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"value": "1. General information Spire Healthcare group plc (the \u2018company\u2019) and its subsidiaries (collectively, the \u2018group\u2019) owns and operates
\nprivate hospitals and clinics in the UK and provides a range of private healthcare services.
\nThe \ufb01nancial statements for the year ended 31 December 2022 were authorised for issue by the board of
\ndirectors of the company on 1 March 2023.
\nThe company is a public limited company, which is listed on the London Stock Exchange, incorporated,
\nregistered and domiciled in England and Wales (registered number: 09084066). The address of its registered
\nof\ufb01ce is 3 Dorset Rise, London, EC4Y 8EN.
\n2. Accounting policies
\nThe principal accounting policies applied in the preparation of these \ufb01nancial statements are set out below.
\nThese policies have been consistently applied to all the years presented, unless otherwise stated.
\nBasis of preparation
\nThe consolidated \ufb01nancial statements of the group have been prepared in accordance with UK-adopted
\nInternational Accounting Standards (\u2018UK-adopted IFRS\u2019) as issued by the International Accounting Standards
\nBoard (\u2018IASB\u2019) and in accordance with the Companies Act 2006.
\nThe consolidated \ufb01nancial statements have been prepared on a historical cost basis except for derivative
\n\ufb01nancial instruments and \ufb01nancial assets measured at fair value. The group \ufb01nancial statements are presented
\nin UK sterling and all values are rounded to the nearest million pounds (\u00a3m), except when otherwise indicated.
\nThe preparation of \ufb01nancial statements in accordance with UK-adopted IFRS requires the use of certain critical
\naccounting estimates. It also requires management to exercise its judgement in the process of applying the
\ngroup\u2019s accounting policies. Further details on the group\u2019s critical judgements and estimates are included in
\nnote 3.
\nThe group has considered the future potential environmental impact on its current and future \ufb01nancial
\nposition and considered the impact to below.
\nGoing concern
\nThe group assessed going concern risk for the period through to 31 March 2024. As at 31 December 2022 the
\ngroup had cash of \u00a374.2 million, a Senior Loan Facility of \u00a3325 million and an undrawn Revolving Credit Facility
\nof \u00a3100 million. On 24 February 2022, the group successfully re\ufb01nanced its debt facilities with a syndicate of
\nexisting and new Lenders. As part of the re\ufb01nancing exercise and in recognition of the fact that the group had
\nsubstantial cash reserves at 31 December 2021, the group repaid \u00a3100 million of the Senior Loan Facility. The
\nnew arrangement has a maturity of four years. The \ufb01nancial covenants relating to this new agreement are
\nmaterially unchanged.
\nThe group has undertaken extensive activity to identify plausible risks which may arise and mitigating actions,
\nwhich in the \ufb01rst instance would include management of working capital and constrained levels of capital
\ninvestment. Based on the current assessment of the likelihood of these risks arising by 31 March 2024, together
\nwith their assessment of the planned mitigating actions being successful, the directors have concluded it is
\nappropriate to prepare the accounts on a going concern basis. In arriving at their conclusion, the directors have
\nalso noted that, were three of the most likely speci\ufb01c risks to arise in combination, it could result in a liquidity
\nconstraint or breach of covenant, however, the risk of this is considered remote.
\nThe group has also assessed, as part of its reverse stress testing, what degree of downturn in trading it could
\nsustain before it no longer forecasts a positive cash balance. This stress testing was based on \ufb02exing revenue
\ndownwards with a consistent percentage decline in variable costs, whilst maintaining the forecast of \ufb01xed
\ncosts. The testing did not allow for the bene\ufb01t of any action that could be taken by management to preserve
\ncash. This testing suggested that there would have to be at least a 35% fall in annual revenue before the group
\nno longer forecast a positive cash balance. We do not believe that such a reduction of income revenue is a
\nplausible consequence of the group\u2019s identi\ufb01ed principal risks.
\nIt should be noted that we are in a period of unprecedented geo-political and macro-economic uncertainty.
\nWhilst the directors continue to closely monitor these risks and their plausible impact, their severity is hard
\nto predict and is dependent upon many external factors. Accordingly the actual \ufb01nancial impact of these risks
\nmay materially vary against the current view of their plausible impact.
\nFurther detail on both aacroeconomic related risk and COVID-19 is provided in the risk management and
\ninternal control section on pages 66 to 76.
\nOther speci\ufb01c scenarios covered by our testing were as follows:
\n\u2013
The group is subject to temporary suspension of trade, with a temporary adverse impact on revenue,
\nfor example, as a result of a successful cyber-attack on key business systems
\n\u2013
The downside modelling of a number of risks which result in a decline in earnings, including the loss of
\na contractual relationship with a key insurer
\n\u2013
Signi\ufb01cant change in government policy resulting in consultants going on payroll
\n\u2013
Short term disruption to trade at a sub-set of hospitals owing to an extreme weather event
\nThis review included the following key assumptions:
\n\u2013
No change in capital structure given the group has re\ufb01nanced its existing senior \ufb01nance facility and
\nrevolving credit facility since the 2022 year end
\n\u2013
The government will not make signi\ufb01cant change to its existing policy towards utilising private provision
\nof healthcare services to supplement the NHS
\nRevenue recognition
\nThe group derives its revenue primarily from providing private healthcare services to both the public sector
\nand private patients in the UK. Revenue from charges to patients is recognised when the treatment is provided.
\nRevenue from contracts with customers
\nThe criteria for revenue recognition are as follows; identify the contract with the customer, identify the
\nperformance obligation, determine the transaction price, allocate the transaction price to the performance
\nobligations, and satisfying the performance obligation. It applies to all contracts with customers, except those
\nin the scope of other standards.
\nRevenue is recorded as services are transferred to the patient, with the consideration based on the total
\namount the group expects to receive, taking account of discounts where they are quanti\ufb01able and probable.
\nApproximately 70% of the group\u2019s revenue is derived from inpatient and daycase admissions. Revenue is
\nrecognised day by day, as services are provided to patients. These services are typically provided over a short
\ntime frame, that is, one to three days. Outpatient cases and other revenue represent approximately 30% of the
\ngroup\u2019s revenue. Outpatient cases generally do not involve surgical procedures and revenue is recognised on
\nan individual component basis when performance obligations are satis\ufb01ed. Similarly, other revenue, which
\nincludes consultant revenue and other third-party revenue streams, is recognised when performance
\nobligations are satis\ufb01ed and the control of goods or services is transferred.
\n
\n
\n
\n\n\n
The group reports disaggregated revenue by material revenue stream (ie type of payor: PMI, NHS and self-pay)
\nand other revenue which includes consultant revenue, third party revenue streams (eg pathology services)
\nand \u2018commissioning for quality and innovation payments\u2019 (CQUIN). Material revenue streams are consistent
\nin nature, being the consideration received in return for the provision of healthcare services to patients. The
\ntiming and uncertainty of cash \ufb02ows is similar for PMI and NHS business while self-pay revenue is received in
\nadvance or collected by credit card shortly after treatment. In addition, where possible and meaningful, Spire
\nHealthcare reports revenue split between inpatient/daycase, outpatient and other. As noted above, in all cases,
\nrevenue is recognised as performance obligations are completed in the form of services being provided to
\npatients. Unbilled revenue is accrued at period ends. Invoices for the combination of services provided to
\npatients are generally produced within three days of discharge.
\nRevenue recognition \u2013 the NHS contracts
\nApproximately 0.3% of the group\u2019s revenue is derived from the NHS COVID-19 contracts (2021: 5%). Revenue
\nfrom the NHS COVID-19 contracts is recognised as the services are transferred to the customer over the life
\nof the contract. In the prior year the contracts\u2019 transaction price is based on variable consideration, recognition
\nof revenue is constrained to the extent that it is probable that a signi\ufb01cant reversal will not occur when the
\nuncertainty is resolved.
\nInterest income
\nInterest is recognised on an effective interest rate basis.
\nCost of sales
\nCost of sales principally comprises salaries of clinical staff, consultant and clinical fees, medical services and
\ninventories, including drugs, consumables and prostheses.
\nOther operating costs
\nOther operating costs mainly comprise non-clinical staff costs, rent associated with short or low value leases,
\nthe depreciation of property, plant and equipment and right of use assets and the maintenance and running
\ncosts of properties and equipment. It also includes administrative expenses, including the provision of central
\nsupport services, IT and other administrative costs.
\nOther income
\nOther income comprises fair value movements on the \ufb01nancial asset, a pro\ufb01t share arrangement with Genesis
\nCare.
\nOperating pro\ufb01t
\nOperating pro\ufb01t is the pro\ufb01t arising from the normal, recurring operations of the business and after charging
\nadjusting items, as de\ufb01ned below. Operating pro\ufb01t is adjusted to exclude adjusting items to calculate the Key
\nPerformance Indicator (KPI) \u2018Operating pro\ufb01t before adjusting items (adjusted EBIT)\u2019.
\nAdjusting items
\nAdjusting items are those items which the directors believe, by virtue of their nature, size or incidence, either
\nindividually or in aggregate, should be disclosed separately to allow a full understanding and comparison of the
\nunderlying performance of the group. Examples of items which may be considered this way in nature include
\nsigni\ufb01cant write-downs of goodwill and other assets, restructuring costs relating to strategic review,
\nimpairments, hospital closures and set-up costs, business acquisition costs, medical malpractice provisions,
\naborted project costs and compliance set-up costs.
\nCash and cash equivalents
\nCash and cash equivalents comprise cash balances and call deposits. Bank overdrafts that are repayable on
\ndemand and form an integral part of the group\u2019s cash management are included as a component of cash and
\ncash equivalents for the purpose only of the statement of cash \ufb02ows. There are no bank overdrafts in either
\nyear presented.
\nTaxation including deferred taxation
\nTotal income tax on the result for the year comprises current and deferred tax. Income tax is recognised in
\nthe income statement except to the extent that it relates to items recognised directly in equity and other
\ncomprehensive income.
\nCurrent tax is the expected tax payable on the taxable result for the year, using tax rates enacted, or
\nsubstantively enacted, at the balance sheet date, and any adjustments to tax payable in respect of previous
\nyears.
\nWhere there is an uncertain tax position, a provision is recognised when it is not probable that the tax
\nauthority will accept the uncertain tax position, based on either the most likely amount where the range
\nof results is binary, or as a weighted average of possible outcomes where a range of outcomes is possible.
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\n\u2013
Goodwill not deductible for tax purposes
\n\u2013
The initial recognition of an asset or liability in a transaction that is not a business combination and which,
\nat the time of the transaction, affects neither the accounting pro\ufb01t nor the taxable pro\ufb01t or loss
\n\u2013
Investments in subsidiary companies where the timing of the reversal of the temporary difference is
\ncontrolled by the group and it is probable that the temporary difference will not reverse in the foreseeable
\nfuture
\nIt should be noted that the initial recognition exception does not apply to the majority of the group\u2019s freehold
\nproperty portfolio as these were acquired through the Bupa and Classics acquisitions in 2007 and 2008, which
\nwere accounted for as a business combination.
\nThe amount of deferred tax recognised is based on the expected manner of realisation or settlement of the
\ncarrying amounts of assets and liabilities, using tax rates enacted, or substantively enacted, at the balance
\nsheet date. The group offsets deferred tax assets and deferred tax liabilities if, and only if, it has a legally
\nenforceable right to set off current tax assets and current tax liabilities and the deferred tax assets and
\ndeferred tax liabilities relate to income taxes levied by the same taxation authority on either the same taxable
\nentity or different taxable entities which intend either to settle current tax liabilities and assets on a net basis,
\nor to realise the assets and settle the liabilities simultaneously, in each future period in which signi\ufb01cant
\namounts of deferred tax liabilities or assets are expected to be settled or recovered.
