robust assets. Spire operates 38 hospitals as well as more than 50 other medical facilities, offering services to both NHS and private patients, and maintains corporate health contracts with over 800 clients.

To offset inflationary pressures, increased labour costs, and higher contributions to national insurance, Spire expects to generate £30 million in cost savings this year. The company has also secured an eighteen-month extension to its £425 million banking facilities, now running to August 2028, on existing terms. Spire’s largest shareholder remains Mediclinic Group, followed by Toscafund, ensuring the share register is closely held amid rapidly changing market conditions.