Financial Data and Key Metrics Changes - Revenue grew by 4.9% year-on-year, with hospitals up 4.7% and adjusted EBITDA increased by 2.8% to £133 million [7][8] - Adjusted profit before tax declined by 11.2% to £23.8 million, primarily due to the phasing of savings and increased depreciation and finance costs [7][8] - Adjusted free cash flow decreased, attributed to the same phasing impacts, with a cash balance of £20.8 million at the period end [23][24] - Return on capital employed expanded by 50 basis points to 8.1% [7][22] Business Line Data and Key Metrics Changes - Hospital revenue increased by 4.7% to £732.3 million, with adjusted EBITDA rising by 3.3% to £130 million, representing a margin of 17.8% [8][9] - Private business revenue grew just under 1%, with average revenue per case increasing by 5.4% [12][11] - NHS revenue saw strong growth of over 16%, with a 4.2% uplift in average revenue per case [15][16] - Primary Care revenue reached £64.4 million, a 6.5% increase, with adjusted EBITDA at £3.8 million [17][18] Market Data and Key Metrics Changes - The independent sector treated 500,000 patients since the start of the administration, highlighting the government's commitment to reducing waiting lists [45][46] - The market for integrated healthcare is valued at £12 billion, with a focus on preventative care and elective operative care [28][27] - Spire continues to lead in its addressable markets, conducting the largest number of hip and knee procedures across all patient groups [17][16] Company Strategy and Development Direction - The company is focused on a diversified three-payer strategy, transformation, scaling primary care, and maintaining quality and innovation [3][28] - The transformation program aims to enhance efficiency and service delivery, with significant changes in hospital resourcing and administrative functions [19][20][32] - The company is pursuing targeted acquisitions to support growth, including the recent acquisition of Acorn Health and Physiolistic [36][49] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in navigating a dynamic environment, with expectations for full-year performance in line with market expectations [4][25] - The government remains focused on reducing waiting lists, which supports the independent sector's role in healthcare delivery [45][46] - Management highlighted the importance of maintaining a disciplined approach to capital expenditure and M&A activities [25][88] Other Important Information - The company has invested £51 million in capital expenditures in the first half, focusing on growth and efficiency projects [21][22] - The company maintains a strong balance sheet, supported by a freehold portfolio valued at over £1.4 billion [22][24] Q&A Session Summary Question: Can you provide insights on budgetary pressures at the ICB level and mitigation opportunities? - Management noted that NHS England is focused on reducing waiting lists and balancing budgets, with ongoing discussions with local commissioners to navigate these pressures [43][45][46] Question: What is the M&A landscape for the Primary Care business? - Management indicated that they are pursuing targeted acquisitions while maintaining a disciplined approach, with a focus on integrating new businesses into their existing operations [49][50] Question: What are the potential impacts of doctor strikes on self-pay and PMI? - Management acknowledged that while strikes are undesirable, they have continued to deliver services and noted that increased waiting lists could support self-pay demand [57][58] Question: What are the expectations for volume growth in PMI in the second half? - Management expressed confidence in leveraging patient service centers to build on existing platforms, although specific volume growth figures were not provided [103][104] Question: Is there a plan to crystallize the value of the property portfolio? - Management highlighted the value of the property portfolio but did not indicate any immediate plans for crystallization, stating that it underpins their valuation [68][69]