\nIn assessing the recoverability of deferred tax assets, the group relies on the same forecast assumptions used
\nelsewhere in the \ufb01nancial statements and in other management reports, which, among other things, re\ufb02ect
\nthe potential impact of climate-related development on the business, such as increased costs as a result of
\nmeasures to reduce carbon emission.
\nA deferred tax asset, subject to the offsetting above, is only recognised to the extent that it is probable that
\nfuture taxable pro\ufb01ts will be available against which the asset can be used.
\n
\n\n
\n
Property, plant and equipment
\nProperty, plant and equipment is stated at cost less accumulated depreciation. Major projects are treated as
\nassets in the course of construction until completed when they are transferred to the appropriate asset class.
\nNo depreciation is charged on freehold land or assets in the course of construction. Other assets are depreciated
\nso as to write off the carrying amounts of the assets, less their estimated residual values, over their expected
\nuseful lives, as follows:
\nFreehold property and improvements
\u2013
5 to 60 years
\nLeasehold improvements
\u2013
lower of unexpired lease term or expected life, with a maximum
\nof 35 years
\nEquipment
\u2013
3 to 10 years
\nThe expected useful lives and residual values of property, plant and equipment are reviewed semi-annually and
\nrevised as appropriate. The review of the asset lives and residual values of properties takes into consideration
\nthe plans of the business and levels of expenditure incurred on an ongoing basis to maintain the properties
\nin a \ufb01t and proper state for their ongoing use as hospitals. In addition, the potential impact of future climate
\nchange is considered. In the case of major facilities opening in new locations, depreciation may be applied
\nto only those assets available for use at the of\ufb01cial opening date to re\ufb02ect that the site is not always fully
\noperational at this opening date. During the year management revised the useful life and residual value
\nof freehold land and buildings refer to changes in accounting estimates for further details.
\nConsolidation
\nThe results of all subsidiary undertakings are included in the consolidated \ufb01nancial statements. Assets,
\nliabilities, income and expenses of a subsidiary acquired or disposed of during the year are included in the
\nconsolidated \ufb01nancial statements from the date the group gains control until the date the group ceases
\nto control the subsidiary.
\nControl is achieved when the group is exposed, or has rights, to variable returns from its involvement with the
\ninvestee and has the ability to affect those returns through its power over the investee. Speci\ufb01cally, the group
\ncontrols an investee if, and only if, the group has:
\n\u2013
Power over the investee (ie existing rights that give it the current ability to direct the relevant activities
\nof the investee)
\n\u2013
Exposure, or rights, to variable returns from its involvement with the investee
\n\u2013
The ability to use its power over the investee to affect its returns
\nThe Employee Bene\ufb01t Trust (EBT) is treated as an extension of the group and the company.
\nBusiness combinations
\nBusiness combinations are accounted for using the acquisition method. The cost of an acquisition is measured
\nas the aggregate of the consideration transferred measured at acquisition date fair value and the amount of
\nany non-controlling interests in the acquiree. For each business combination, the group elects whether to
\nmeasure the non-controlling interests in the acquiree at fair value or at the proportionate share of the
\nacquiree\u2019s identi\ufb01able net assets. Acquisition-related costs are expensed as incurred and included in other
\noperating costs.
\nThe group determines that it has acquired a business when the acquired set of activities and assets include
\nan input and a substantive process that together signi\ufb01cantly contribute to the ability to create outputs.
\nThe acquired process is considered substantive if it is critical to the ability to continue producing outputs,
\nand the inputs acquired include an organised workforce with the necessary skills, knowledge, or experience
\nto perform that process or it signi\ufb01cantly contributes to the ability to continue producing outputs and is
\nconsidered unique or scarce or cannot be replaced without signi\ufb01cant cost, effort, or delay in the ability
\nto continue producing outputs.
\nWhen the group acquires a business, it assesses the \ufb01nancial assets and liabilities assumed for appropriate
\nclassi\ufb01cation and designation in accordance with the contractual terms, economic circumstances and
\npertinent conditions as at the acquisition date.
\nGoodwill
\nGoodwill represents the excess of the cost of acquisition (being the fair value of consideration transferred) over
\nthe fair value of the assets, liabilities and contingent liabilities of acquired businesses at the date of acquisition.
\nGoodwill is stated at cost less accumulated impairment losses.
\nGoodwill is allocated to one cash-generating unit and is not amortised but is tested annually for impairment,
\nor more frequently if there is an indication that the value of the goodwill may be impaired (see impairment
\npolicy).
\nFinancial Instruments
\nA \ufb01nancial instrument is any contract that gives rise to a \ufb01nancial asset of one entity and a \ufb01nancial liability
\nor equity instrument of another entity.
\ni) Financial assets other than derivatives
\nInitial recognition and measurement
\nFinancial assets are classi\ufb01ed as \ufb01nancial assets at fair value through pro\ufb01t or loss, amortised cost or fair value
\nthrough other comprehensive income (\u2018OCI\u2019).
\nThe classi\ufb01cation of \ufb01nancial assets at initial recognition depends on the \ufb01nancial asset\u2019s contractual cash \ufb02ow
\ncharacteristics and the group\u2019s business model for managing them. With the exception of trade receivables
\nthat do not contain a signi\ufb01cant \ufb01nancing component or for which the group has applied the practical expedient,
\nthe group initially measures a \ufb01nancial asset at its fair value plus, in the case of a \ufb01nancial asset not at fair value
\nthrough pro\ufb01t or loss, transaction costs. Trade receivables that do not contain a signi\ufb01cant \ufb01nancing component
\nor for which the group has applied the practical expedient are measured at the transaction price determined
\nunder IFRS 15.
\nIn order for a \ufb01nancial asset to be classi\ufb01ed and measured at amortised cost or fair value through OCI, it needs
\nto give rise to cash \ufb02ows that are \u2018solely payments of principal and interest (SPPI)\u2019 on the principal amount
\noutstanding. This assessment is referred to as the SPPI test and is performed at an instrument level.
\n
\n\n
\n
The group\u2019s business model for managing \ufb01nancial assets refers to how it manages its \ufb01nancial assets in order
\nto generate cash \ufb02ows. The business model determines whether cash \ufb02ows will result from collecting
\ncontractual cash \ufb02ows, selling the \ufb01nancial assets, or both.
\nThe company\u2019s \ufb01nancial assets include cash and short-term deposits, trade and other receivables, unbilled
\nreceivables and receivables from pro\ufb01t share arrangements. Unbilled receivables may include contract assets
\nwhere the performance obligation has been met, but the invoice not raised due to agreement with the
\ncustomer being required in respect of the variable consideration. Unbilled receivables can also include
\namounts where the performance obligation has been met, but the invoice not yet raised due to the timing
\nof the reporting period.
\nSubsequent measurement
\nTrade receivables and unbilled receivables are accounted for at amortised cost. The group applies the IFRS 9
\nsimpli\ufb01ed approach to measuring expected credit losses, which uses a lifetime expected loss allowance for all
\ntrade receivables. At each reporting period, the group makes an assessment of the asset\u2019s recoverable amount
\nbased on forward looking information. Losses arising from impairment are recognised in the consolidated
\nincome statement in other operating costs.
\nLoans and receivables are non-derivative \ufb01nancial assets with \ufb01xed or determinable payments that are not
\nquoted in an active market. On initial recognition, loans and receivables are measured at fair value plus directly
\nattributable transaction costs. Subsequently, such assets are measured at amortised cost, using the effective
\ninterest rate (\u2018EIR\u2019) method, less any allowance for impairment.
\nAmortised cost is calculated by taking into account any discount or premium on acquisition and fees or costs
\nthat are an integral part of the EIR. The EIR amortisation is included in interest receivable in the consolidated
\nincome statement.
\nReceivables relating to pro\ufb01t share arrangements are recognised as fair value through pro\ufb01t and loss. At each
\nreporting period, the assets are revalued, with any movement in fair value being recognised in the consolidated
\nincome statement. Any cash received from pro\ufb01t share arrangements is presented within cash \ufb02ows from
\ninvesting activities within the Cash Flow statement.
\nDerecognition
\nA \ufb01nancial asset is derecognised when the rights to receive cash \ufb02ows from the asset have expired, or the
\ngroup has transferred its rights to receive cash \ufb02ows from the asset including transferring substantially all
\nthe risks and rewards of the asset.
\nImpairment
\nThe group recognises an allowance for expected credit losses (ECLs) for all debt instruments not held at fair
\nvalue through pro\ufb01t or loss. ECLs are based on the difference between the contractual cash \ufb02ows due in
\naccordance with the contract and all the cash \ufb02ows that the group expects to receive, discounted at an
\napproximation of the original effective interest rate. The expected cash \ufb02ows will include cash \ufb02ows from
\nthe sale of collateral held or other credit enhancements that are integral to the contractual terms.
\nFor trade receivables and contract assets (including unbilled receivables), the group applies a simpli\ufb01ed
\napproach in calculating ECLs. Therefore, the group does not track changes in credit risk, but instead recognises a
\nloss allowance based on lifetime ECLs at each reporting date. The group has established a provision matrix that
\nis based on its historical credit loss experience, adjusted for forward-looking factors speci\ufb01c to the receivables
\nand the economic environment. To measure the expected credit losses, trade receivables have been grouped
\nbased on shared characteristics and the days past due. The group has concluded that the expected loss rates
\nfor trade receivables, are a reasonable approximation of the loss rates for each ageing bucket based on
\nhistorical debt trends of our portfolio of customers for the last two reporting periods, with the exception
\nof patient debt. Patient debt is more susceptible to the economic environment. As a result, the group have
\nreviewed the expected loss rates for this payor group, as well as considering forward looking information
\n(speci\ufb01cally the cost of living and COVID-19) and increased the loss rates accordingly.
\nii) Financial liabilities other than derivatives
\nFinancial liabilities within the scope of IFRS 9 are classi\ufb01ed as \ufb01nancial liabilities at fair value through pro\ufb01t or
\nloss, or at amortised cost. The group determines the classi\ufb01cation of \ufb01nancial liabilities at initial recognition.
\nInitial recognition and measurement
\nAll \ufb01nancial liabilities are recognised initially at fair value and in the case of loans and borrowings, net of directly
\nattributable transaction costs.
\nThe group\u2019s \ufb01nancial liabilities include trade and other payables, loans and borrowings, and derivative \ufb01nancial
\ninstruments.
\nSubsequent measurement
\nAfter initial recognition, interest bearing loans and borrowings are subsequently measured at amortised cost
\nusing the effective interest rate (EIR) method. Gains and losses arising on the repurchase, settlement or
\notherwise cancellation of liabilities are recognised respectively in interest receivable and interest payable in the
\nconsolidated income statement. Amortised cost is calculated by taking in to account any discount or premium
\non acquisition and fees or costs that are an integral part of the EIR. The EIR amortisation is included as \ufb01nance
\ncosts in the consolidated income statement.
\nFinancial liabilities on business combination
\nOn acquisition of a business combination, a \ufb01nancial liability may be recognised at fair value through pro\ufb01t and
\nloss where there is an obligation on the group to settle a liability. In subsequent periods, the liability will be
\nremeasured based on its fair value, with movements being recognised in the income statement. Cash \ufb02ows
\nwill be discounts as appropriate.
\nTo determine the obligation, the group will review whether the liability arises as a result of an action or decision
\nof the group, or if an action by a third party would result in the obligation crystallising.
\nDerecognition
\nA \ufb01nancial liability is derecognised when the obligation under the liability is discharged or cancelled or expires.
\nWhen an existing \ufb01nancial liability is replaced by another from the same lender on substantially different
\nterms, or the terms of an existing liability are substantially modi\ufb01ed, such an exchange or modi\ufb01cation is
\ntreated as the derecognition of the original liability and the recognition of a new liability. The difference in the
\nrespective carrying amounts is recognised in the consolidated income statement.
\niii) Derivative \ufb01nancial instruments
\nThe group may enter into derivative \ufb01nancial instrument arrangements to manage its exposure to interest
\nrate risk. Derivatives are initially recognised at fair value on the date on which a derivative contract is entered
\nin to and subsequently remeasured at fair value at each balance sheet date. Derivatives are carried as \ufb01nancial
\nassets when the fair value is positive and as \ufb01nancial liabilities when the fair value is negative.
\nThe group applies cash \ufb02ow hedge accounting to such derivatives if the criteria for doing so are met. At the
\ninception of a hedge relationship, the group formally designates and documents the hedge relationship to
\nwhich it wishes to apply hedge accounting and the risk management objective and strategy for undertaking
\nthe hedge.
\n\n\n\n
The effective portion of the changes in the fair value of derivatives that are designated and qualify as cash \ufb02ow
\nhedges is recognised in other comprehensive income. The gain or loss relating to the ineffective portion is
\nrecognised immediately in the income statement. The cash \ufb02ow hedge reserve is adjusted to the lower of the
\ncumulative gain or loss on the hedging instrument and the cumulative change in fair value of the hedged item.
\nAmounts deferred in equity are recycled in the income statement in the periods when the hedged item is
\nrecognised, in the same line of the income statement as the recognised hedged item. If cash \ufb02ow hedge
\naccounting is discontinued, the amount that has been accumulated in the consolidated statement of other
\ncomprehensive income is maintained if the hedged future cash \ufb02ows are still expected to occur. Otherwise,
\nthe amount is immediately reclassi\ufb01ed to pro\ufb01t or loss as a reclassi\ufb01cation adjustment.
\niv) Offsetting of \ufb01nancial instruments
\nFinancial assets and \ufb01nancial liabilities are offset and the net amount reported in the consolidated balance
\nsheet if, and only if, there is a currently enforceable legal right to offset the recognised amounts and there is
\nan intention to settle on a net basis, or to realise the assets and settle the liabilities simultaneously.
\nInventories
\nInventories are stated at the lower of cost and net realisable value. Cost means purchase price, less trade
\ndiscounts, calculated on an average basis. Net realisable value means estimated selling price less incremental
\ncosts including trade discounts and all costs to be incurred in marketing, selling and distribution.
\nThe group holds consignment stock on sale or return. The group is only required to pay for the equipment
\nit chooses to use and therefore this stock is not recognised as an asset.
\n2. Accounting policies
continued
\nBorrowing costs
\nBorrowing costs that are directly attributable to the acquisition and construction of qualifying assets, which
\nare assets that necessarily take a substantial period of time to get ready for their intended use or sale, are
\nadded to the cost of those assets, until such time as the assets are substantially ready for their intended
\nuse or sale.
\nAll other borrowing costs are recognised as an expense in the period in which they are incurred.
\nProvisions
\nA provision is recognised in the consolidated balance sheet when the group has a present legal or constructive
\nobligation as a result of a past event, and it is probable that an out\ufb02ow of economic bene\ufb01ts will be required
\nto settle the obligation. If the effect is material, provisions are determined by discounting the expected,
\nrisk-adjusted, future cash \ufb02ows at a pre-tax risk-free rate. Management consider their best estimate of the likely
\noutcomes of the obligation when determining the recognition. Where a material range of outcomes could arise,
\ndetails are disclosed accordingly. Provisions are measured gross of any expected insurance recovery. Any such
\ninsurance recoveries are recognised in other receivables when the receipt of them is judged virtually certain.
\nLeases
\nAt inception, the group assesses whether a contract is or contains a lease. This assessment involves the exercise
\nof judgement about whether the group obtains substantially all the economic bene\ufb01ts from the use of that
\nasset, and whether the group has the right to direct the use of the asset when considering whether the
\ncontract conveys the right to control the use of an identi\ufb01ed asset for a period of time in exchange for
\nconsideration. After initial recognition, the lease liability is measured at amortised cost using the effective
\ninterest method. A reassessment of the lease liability occurs when there is a change in lease payments. The
\nincremental borrowing rate is only revised where the change in payments is a result of a change in \ufb02oating
\ninterest rates, lease term change or a change in assessment relating to the exercise of purchase option charges.
\nThe group has elected not to separate lease and non-lease components for leases of vehicles or buildings.
\nThe group recognises a Right Of Use (ROU) asset and a lease liability at the commencement of the lease. The
\nROU is initially measured based on the present value of lease payments, less any incentives received. Initial
\ndirect costs and costs to dismantle or restore an asset are included. The ROU is depreciated over the shorter
\nof the lease term or the useful life of the underlying asset. The incremental borrowing rate is used to discount
\nthe assets over the relevant term. The ROU is subject to testing for impairment if there is an indicator for
\nimpairment.
\nLease payments generally include \ufb01xed payments and variable payments that depend on an index (such as
\nin\ufb02ation index) or rate. When the lease contains an extension or purchase option that the group considered
\nreasonably certain to be exercised, the cost of the option is included in the lease payments. The incremental
\nborrowing rate is used to discount the lease payments over the term of the lease.
\nROU assets are categorised to re\ufb02ect the nature of the underlying asset and to be consistent with the plant,
\nproperty and equipment (PPE) note. The assets are depreciated over the term of the lease, accounting for break
\nclauses or options to extend in line with the lease liability decision.
\nROU assets are disclosed as PPE on the balance sheet (non-current) with a separate disclosure within the
\nassociated note, and the lease liability is included in the headings lease liability (current and non-current)
\non the Consolidated balance sheet.
\nThe group has elected not to recognise ROU assets and liabilities for leases where the total lease term is less
\nthan 12 months, or for leases of low value equipment. The payments for such leases are recognised in the
\nConsolidated income statement on a straight line basis over the lease term.
\nSale and leaseback of properties
\nIn circumstances where the group sells a property to a third party and then enters into an agreement with the
\nbuyer to lease the asset back under a lease arrangement (a \u2018sale and leaseback transaction\u2019) which meets the
\ncriteria of a sale under IFRS 15, the group derecognises the underlying asset from PPE, and instead recognises a
\nROU asset measured at the retained portion of the previous carrying amount, recognising a gain or loss on the
\nrights transferred to the lessor. Values recognised will be adjusted where the sale is not completed at fair value,
\nor where lease payments do not re\ufb02ect market value.
\nWhere the sale of a property is not deemed a sale under IFRS 15, the group will continue to recognise the
\nunderlying asset within PPE, and will also recognise a \ufb01nancial liability for any amount received from the
\nbuyer/lessor.
\n
\n\n
\n
Share capital
\nOrdinary shares are classi\ufb01ed as equity. Incremental costs directly attributable to the issue of new shares
\nare deducted from share premium. Where the employee bene\ufb01t trust purchases the company\u2019s equity share
\ncapital, the consideration paid, including any directly attributable incremental costs, is deducted from equity
\nattributable to the company\u2019s equity holders in both the company and the consolidated balance sheet until
\nthe shares are cancelled or reissued.
\nDividend distribution
\nDividend distribution to the company\u2019s shareholders is recognised as a liability in the group\u2019s \ufb01nancial
\nstatements in the period in which the dividend is approved by the company\u2019s shareholders. Interim dividends
\nare recognised when paid.
\nPensions
\nThe group operates the Spire Healthcare Pension Plan, a de\ufb01ned contribution scheme. The assets of the
\nscheme are held separately from those of the group in independently administered funds.
\nObligations for contributions to de\ufb01ned contribution pension schemes are recognised as an expense in the
\nincome statement as incurred.
\nOther employee bene\ufb01ts
\nShort-term employee bene\ufb01t obligations are measured on an undiscounted basis and are expensed as the
\nrelated service is provided. A provision is recognised for the amount expected to be paid under short-term cash
\nbonuses if the group has a present legal or constructive obligation to pay this amount as a result of past service
\nprovided by the employee and the obligation can be estimated reliably.
\nShare based payments
\nThe group operates a number of equity-settled share-based payment schemes under which the group receives
\nservices from employees as consideration for equity instruments of the group. The fair value of the employee
\nservices received in exchange for the grant of the options is recognised as an expense. The group has estimated
\nthe relevant fair value of the share options and awards, which are subject to total shareholder return (\u2018TSR\u2019)
\nmarket-related performance criteria, using a Monte Carlo simulation model (see note 27). This applies to LTIP
\nAwards and Deferred Share Bonus Schemes.
\nThe group also operates a Save-As-You-Earn (\u2018SAYE\u2019) scheme, which is open to all employees. Employees are
\nrequired to save a \ufb01xed amount, up to a cap, every month for three years. At the end of the three year period
\nemployees are entitled to use their savings to purchase shares in the company at a stated exercise price.
\nEmployees are free to stop contributing to the scheme and obtain a refund of contributions at any time, but
\nforfeit their entitlement to exercise the options if they do so. Payment of contributions into a SAYE scheme is
\nnot a vesting condition; it does not meet the de\ufb01nition of a performance condition because it has no link to
\nservice. Failure to meet a non-vesting condition (eg by ceasing to contribute to an SAYE scheme) is accounted
\nfor as a cancellation of the options so that the expense is accelerated and recognised in the income statement,
\nwith a corresponding adjustment to equity as required. The IFRS 2 charge has been calculated using an
\nadjusted Black Scholes model with judgements including leavers of the scheme (employees who may cease
\nto save) and dividend yields.
\nAt the end of each year, the group revises its estimates of the number of options that are expected to vest
\nbased on the non-market conditions and recognises the impact of the revision to original estimates, if any,
\nin the income statement, with a corresponding adjustment to equity.
\nNon-current assets held for sale
\nNon-current assets and disposal groups are classi\ufb01ed as held for sale if their carrying amount will be recovered
\nprincipally through a sale transaction rather than through continuing use. This condition is regarded as met
\nonly when the sale is highly probable and the asset (or disposal group) is available for immediate sale in its
\npresent condition. Management must be committed to the sale, which should be expected to qualify for
\nrecognition as a completed sale within one year from the date of classi\ufb01cation.
\nNon-current assets (and disposal groups) classi\ufb01ed as held for sale are measured at the lower of their carrying
\namount and fair value less costs to sell.
\nImpairment
\nThe group applies its impairment policy to non-\ufb01nancial assets, being intangible assets (goodwill), plant,
\nproperty and equipment and right of use assets. The group assesses, at each reporting date, whether there
\nis an indication that an asset may be impaired. If any indication exists, or when annual impairment testing
\nfor an asset is required, the group estimates the asset\u2019s recoverable amount. An asset\u2019s recoverable amount
\nis the higher of an asset\u2019s or CGU\u2019s fair value less costs of disposal or its value in use. The recoverable amounts
\nis determined for an individual asset, unless the asset does not generate cash in\ufb02ows that are largely
\nindependent of those from other assets or groups of assets. When the carrying amount of an asset or CGU
\nexceeds its recoverable amount, the asset is considered impaired, and is written down to its recoverable
\namount.
\nIn assessing value in use, the estimated future cash \ufb02ows are discounted to their present value using a discount
\nrate that re\ufb02ects current market assessments of the time value of money and risks speci\ufb01c to the asset. As part
\nof this, the group assesses where climate risks could have a signi\ufb01cant impact, such as the introduction of
\nemission-reduction legislation that may increase costs. These risks in relation to climate-related matters are
\nincluded as key assumptions where they materially impact the measure of recoverable amount. The group
\nbases its impairment calculation on most recent budgets and forecast calculations, which are prepared for
\neach CGU. The forecasts generally cover a \ufb01ve year period. A long term growth rate is calculated and applies
\nto project future cash \ufb02ows after the \ufb01fth year.
\nImpairment losses of continuing operations are recognised in the consolidated income statement in other
\noperating costs. Impairment is likely to be considered an Adjusting item.
\nFor assets excluding goodwill, an assessment is made at each reporting date to determine whether there is an
\nindication that previously recognised impairment losses no longer exist or have decreased. If such indication
\nexists, the group estimates the asset\u2019s or CGU\u2019s recoverable amount. A previously recognised impairment
\nloss is reversed only if there has been a change in the assumptions used to determine the asset\u2019s recoverable
\namount since the last impairment loss was recognised. The reversal is limited so that the carrying amount
\nof the asset does not exceed its recoverable amount, nor exceed the carrying amount that would have been
\ndetermined, net of depreciation, had no impairment loss been recognised for the asset in prior years. Such
\nreversal is recognised in the statement of pro\ufb01t or loss.
\nGoodwill is tested for impairment annually as at 31 December and when circumstances indicate that the
\ncarrying value may be impaired.
\nImpairment is determined for goodwill by assessing the recoverable amount of each CGU (or group of CGUs)
\nto which the goodwill relates. When the recoverable amount of the CGU is less than its carrying amount, an
\nimpairment loss is recognised. Impairment losses relating to goodwill cannot be reversed in future periods.
\nIntangible assets with inde\ufb01nite useful lives are tested for impairment annually as at 31 December at the
\nCGU level, as appropriate, and when circumstances indicate that the carrying value may be impaired.
\n
\n\n
\n
Changes in accounting policy and estimates
\nNew standards, interpretations and amendments applied
\nThe following amendments to existing standards were effective for the group from 1 January 2022. Other than
\nsome additional disclosures, these amendments have not had a material impact.
\nEffective date*
\nAmendments to IFRS 3 Business Combinations \u2013 reference to the conceptual framework
1 January 2022
\nAmendments to IAS 16 \u2013 Property, Plant and Equipment: proceeds before intended use
1 January 2022
\nAmendments to IAS 37 \u2013 Onerous Contracts \u2013 costs of fulfilling a contract
1 January 2022
\nIFRS 9 Financial Instruments \u2013 Fees in the \u201810 per cent\u2019 test for derecognition of financial liabilities
1 January 2022
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations that are consistent with
\nthe endorsement process for use in the UK.
\nNew standards, interpretations and amendments in issue, but not yet effective
\nAs at date of approval of the group \ufb01nancial statements, the following new and amended standards,
\ninterpretations and amendments in issue are applicable to the group but not yet effective and thus, have not
\nbeen applied by the group:
\nEffective date*
\nAmendments to IAS 1 \u2013 Classification of liabilities as current or non-current
1 January 2023
\nAmendments to IAS 8 \u2013 Definition of accounting estimates
1 January 2023
\nAmendments to IAS 12 \u2013 Deferred tax related to assets and liabilities arising from a single
\ntransaction
1 January 2023
\nIFRS 17 \u2013 Insurance contracts
1 January 2023
\nAmendments to IFRS 16 \u2013 Lease Liability in a sale and leaseback
1 January 2024
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations. As the group prepares
\nits \ufb01nancial statements in accordance with IFRS as issued by the IASB as endorsed by the UK, the application of new standards
\nand interpretations will result in an effective date subject to that agreed by the UK Endorsement process.
\nIFRS 17 is under review by management and the impact if any is still to be quanti\ufb01ed. All other amendments
\nare not expected to have a material impact on the group.
\nChanges in accounting estimates
\nIn line with our accounting policy, management has reviewed the expected useful lives and residual values of
\nproperty, plant and equipment. This exercise included a detailed benchmarking exercise. As a result, the useful
\nlife and residual value for freehold land and buildings has been revised, and with effect from 1 July 2022 the
\ngroup changed its estimate for freehold buildings from 5-50 years to 5-60 years.
\nThe benchmarking exercise con\ufb01rmed that it would be appropriate to also revise the residual value on freehold
\nhospital buildings to 20% from a nil residual value and this change took place with effect from 1 July 2022.
\nManagement has therefore concluded that it would be appropriate to apply a 20% residual value to the original
\ncost of the freehold properties, and this change took effect on 1 July 2022.
\nManagement has concluded that the impact of climate-related risks would not have a material impact on the
\nextended useful life and residual value of its freehold land and buildings, as these risks have been mitigated.
\nThe depreciation charged to the pro\ufb01t and loss in the current year was \u00a397.9 million (2021:\u00a397.1 million).
\nThe change in accounting estimate has resulted in a reduction in depreciation of \u00a32.9 million in the current
\nyear. In addition this has given rise to a one-off deferred tax credit of \u00a39.0 million. The effect of the change
\nin future period is to decrease annual depreciation by c. \u00a36.0 million.
\n3. Critical accounting judgements and estimates
\nIn the application of the group\u2019s accounting policies, the directors are required to make judgements and
\nestimates about the carrying amounts of assets and liabilities that are not readily apparent from other sources.
\nThe estimates and associated assumptions are based on historical experience and other factors that are
\nconsidered to be relevant. Actual results may differ from these estimates.
\nJudgements
\nAdjusting items
\nJudgements are required as to whether items that are material in size, unusual or infrequent in nature should
\nbe disclosed as adjusting items. Deciding which items meet the respective de\ufb01nitions requires the group to
\nexercise its judgement. Details of these items categorised as adjusting items are outlined in note 10.
\nLeases
\nThe application of IFRS 16 requires the group to make certain judgements which affect the value of the ROU
\nasset and lease liability, and these include: determining contracts in the scope of IFRS 16 and the contract term.
\nThe lease term is determined by the group and includes the non-cancellable period of lease contracts, periods
\ncovered by an option to extend the lease if the group is reasonably certain to exercise that option and period
\ncovered by an option to terminate the lease if the group is reasonably certain not to exercise that option. The
\ngroup reviews the business plan, investment in leasehold improvements and market conditions when
\nconsidering the certainty of options to extend or terminate. For lease contracts with an inde\ufb01nite term, the
\ngroup determines the length of the contract to be equal to the average or typical market contract term of the
\nparticular type of lease. The same life is then applied to determine the depreciation rate of ROU assets.
\nIn the prior period, the group undertook a sale and leaseback. The group determined that the sale criteria had
\nbeen met. There was no option to purchase, and any option to extend would be completed at fair value at the
\npoint of exercise of such option.
\nSigni\ufb01cant accounting estimates
\nThe preparation of the group\u2019s consolidated \ufb01nancial statements includes the use of estimates and
\nassumptions. The signi\ufb01cant accounting estimates with a signi\ufb01cant risk of a material change to the carrying
\nvalue of assets and liabilities within the next year in terms of IAS 1, \u2018Presentation of Financial Statements\u2019, are:
\nGoodwill
\nGoodwill is tested for impairment at least annually or more frequently if there is an indication that goodwill
\nmay be impaired. This is achieved by comparing the carrying value in the accounts with the recoverable
\namount (being the value-in-use), as set out in the impairment policy. The value-in-use calculations require
\nthe group to estimate future cash \ufb02ows expected to arise in the future, taking into account market conditions.
\nThe current value of goodwill is underpinned by these forecasts. The present value of these cash \ufb02ows is
\ndetermined using an appropriate discount rate.
\nThe assumptions are considered to be most critical in reviewing goodwill for impairment are contained in
\nnote 14.
\n
\n\n
\n
Property impairment
\nProperty, including property ROU assets, is considered for indicators of impairment at each reporting date, or
\nearlier if a trigger indicates, as set out in the impairment policy. The recoverable amount, being the value-in-use,
\nrequire the group to estimate cash \ufb02ows expected to arise in the future, taking into account market conditions.
\nThe variables in the cash \ufb02ows are interdependent and re\ufb02ect management\u2019s expectations based on past
\nexperience and current market trends, it takes into account both current business and committed initiatives.
\nThe present value of these cash \ufb02ows is determined using an appropriate discount rate.
\nThe assumptions are considered to be most critical in reviewing properties for impairment are contained
\nin note 13.
\nOther areas of accounting estimates
\nThe consolidated \ufb01nancial statements include other areas of judgement and accounting estimates. While
\nthese areas do not meet the de\ufb01nition under IAS 1 of signi\ufb01cant accounting estimates and critical accounting
\njudgements, the recognition and measurement of certain material assets and liabilities are based on
\nassumptions and/or are subject to longer term uncertainties. The other areas of accounting estimates
\nand judgement are:
\nLeases
\nThe present value of the lease payment is determined using the discount factor (incremental borrowing rate)
\nwhich is based on a risk free UK gilt rate plus an applicable credit spread or margin to re\ufb02ect the credit standing
\nof the group observed in the period when the lease contract commences or is modi\ufb01ed. The incremental
\nborrowing rate applied re\ufb02ects a rate for a similar term and security to that of the lease and is determined
\nat inception.
\nDetails of incremental borrowing rates can be found in note 22.
\nExpected credit losses
\nThe group has not changed the methodology in respect of the expected credit loss (ECL) calculations. The
\ngroup\u2019s customer pro\ufb01le includes large organisations that have stable credit ratings, and the payment pro\ufb01les
\nhave remained stable for historical debts. The exception to this is patient debt where economic circumstances
\ncan have a signi\ufb01cant impact and, given the current economic uncertainty, remains the highest risk for the
\ngroup. The ECL as at December 2022 is \u00a35.0 million (December 2021: \u00a34.1 million). See note 18.
\nClimate-related risk and opportunities on the \ufb01nancial statements
\nTo date, the board has not identi\ufb01ed any climate-related risks or opportunities that would have a material
\nimpact on the assets or liabilities of the group, and therefore has not adjusted \ufb01nancial balances for climate-
\nrelated risks or opportunities.
\n4. Auditor\u2019s remuneration
\nDuring the year, the group (including its subsidiary undertakings) obtained the following services from the
\ngroup\u2019s external auditor as detailed below:
\n(\u00a3m)
2022
2021
\nAudit of these financial statements
1.0
0.6
\nAudit of the financial statements of subsidiaries of the company pursuant to
\nlegislation
0.3
0.2
\nAudit-related assurance services
0.1
0.1
\nTotal
1.4
0.9
\n5. Segmental reporting
\nIn determining the group\u2019s operating segment, management has primarily considered the \ufb01nancial information
\nin internal reports that are reviewed and used by the executive management team and board of directors
\n(who together are the chief operating decision maker of Spire Healthcare) in assessing performance and in
\ndetermining the allocation of resources. The \ufb01nancial information in those internal reports in respect of
\nrevenue and expenses has led management to conclude that the group has a single operating segment,
\nbeing the provision of healthcare services. All revenue is attributable to, and all non-current assets are located
\nin, the United Kingdom.
\nThe nature of the NHS COVID-19 speci\ufb01c contracts in Q1 2021, and speci\ufb01c agreement with one hospital in
\nFY22, means that not all of the detail of revenue by location (inpatient, daycase or outpatient) is available. In Q1
\n2021, where a patient was admitted, this revenue has been recorded within the revenue by location. Amounts
\nrelating to the minimum income guarantee over and above admitted patients, or any other elements are
\nre\ufb02ected in the NHS COVID-19 line.
\nRevenue by location (inpatient, daycase or outpatient) and wider customer (payor) group is shown below:
\n(\u00a3m)
2022
2021
\nInpatient
487.5
414.2
\nDaycase
348.0
307.0
\nOutpatient
333.1
300.9
\nOther
\n1
\n26.4
26.0
\nNHS \u2013 COVID-19
3.5
58.1
\nTotal revenue
1,198.5
1,106.2
\nInsured
538.7
473.7
\nSelf-pay
338.0
292.0
\nNHS
295.4
314.5
\nOther
\n1
\n26.4
26.0
\nTotal revenue
1,198.5
1,106.2
\n1.
Other revenue includes fees paid to the group by consultants (eg for the use of group facilities and services) and third-party
\nrevenue (eg pathology services to third-parties).
\nGroup revenues increased 8.3% to \u00a31,198.5 million (2021: \u00a31,106.2 million). The increase in revenue driven
\nby the ongoing strong demand for private treatment with the continued growth in self-pay seen during the
\nprior period, but also the recovery by Insured patients. NHS revenue of \u00a3295.4 million includes \u00a33.5 million
\n(2021: \u00a3314.5 million and \u00a358.1 million respectively) revenue from speci\ufb01c COVID-19 contracts. In the prior
\nyear (Q1 2021) the group operated under an NHS volume based contract with a minimum income guarantee,
\nincluded in the \u00a358.1 million was \u00a347.4 million re\ufb02ecting the \u2018top up\u2019 to minimum income guaranteed under
\nthe contract.
\n
\n\n
\n
6. Other income
\n(\u00a3m)
2022
2021
\nFair value movement on financial asset
2.3
0.7
\nRealised profit in respect of financial asset
0.7
0.4
\nProfit on disposal relating to sale and leaseback, net of costs (adjusting item)
\n(see note 10)
\u2013
23.3
\nTotal other income
3.0
24.4
\nThe fair value movement and realised pro\ufb01t in respect of the \ufb01nancial asset re\ufb02ect the on-going pro\ufb01t share
\narrangement with Genesis Care which arose as part of the sale of the Bristol Cancer Centre sold in 2019.
\n7. Operating pro\ufb01t
\nArrived at after charging/(crediting):
\n(\u00a3m)
2022
2021
\nDepreciation of property, plant and equipment (see note 13)
64.2
67.4
\nDepreciation of right of use assets (see note 13)
33.7
29.7
\nAcquisition-related transaction costs (adjusting Item) (see note 10)
1.8
1.5
\nLease payments made in respect of low value and short leases
13.6
12.3
\nProvision following a court judgment related to Ian Paterson (adjusting Item)
\n(see note 10)
0.3
12.2
\nImpairment on assets held for sale (see note 20)
0.5
\u2013
\nMovement on the provision for expected credit losses of trade receivables
\n(see note 18)
0.9
(1.2)
\nLoss on disposal of property, plant and equipment
0.3
\u2013
\nFair value adjustment on financial liability
0.8
\u2013
\nStaff restructuring costs (see notes 9)
4.5
1.2
\nStaff costs (net of staff restructuring costs and including share based payment
\ncharge) (see note 9 and 27)
413.9
396.4
\nProfit on disposal relating to sale and leaseback (adjusting Item) (see note 10)
\u2013
(23.5)
\nProfit on disposal relating to a lease modification at Spire Sussex (adjusting Item)
\n(see note 10)
\u2013
(0.4)
\nProfit on the early termination of a lease (adjusting Item) (see note 10)
\u2013
(0.2)
\nImpairment losses and reversals of impairment are included in other operating costs.
\nInventory recognised as an expense in the current year is disclosed in note 17.
\n8. Finance income and costs
\n(\u00a3m)
2022
2021
\nFinance cost
\nInterest on bank facilities
12.4
18.8
\nInterest on the RSA judgement repayable (included in adjusting items)
\u2013
0.8
\nRefinancing fees
1.0
\u2013
\nAmortisation of fee arising on facilities extensions/borrowing costs
\n1
\n1.5
1.0
\nAccelerated amortisation and loss on extinguishment of loan
\n1
\n3.1
\u2013
\nIFRS 9 release arising on facilities extension
\n1
\n\u2013
0.1
\nInterest on obligations under leases
73.5
68.2
\nTotal finance costs
91.5
88.9
\nTotal net finance costs
91.5
88.9
\n1.
\u00a35.0 million of borrowing costs were capitalised on the re\ufb01nancing of the senior facility, these are being amortised. In the prior
\nyear \u00a33.3 million that was recorded at the date of the 2018 extension and \u00a30.3 million recorded at the date of the 2020 extension.
\nThe remaining balance of these fees were changed to the pro\ufb01t and loss in the year on the extinguishment of the old loan.
\n9. Staff costs
\n(No.)
2022
\nRestated
\n1
\n2021
\nThe average number of persons employed by the group (including directors) during
\nthe year:
\nClinical
7,388
7,280
\nNon-clinical
5,227
5,426
\nCentral
614
596
\nTotal
13,229
13,302
\n(No.)
2022
2021
\nThe average number of full-time equivalent persons employed by the group during
\nthe year:
\nClinical
5,539
5,476
\nNon-clinical
4,017
4,134
\nCentral
538
521
\nTotal
10,094
10,131
\n1.
The prior year average number of persons employed by the group was restated to include bank staff. The average number of
\npersons employed by the group disclosed in the prior year was 11,220.
\nThe aggregate payroll costs of these persons were as follows:
\n(\u00a3m)
2022
2021
\nWages and salaries
350.3
336.8
\nSocial security costs
34.7
31.1
\nPension costs, defined contribution scheme
33.4
29.7
\n418.4
397.6
\n
\n\n\n
There were \u00a34.7 million wages and salaries and social security costs for year ended 31 December 2022 in
\nAdjusting items (2021: \u00a31.3 million) of which \u00a34.5 million relate to business restructuring costs and which
\nare included in staff costs (2021: \u00a31.2 million), and are set out in note 7.
\nPension costs are in respect of the de\ufb01ned contribution scheme; unpaid contributions at 31 December 2022
\nwere \u00a32.7 million (2021: \u00a32.8 million).
\n10. Adjusting items
\n(\u00a3m)
2022
2021
\nBusiness reorganisation and corporate restructuring costs
4.5
1.2
\nAsset acquisitions, disposals, impairment and aborted project costs
4.3
4.5
\nRemediation of regulatory compliance or malpractice costs
1.1
11.4
\nHospital set up and closure costs
0.3
0.3
\nIncome from asset disposals
\u2013
(23.3)
\nTotal adjusting items in operating costs
10.2
(5.9)
\nInterest payable on adjusting items
\u2013
0.8
\nTotal pre-tax adjusting items
10.2
(5.1)
\nIncome tax (credit)/charge on adjusting items
(1.8)
(13.8)
\nTotal post-tax adjusting items
8.4
(18.9)
\nAdjusting items comprise those matters where the directors believe the \ufb01nancial effect should be adjusted
\nfor, due to their nature, size or incidence, in order to provide a more accurate comparison of the group\u2019s
\nunderlying performance.
\nDuring H2 21, the group announced a strategic, group wide initiative that impacts the operating model of the
\ngroup to allow a more ef\ufb01cient governance and reporting structure, as well as a drive on digital functionality.
\nThis initiative will be implemented over several phases. In the period, \u00a34.5 million (2021: \u00a31.2 million) has been
\nincurred. The initial phase of the initiative was completed in 2022, the estimated time frame to overall
\ncompletion being the end of 2024.
\nAsset acquisitions, disposals, impairment and aborted project costs of \u00a34.3 million mainly comprise costs in
\nrespect of the acquisition of The Doctors Clinic Group, and the acquisition of the minority interest in Claremont,
\nas well as its integration with the group. In the prior year costs incurred by the group relating to Merger and
\nAcquisition (M&A) costs, related to the attempted takeover bid by Ramsay Health Care, and the acquisition
\nand integration of Claremont.
\nIn December 2022, the group acquired 100% of the share capital in The Doctors Clinic Group Limited for
\n\u00a312 million as part of its strategic investment in its broader healthcare offering. The costs of acquisition
\nof \u00a31.8 million have been incurred in the period. Costs for integration are expected to continue into FY23.
\nFollowing the acquisition of Claremont Hospital in November 2021, the group has incurred costs of \u00a30.5 million
\nfor integration alongside some transitional services in the period. In addition, on 31 March 2022, the group
\nacquired the remaining minority interest for \u00a32.7 million, of which \u00a31.9 million had been provided for in FY21.
\nTherefore, \u00a30.8 million is included in adjusting items. Other costs incurred mainly relate to the \ufb01nal business
\ntransfer of the Sussex Hospital to the NHS Trust which completed on 31 March 2022, as announced during
\nFY21. In addition, integration costs of \u00a30.5 million were incurred in the period.
\nIn December 2022, the group completed on the sale of St Saviours, an asset held for sale, for \u00a33.2 million,
\nfollowing a write down in value reported at H1 2022 of \u00a30.5 million recognised in other operating costs.
\nIn the prior period, the group agreed the sale and leaseback of its Cheshire Hospital for consideration of
\n\u00a389 million. A gain on disposal of \u00a323.5 million has been recognised, offset by \u00a30.2 million of costs to sell.
\nRemediation of regulatory compliance or malpractice costs includes amounts paid to the insurer following
\nthe Court of Appeal hearing. \u00a313.0 million was provided in FY21, with \u00a313.3 million being settled in FY22.
\nThe \u00a30.3 million recognised in the period re\ufb02ects this additional amount. In the prior year, and in response
\nto the Public Inquiry the group commenced a detailed patient review initiative, during the year the group has
\nre-evaluated the expected cost of completing this complex project, and its associated settlement of claims.
\nAs a result, the group has increased its overall provision in respect of Paterson by \u00a30.9 million. In the prior year,
\na credit of \u00a30.4 million was recognised following the settlement of costs to Spire Healthcare from its insurer
\nfollowing the original judgment \ufb01nding in favour of the group in FY20.
\nHospital set-up and closure costs mainly relate to the maintenance costs of non-operational sites.
\n11. Taxation
\n(\u00a3m)
2022
2021
\nCurrent tax
\nUK corporation tax expense
0.1
0.8
\nAdjustments in respect of prior years
(0.7)
\u2013
\nTotal current tax (credit)/charge
(0.6)
0.8
\nDeferred tax
\nOrigination and reversal of temporary differences
(2.6)
(15.0)
\nEffect of change in tax rate
\u2013
17.7
\nAdjustments in respect of prior years
(1.1)
3.5
\nTotal deferred tax (credit)/charge
(3.7)
6.2
\nTotal tax (credit)/charge
(4.3)
7.0
\nIn addition to the above, a charge of \u00a32.1 million has been recognised in Other Comprehensive income
\n(2021: \u00a30.6 million charge) and \u00a30.1 million charge (2021: \u00a33.0 million credit) through equity.
\nCorporation tax is calculated at 19.0% (2021: 19.0%) of the estimated taxable pro\ufb01t or loss for the year. The
\neffective tax rate on pro\ufb01t before taxation for the year was not meaningful (2021: not meaningful) as a result
\nof adjustments in respect of prior years and movements on deferred tax which are not directly linked to pro\ufb01t.
\nDuring the period, the group has reassessed the useful life and residual value of its freehold property portfolio.
\nThis has results in a one-off deferred tax credit of \u00a39.0 million. The prior year deferred tax charge was largely
\ndriven by the effects of revaluing deferred tax assets and liabilities from 19% to 25% due in April 2023, and
\nthe deferred tax movement as a result of the sale and leaseback of Spire Cheshire. Deferred tax is detailed
\nin note 23.
\n
\n\n
\n
The effective tax assessed for the year, all of which arises in the UK, differs from the standard weighted rate
\nof corporation tax in the UK. The reconciliation of the actual tax charge to that at the domestic corporation tax
\nrate is as follows:
\n(\u00a3m)
2022
2021
\nProfit/(loss) before taxation
3.9
(1.9)
\nTax at the standard rate
0.7
(0.4)
\nEffects of:
\nExpenses and income not deductible or taxable
8.2
4.5
\nTax adjustment for the super-deduction allowance
(2.6)
(2.2)
\nTax adjustment in respect of sale and leaseback
\u2013
(16.0)
\nImpairment charge in respect of held for sale assets (not tax deductible)
0.1
\u2013
\nOne-off impact of revision to useful economic life and residual value of freehold
\nproperty portfolio
(9.0)
\u2013
\nAdjustments to prior year
(1.8)
3.5
\nDifference in tax rates
0.1
17.7
\nDeferred tax not previously recognised
\u2013
(0.1)
\nTotal tax (credit)/charge
(4.3)
7.0
\nExpenses and income not deductible or taxable relate mostly to depreciation on non-qualifying \ufb01xed assets,
\ndisallowable entertaining and legal and professional fees. The one-off impact of revision to useful life and
\nresidual value of the freehold property portfolio is described in note 23.
\nThe charge above in the prior year was driven mainly by the revaluation of deferred tax assets and liabilities
\nto 25% from 19% as a result of the substantive enactment of the government\u2019s decision to increase the
\ncorporation tax rate from 1 April 2023, as well as the deferred tax movement as a result of the sale and
\nleaseback of Spire Cheshire. The current year charge driven by expenses not deductible for tax purposes, offset
\nby the one-off deferred tax credit of \u00a39.0 million as a result in the revision to the useful life and residual value
\nof the freehold property portfolio, an adjustment in respect of prior year and the claim of the super deduction
\nfor capital allowance purposes.
\nThe group does not hold any uncertain tax positions under IFRIC 23 at the year-end (2021: none).
\n12. Earnings per share (EPS)
\nBasic EPS is calculated by dividing the pro\ufb01t for the year attributable to ordinary equity holders of the parent
\nby the weighted average number of ordinary shares outstanding during the year.
\n2022
2021
\nProfit/(loss) for the year attributable to ordinary equity holders of the parent (\u00a3m)
8.6
(9.7)
\nWeighted average number of ordinary shares for basic EPS (No.)
402,756,797
401,087,547
\nAdjustment for weighted average number of shares held in EBT
(77,501)
(239,283)
\nWeighted average number of ordinary shares in issue (No.)
402,679,296
400,848,264
\nBasic earnings per share (in pence per share)
2.1
(2.4)
\nFor dilutive EPS, the weighted average number of ordinary shares in issue is adjusted to include all dilutive
\npotential ordinary shares arising from share options. Refer to the remuneration committee report for the terms
\nand conditions of instruments generating potential ordinary shares that affect the measurement of diluted
\nEPS.
\n2022
2021
\nProfit/(loss) for the year attributable to ordinary equity holders of the parent (\u00a3m)
8.6
(9.7)
\nWeighted average number of ordinary shares in issue (No.)
402,679,296
400,848,264
\nAdjustment for weighted average number of contingently issuable shares
9,363,470
\u2013
\nDiluted weighted average number of ordinary shares in issue (No.)
412,042,766
400,848,264
\nDiluted earnings per share (in pence per share)
2.1
(2.4)
\nIn the prior year the weighted average number for contingently issuable shares would be anti-dilutive, they are
\nexcluded from the above. However 8,891,739 shares are potentially dilutive.
\nThe directors believe that EPS excluding adjusting items (\u2018adjusted EPS\u2019) better re\ufb02ects the underlying
\nperformance of the business and assists in providing a clearer view of the performance of the group.
\nReconciliation of pro\ufb01t after taxation to pro\ufb01t after taxation excluding adjusting items (\u2018adjusted pro\ufb01t\u2019):
\n2022
2021
\nProfit/(loss) for the year attributable to owners of the parent (\u00a3m)
8.6
(9.7)
\nAdjusting items (see note 10)
8.4
(18.9)
\nAdjusted profit/(loss) (\u00a3m)
17.0
(28.6)
\nWeighted average number of Ordinary Shares in issue
402,679,296
400,848,264
\nWeighted average number of dilutive Ordinary Shares
412,042,766
400,848,264
\nAdjusted basic earnings per share (in pence per share)
4.2
(7.1)
\nAdjusted diluted earnings per share (in pence per share)
4.1
(7.1)
\nIn the prior year the weighted average number for contingently issuable shares would be anti-dilutive, they are
\nexcluded from the above. However 8,891,739 shares are potentially dilutive.
\n
\n\n
\n
13. Property, plant and equipment
\n(\u00a3m)
\nFreehold
\nproperty
\nLeasehold
\nimprovements
Equipment
\nAssets in the
\ncourse of
\nconstruction
\nRight of use
\n(ROU)
Total
\nCost:
\nAt 1 January 2021
870.5
164.0
447.4
9.2
763.9
2,255.0
\nAdditions
11.4
11.9
47.6
6.2
\u2013
77.1
\nAcquisition of a subsidiary (Note 32)
\u2013
0.1
4.7
25.5
30.3
\nAdditions to ROU assets
\u2013
\u2013
\u2013
\u2013
32.6
32.6
\nAdjustments to existing assets (eg
\nindexation)
\u2013
\u2013
\u2013
\u2013
9.7
9.7
\nDisposals
(35.9)
(1.7)
(20.9)
\u2013
(5.8)
(64.3)
\nTransfers
\n1
\n(0.7)
3.4
1.8
(4.5)
\u2013
\u2013
\nAt 1 January 2022
845.3
177.7
480.6
10.9
825.9
2,340.4
\nAdditions
8.5
6.4
55.9
19.3
\u2013
90.1
\nAcquisition of a subsidiary (Note 32)
\u2013
\u2013
0.6
\u2013
\u2013
0.6
\nAdditions to ROU assets
\u2013
\u2013
\u2013
\u2013
4.9
4.9
\nAdjustments to existing assets (eg
\nindexation)
\u2013
\u2013
\u2013
\u2013
34.0
34.0
\nDisposals
(3.6)
(3.7)
(71.8)
\u2013
(0.9)
(80.0)
\nTransfer
\u2013
\u2013
(10.0)
\u2013
10.0
\u2013
\nAt 31 December 2022
850.2
180.4
455.3
30.2
873.9
2,390.0
\nAccumulated depreciation and
\nimpairment:
\nAt 1 January 2021
180.3
46.9
295.3
\u2013
197.2
719.7
\nCharge for the year
17.9
8.4
41.1
\u2013
29.7
97.1
\nAcquisition of a subsidiary (Note 32)
\u2013
\u2013
4.1
\u2013
\u2013
4.1
\nDisposals
(9.2)
(0.9)
(19.7)
\u2013
(4.2)
(34.0)
\nAt 1 January 2022
189.0
54.4
320.8
\u2013
222.7
786.9
\nCharge for the year
12.3
9.3
42.6
\u2013
33.7
97.9
\nDisposals
(3.1)
(3.6)
(71.6)
\u2013
(0.9)
(79.2)
\nAt 31 December 2022
198.2
60.1
291.8
\u2013
255.5
805.6
\nNet book value:
\nAt 31 December 2022
652.0
120.3
163.5
30.2
618.4
1,584.4
\nAt 31 December 2021
656.3
123.3
159.8
10.9
603.2
1,553.5
\nThe net book value of land is \u00a3156.3 million (2021: \u00a3156.3 million). During the year the group re\ufb01nanced
\nits senior \ufb01nance facility and pledged nine of its freehold properties as security, the net book value of these
\nproperties are \u00a3157.6 million as at 31 December 2022. No assets in the prior year were subject to restriction
\non title or pledged as security for liabilities. There were no borrowing costs capitalised during the year ended
\n31 December 2022 (2021: Nil).
\nImpairment testing
\nThe directors consider property and property right-of-use assets for indicators of impairment semi-annually.
\nAs equipment and leasehold improvements do not generate independent cash \ufb02ows, they are considered
\nalongside the property as a single cash-generating unit (\u2018CGU\u2019). When making the assessment, the value-in-use
\nof the property is compared with its carrying value in the accounts. Where headroom is signi\ufb01cant, no further
\nwork is undertaken. Where headroom is minimal, a detailed assessment is performed for the property, which
\nincludes identifying the factors resulting in limited headroom and undertaking \ufb01nancial forecasts to assess the
\nlevel of sensitivity this has to key assumptions.
\nIn order to estimate the value-in-use, management has used trading projections covering the period to
\nDecember 2027 from the most recent board approved strategic plan. The variables in the cash \ufb02ows are
\ninterdependent and re\ufb02ect management\u2019s expectations based on past experience and current market trends,
\nit takes into account both current business and committed initiatives. To the extent that there was a shortfall
\nbetween the recent actual cash \ufb02ows and forecast, the future cash \ufb02ows have been adjusted to re\ufb02ect any
\ninitiatives implemented by management to address the underlying cause. In addition, management consider
\nthe potential \ufb01nancial impact from short term climate change scenarios, and the cost of initiatives by the
\ngroup to manage the longer term climate impacts.
\nKey assumptions
\nManagement identi\ufb01ed a number of key assumptions relevant to the value-in-use calculations, being EBITDA
\ngrowth over the \ufb01ve year period, capital maintenance spend, discount rates and long term growth rates. The
\nassumptions are based on past experience and external sources of information.
\nThere were three properties triggered for detailed review in the period owing to the relatively lower level of
\nheadroom. Management has performed a sensitivity analysis on these properties using reasonably possible
\nchanges for each key assumption, keeping all other assumptions constant. The sensitivity analysis included
\nan assessment of the break-even point for each of the key assumptions.
\nThe trading projections for the \ufb01ve-year period underlying the value in use re\ufb02ect a growth in EBITDA. EBITDA
\nis based on a number of elements of the operating model over the longer-term, including pricing trends,
\nvolume growth and the mix and complexity of procedures and assumptions regarding cost in\ufb02ation. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible change that would result the elimination of headroom
\nfor each property as shown in the table below.
\nThe group has used a pre-tax discount rate of 10.6% (2021: 8.5%), adjusted for the effect of IFRS 16. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible change in the pre-tax discount rate, would result in the
\nelimination of headroom as shown in the table below.
\nFor the properties triggered for review the table below provides the headroom and the reasonably possible
\nchange identi\ufb01ed in the sensitivity analysis mentioned above which would result in the elimination of headroom.
\nHeadroom (the amount
\nthat recoverable amount
\nexceeded the carrying
\namount)
\nEBITDA growth over
\nthe five year period
\nSensitivity for
\ndecrease of EBITDA
\ngrowth per annum
\nSensitivity for increase
\nof the pre-tax discount
\nrate sensitivity
\nProperty CGU 1
\u00a35.7m
2%\u201362%
8.6%
270 bps
\nProperty CGU 2
\u00a35.0m
2%\u201370%
4.5%
299 bps
\nProperty CGU 3
\u00a37.4m
0%\u201379%
2.6%
135 bps
\n
\n\n
\n
Impairment
\nA long-term growth rate of 2.0% has been applied to cash \ufb02ows beyond 2027 based on long term view of
\nin\ufb02ation, revenue growth and market conditions. Capital maintenance spend is based on historic run rates and
\nour expectations of the group\u2019s requirements. The sensitivity testing identi\ufb01ed no reasonably possible changes
\nin the capital maintenance and long term growth rates that would cause the carrying amount of any CGU to
\nexceed its recoverable amount.
\nAs a result, management believe that some of the key impairment review assumptions constitute a major
\nsource of estimation uncertainty as they consider that there is a signi\ufb01cant risk of a material change to its
\nestimate of these assumptions within the next 12 months.
\nRight of use (ROU) assets
\n(\u00a3m)
\nLeasehold
\nproperty
\nEquipment and
\nmotor vehicles
Total
\nCost:
\nAt 1 January 2021
760.4
3.5
763.9
\nNew leases entered
25.5
7.1
32.6
\nAcquisition of a subsidiary (Note 32)
25.5
\u2013
25.5
\nAdjustments to existing assets (eg indexation)
9.7
\u2013
9.7
\nDisposals
(5.6)
(0.2)
(5.8)
\nTransfers
\u2013
\u2013
\u2013
\nAt 1 January 2022
815.5
10.4
825.9
\nNew leases entered
0.4
4.5
4.9
\nAdjustments to existing assets (eg indexation)
34.0
\u2013
34.0
\nDisposals
(0.1)
(0.8)
(0.9)
\nTransfers
\u2013
10.0
10.0
\nAt 31 December 2022
849.8
24.1
873.9
\nAccumulated depreciation and impairment:
\nAt 1 January 2021
194.8
2.4
197.2
\nCharge for year
27.4
2.3
29.7
\nDisposals
(4.0)
(0.2)
(4.2)
\nAt 1 January 2022
218.2
4.5
222.7
\nCharge for the year
29.9
3.8
33.7
\nDisposals
(0.1)
(0.8)
(0.9)
\nAt 31 December 2022
248.0
7.5
255.5
\nNet book value:
\nAt 31 December 2022
601.8
16.6
618.4
\nAt 31 December 2021
597.3
5.9
603.2
\n14. Intangible assets
\n(\u00a3m)
Goodwill
\nCost or valuation:
\nAt 1 January 2021
518.8
\nAcquisition of a subsidiary
17.0
\nAt 31 December 2021
535.8
\nAcquisition of a subsidiary
11.1
\nAdjustment to prior year goodwill acquired
(0.1)
\nAt 31 December 2022
546.8
\nImpairment:
\nAt 31 December 2021 and 31 December 2022
201.0
\nCarrying amount:
\nAt 31 December 2022
345.8
\nAt 31 December 2021
334.8
\nAcquisition during the year
\nOn 16 December 2022, the group acquired 100% of the voting shares of The Doctors Clinic Group, a non-listed
\ncompany based in England who are an integrated provider of occupational health services and private GP
\nservices, for \u00a312 million generating goodwill of \u00a311.1 million.
\nImpairment testing
\nThe directors treat the business as a single cash-generating unit for the purposes of testing goodwill for
\nimpairment prior to the acquisition of The Doctors Clinic Group. The recoverable amount of goodwill is
\ncalculated by reference to its estimated value-in-use. In order to estimate the value-in-use, management has
\nused trading projections covering the period to December 2027 from the most recent board approved strategic
\nplan. The variables in the cash \ufb02ows are interdependent and re\ufb02ect management\u2019s expectations based on past
\nexperience and current market trends, it takes into account both current business and committed initiatives. In
\naddition, management consider the potential \ufb01nancial impact from short term climate change scenarios, and
\nthe cost of initiatives by the group to manage the longer term climate impacts. The recoverable amount
\nexceeded the carrying amount by c\u00a3400 million.
\nKey assumptions
\nManagement identi\ufb01ed a number of key assumptions relevant to the value-in-use calculations, being EBITDA
\nmargin growth over the \ufb01ve year period, capital maintenance spend, discount rates and long term growth
\nrates. The assumptions are based on past experience and external sources of information.
\nManagement has performed a sensitivity analysis using reasonably possible changes for each key assumption,
\nkeeping all other assumptions constant. The sensitivity analysis included an assessment of the break-even
\npoint for each of the key assumptions.
\nThe trading projections for the \ufb01ve year period underlying the value in use re\ufb02ect a growth in EBITDA margin.
\nEBITDA Margin is dependent on a number of elements of the operating model over the longer-term, including
\npricing trends, volume growth and the mix and complexity of procedures and assumptions regarding cost
\nin\ufb02ation. The growth in EBITDA margin over the next 5 years ranges between 0.5% and 1.8% per annum. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible decrease of 12% in the annual EBITDA forecast within
\nthe trading projection (2023-2027) would result in the elimination of headroom.
\n
\n\n\n
The group has used a pre-tax discount of 10.6% (2021: 8.5%), adjusted for the effect of IFRS 16. The sensitivity
\nanalysis identi\ufb01ed that a reasonably possible increase of 250 bps in the pre-tax discount rate, would result in
\nthe elimination of headroom.
\nA long-term growth rate of 2.0% has been applied to cash \ufb02ows beyond 2027 based on long term view of
\nin\ufb02ation and market conditions. Capital maintenance spend is based on historic run rates and our expectation
\nof the group\u2019s requirements. The sensitivity testing identi\ufb01ed no reasonably possible changes in the capital
\nmaintenance and long term growth rates that would cause the carrying amount of any CGU to exceed its
\nrecoverable amount.
\nAs a result, management believe that some of the key impairment review assumptions constitute a major
\nsource of estimation uncertainty as they consider that there is a signi\ufb01cant risk of a material change to its
\nestimate of these assumptions within the next 12 months.
\n15. Financial assets
\nOn 31 October 2019, the group entered into a pro\ufb01t share arrangement with Genesis Care. The agreement
\nprovides the group with an entitlement to a gross pro\ufb01t share relating to the chemotherapy business
\ntransferred to Genesis Care as part of the sale of the Bristol Cancer Centre in perpetuity.
\nThe group has recognised a \ufb01nancial asset in respect of this gross pro\ufb01t share and the asset is classed as a fair
\nvalue through pro\ufb01t and loss asset. The \ufb01nancial asset is valued using forward looking information to establish
\ncash \ufb02ows and is discounted back to net present value. This valuation is reviewed at each reporting date,
\nwith movements in fair value being recognised through the consolidated income statement. Cash received
\nis adjusted against the \ufb01nancial asset, and is included within cash \ufb02ows from investing activities on the
\nconsolidated statement of cash \ufb02ows.
\n(\u00a3m)
2022
2021
\nValuation at 1 January
2.3
1.6
\nRealised
(0.7)
(0.4)
\nUnrealised fair value adjustments
3.0
1.1
\nCarrying amount at 31 December (Note 30)
4.6
2.3
\nManagement completes relevant sensitivities on the inputs when assessing the fair value.
\nWith all other inputs remaining constant:
\n\u2013
A 1.2% increase (decrease) in the discount rate used, would see a decrease (increase) in fair value of \u00a30.6
\nmillion (\u00a30.3 million) (2021: 1.3% increase (decrease) \u00a30.3 million (\u00a30.4 million))
\n\u2013
A 20% increase (decrease) in the forecast annual cash \ufb02ow of \u00a30.14 million (2021: \u00a30.36 million), would see
\nan increase (decrease) in fair value of \u00a30.6 million (\u00a31.1 million) (2021: \u00a30.4 million (\u00a30.4 million))
\n16. Subsidiary undertakings and non-controlling interest
\nAs at 31 December 2022, these consolidated \ufb01nancial statements of the group comprise the company and the
\nfollowing companies, most of which are incorporated in, and whose operations are conducted in, the United
\nKingdom. All subsidiaries are 100% owned unless otherwise indicated.
\nIncorporated in England and Wales and registered at 3 Dorset Rise, London, EC4Y 8EN,
\nunless otherwise stated
Principal activity
Class of share
\nClaremont Hospital Holdings Limited
Holding company
Ordinary
\nClaremont Hospital LLP
\n!^
\nHealth provision
N/A
\nClassic Hospitals Group Limited
\n#
\nHolding company
Ordinary
\nClassic Hospitals Limited
\n#
\nNon-trading company
Ordinary
\nClassic Hospitals Property Limited
Property company
Ordinary
\nDidsbury MSK Limited\u00b0
Health provision
Ordinary
\nFox Healthcare Acquisitions Limited
Leasing company
Ordinary
\nFox Healthcare Holdco 2 Limited
\n#
\nHolding company
Ordinary
\nLifescan Limited
\n#
\nNon-trading company
Ordinary
\nMaitland Medical Service Limited
Health provision
Ordinary
\nMedicainsure Limited
Non-trading company
Ordinary
\nMontefiore House Limited
\n+
\nHealth provision
Ordinary
\nSHC Holdings Limited
\n#
\nHolding company
Ordinary
\nSoma Health Limited
Health provision
Ordinary
\nSpire Cambridge (Disposal) Limited
\n#
\nNon-trading company
Ordinary
\nSpire Fertility (Disposal) Limited
\n#
\nNon-trading company
Ordinary
\nSpire Healthcare (Holdings) Limited
Holding company
Ordinary
\nSpire Healthcare Finance Limited*
Holding company
Ordinary
\nSpire Healthcare Group UK Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 1
\n&#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 2 Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 3 Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Limited
Health provision
Ordinary
\nSpire Healthcare Properties Limited
Property company
Ordinary
\nSpire Healthcare Property Developments Limited
Development company
Ordinary
\nSpire Property 1 Limited
Property company
Ordinary
\nSpire Property 4 Limited
Property company
Ordinary
\nSpire Property 5 Limited
Property company
Ordinary
\nSpire Property 6 Limited
Property company
Ordinary
\nSpire Property 13 Limited
Property company
Ordinary
\nSpire Property 16 Limited
Property company
Ordinary
\nSpire Property 18 Limited
Property company
Ordinary
\nSpire Property 19 Limited
Property company
Ordinary
\nSpire Property 23 Limited
Property company
Ordinary
\nSpire Thames Valley Hospital Limited
\n#
\nNon-trading company
Ordinary
\nSpire Thames Valley Hospital Propco Limited
Property company
Ordinary
\nSpire UK Holdco 2A Limited
\n#
\nHolding company
Ordinary
\nSpire UK Holdco 4 Limited
Holding company
Ordinary
\nThe Doctors Clinic Group Ltd
Holding company and
\nhealth provision
\nOrdinary
\nThe London Doctors Clinic Ltd
Non-trading company
Ordinary
\n\u00b0
Ownership interest is 51.0%.
\n+
Ownership interest is 50.1%.
\n*
Direct shareholding of the company.
\n&
Spire Healthcare Holdings 1 is an undertaking with unlimited liability.
\n!
The LLP has \u2018Members\u2019 capital classi\ufb01ed as equity\u2019 in lieu of \u2018Class of shares\u2019.
\n#
In liquidation and expected to be dissolved during 2023.
\n
\n\n
\n
In the prior year, in order to simplify the structure of the group and reduce costs, the group undertook a
\nprocess in which a number of companies within the group were identi\ufb01ed for members\u2019 voluntary liquidation.
\nThe entities in members\u2019 voluntary liquidation at year end are shown above and they are expected to be
\nformally dissolved at Companies House during 2023.
\nNon-controlling interest
\nFinancial information of subsidiaries that have a material non-controlling interest is provided below. The
\nentities, as set out above, are Monte\ufb01ore House Limited, Didsbury MSK Limited and Claremont Hospital LLP.
\nOn the initial acquisition of Claremont Hospital LLP on 30 November 2021, the group owned c 88%. Following
\nthe exercise of a put option during the period, Spire Healthcare acquired the remaining interest in the LLP on
\n31 March 2022, and now owns 100% of this entity. The accumulated interest relating to Claremont has
\ntherefore been reclassi\ufb01ed to retained earnings.
\nAccumulated balances of material non-controlling interest:
\n(\u00a3m)
2022
2021
\nProfit/(loss) allocated to material non-controlling interests:
\nMontefiore House Limited
(0.8)
0.3
\nDidsbury MSK Limited
0.4
0.5
\nClaremont Hospital LLP
\u2013
\u2013
\nAccumulated balances of material non-controlling interest:
\nMontefiore House Limited
(6.4)
(5.6)
\nDidsbury MSK Limited
0.5
0.3
\nClaremont Hospital LLP
\u2013
0.5
\nWithin the entities, the most material assets and liabilities relate to right of use assets and lease liabilities in
\nrespect of property. Except for the lease rental payments, the majority of cash \ufb02ows are generated through
\noperations.
\n17. Inventories
\n(\u00a3m)
2022
2021
\nProstheses, drugs, medical and other consumables
40.6
40.2
\nCost of sales for the year ended 31 December 2022 includes inventories recognised as an expense amounting
\nto \u00a3244.0 million (2021: \u00a3216.1 million).
\n18. Trade and other receivables
\n(\u00a3m)
2022
2021
\nAmounts falling due within one year:
\nTrade receivables
59.8
54.7
\nUnbilled receivables
18.2
12.3
\nPrepayments
15.7
18.4
\nOther receivables
11.8
17.9
\n105.5
103.3
\nAllowance for expected credit losses
(5.0)
(4.1)
\nTotal current trade and other receivables
100.5
99.2
\nUnbilled receivables re\ufb02ects work in progress where a patient had treatment, or was receiving treatment, at
\nthe end of the period and the invoice had not yet been raised.
\nOther receivables includes the \u00a35.4 million insurance reimbursement right (2021: \u00a37.4 million); as well as
\n\u00a32.6 million (2021: \u00a37.9 million) reimbursement right related to the new Paterson fund, which is being held
\nby solicitors on account until payments are made, with any amount not paid out being returned to Spire
\nHealthcare. During the year, \u00a35.3 million was paid out of this fund. The amounts paid to the new Paterson
\nfund do not re\ufb02ect an investment in a \ufb01nancial asset, but merely a right to reimbursement should the fund
\nnot be utilised in full.
\nIn the prior year, as well as the \u00a37.4 million insurance reimbursement right, other receivables includes a
\n\u00a32.2 million receivable from the vendor of Claremont Hospital, which was acquired by the group during the
\nyear, and is the difference between the original estimated purchase price of \u00a319.1 million and the \ufb01nal agreed
\npurchase price of \u00a316.9 million.
\nTrade and other receivables of \u00a31.5 million have been recognised on the acquisition of The Doctors Clinic Group
\nduring the year (Note 32).
\nTrade receivables comprise amounts due from private medical insurers, the NHS, self-pay patients, consultants
\nand other third parties who use the group\u2019s facilities. Invoices to customers fall due within 60 days of the date
\nof issue.
\nThe group was successful in its bid to be included on the NHSE Framework for purchasing additional activity
\nfrom the independent sector, which commenced in April 2021. Inclusion on the Framework is at an agreed
\nprice for activity, based on the NHS tariff, but carries no guaranteed volumes. For contracts under the
\nframework that include an estimated contract value, billing is in advance for the expected volume, with a
\nquarterly true-up for actual volumes undertaken. For contracts under the framework without an estimated
\ncontract value (which can include local agreements), billing is in arrears based on actual volumes only.
\nThe ageing of trade receivables is shown below and shows amounts that are past due at the reporting date
\n(excluding payments on account where there is no right to offset these at the reporting date). A provision for
\nexpected credit losses has been recognised at the reporting date through consideration of the ageing pro\ufb01le
\nof the group\u2019s trade receivables and the perceived credit quality of its customers re\ufb02ecting net debt due. The
\ncarrying amount of trade receivables, net of expected credit losses, is considered to be an approximation to
\nits fair value.
\n
\n\n
\n
The loss allowance as at 31 December 2022 for trade receivables was determined as follows:
\nCurrent
0-30 days
31-90 days
91-364 days
1-2 years
Total
\nExpected loss rate
0.0%
1.8%
8.3%
29.2%
17.5%
7.2%
\nGross debt (\u00a3m)
27.8
16.8
8.4
8.9
8.0
69.9
\nLess payments on account (\u00a3m)
(10.1)
\nCarrying amount of trade receivables (\u00a3m)
59.8
\nLoss allowance (\u00a3m)
\u2013
0.3
0.7
2.6
1.4
5.0
\nThe loss allowance as at 31 December 2021 for trade receivables was determined as follows:
\nCurrent
0-30 days
31-90 days
91-364 days
1-2 years
Total
\nExpected loss rate
0.7%
2.2%
5.1%
19.5%
23.6%
5.5%
\nGross debt (\u00a3m)
27.1
22.9
13.7
7.7
5.5
76.9
\nLess payments on account (\u00a3m)
(22.2)
\nCarrying amount of trade receivables (\u00a3m)
54.7
\nLoss allowance (\u00a3m)
0.2
0.5
0.7
1.5
1.2
4.1
\nTrade receivables are written off when there is no longer a reasonable expectation of recovery. Indicators that
\nthere is no reasonable expectation of recovery include, amongst others, the failure of a debtor to engage in a
\nrepayment plan with the group, and failure to make contractual payments for a period of greater than two
\nyears past due.
\nThe group assesses on a forward looking basis expected credit losses associated with its debt instruments
\ncarried at amortised cost. The impairment methodology applied for trade receivables is the simpli\ufb01ed
\napproach, which requires expected lifetime losses to be recognised from initial recognition of the trade
\nreceivables.
\nTrade receivables after expected credit losses comprise the following wider customer/payor groups:
\n(\u00a3m)
2022
2021
\nPrivate medical insurers
30.4
27.4
\nNHS
8.2
9.2
\nPatient debt
7.2
8.9
\nOther
9.0
5.1
\n54.8
50.6
\nThe movement in the allowance for impairment in respect of trade receivables during the year was as follows:
\n(\u00a3m)
2022
2021
\nAt 1 January
4.1
5.3
\nProvided in the year
1.1
\u2013
\nUtilised during the year
(0.2)
(0.2)
\nReleased during the year
\u2013
(1.0)
\nAt 31 December
5.0
4.1
\nThe group applies the IFRS 9 simpli\ufb01ed approach to measuring Expected Credit Losses (ECLs) for trade
\nreceivables. Under this standard, lifetime ECL provisions are recognised for trade receivables using a matrix
\nof rates dependant on age thresholds and customer types. The ECL rates are determined with reference to
\nhistorical performance of each payor age group during the last two years.
\nTo develop the ECL matrix, trade receivables were grouped according to shared characteristics (payor/payor
\ntype) and the days past due. As the majority of the group\u2019s debt is receivable from large, well-funded insurance
\ncompanies, the National Health Service or from a large number of individuals, the group has concluded that
\nhistorical debt performance of the portfolio during the last two reporting periods provides a reasonable
\napproximation of the future expected loss rates for each payor age category.
\n19. Cash and cash equivalents
\n(\u00a3m)
2022
2021
\nCash at bank
67.1
165.5
\nShort-term deposits
7.1
37.1
\n74.2
202.6
\nCash and cash equivalents comprise cash balances, short-term deposits and other short-term highly liquid
\ninvestments (including money market funds) with maturities not exceeding three months placed with
\ninvestment grade counterparties which are subject to an insigni\ufb01cant risk of change in value.
\nCash and cash equivalents of \u00a30.3 million has been added on the acquisition of The Doctors Clinic Group during
\nthe year (Note 32).
\n20. Non-current assets held for sale
\nDuring the year the group completed the sale of its Spire St Saviours property and received proceeds of
\n\u00a33.2 million. In June 2022 an impairment of \u00a30.5 million was recognised on the property, as the sales price less
\ncosts to sell on the property was lower than the carrying value. No impairment was recognised in the prior year
\n(see Note 10).
\nAs at 31 December 2022 the group\u2019s management have committed to sell a parcel of land at Bostocks Lane as
\nthe group has accepted an offer on the property. The sale is considered highly probable and the assessment
\nhas not changed. It therefore remains as classi\ufb01ed as held for sale.
\n(\u00a3m)
2022
2021
\nSpire St Saviours Hospital property
\u2013
3.7
\nBostocks Lane (East Midlands Cancer Centre)
1.1
1.1
\n1.1
4.8
\n
\n\n
\n
21. Share capital and reserves
\n2022
2021
\nAuthorised shares
\nOrdinary share of \u00a30.01 each
404,108,470
401,104,036
\n404,108,470
401,104,036
\n\u00a30.01 ordinary shares
\nShares
\u00a3\u2019000
\nIssued and fully paid
\nAt 31 December 2022
404,108,470
4,041
\nAt 31 December 2021
401,104,036
4,010
\nDuring the year, the authorised share capital was increased by \u00a331,000 by the issue of 3,004,434 ordinary
\nshares of \u00a30.01 each.
\nShare premium
\nShare premium
2022
2021
\nAt 1 January
826.9
826.9
\nIssue of new shares
3.1
\u2013
\nAt 31 December
830.0
826.9
\nDuring the year the group issued 3,004,434 shares to settle share awards of which 2,916,000 shares were
\nexercised under the save as you earn 2019 scheme at an exercise price of \u00a31.09 per share. The proceeds from
\nthe issue of shares were \u00a33.1 million.
\nCapital reserves
\nThis reserve represents the loans of \u00a3376.1 million due to the former ultimate parent undertaking and
\nmanagement that were forgiven by those counterparties as part of the reorganisation of the group prior to
\nthe IPO in 2014.
\nEBT share reserves
\nEquiniti Trust (Jersey) Limited is acting in its capacity as trustee of the company\u2019s Employee Bene\ufb01t Trust (\u2018EBT\u2019).
\nThe purpose of the EBT is to further the interests of the company by bene\ufb01ting employees and former
\nemployees of the group and certain of their dependants. The EBT is treated as an extension of the group
\nand the company.
\nDuring the year, the EBT purchased 88,354 shares and exercised 300,491 (2021: nil shares acquired and nil
\nexercised) in order to settle share awards in relation to the directors\u2019 share bonus award and Long-Term
\nIncentive Plan.
\nWhere the EBT purchases the company\u2019s equity share capital the consideration paid, including any directly
\nattributable incremental costs, is deducted from equity attributable to the company\u2019s equity holders until the
\nshares are cancelled or reissued. As at 31 December 2022, 27,146 shares (2021: 239,283) were held by the EBT in
\nrelation to the directors\u2019 share bonus award and Long-Term Incentive Plan. The EBT share reserve represents the
\nconsideration paid when the EBT purchases the company\u2019s equity share capital, until the shares are reissued.
\n(Number of shares)
2022
2021
\n(\u00a3m)
(Number of shares)
(\u00a3m)
(Number of shares)
\nAt 1 January
0.8
239,283
0.8
239,283
\nPurchased
\u2013
88,354
\u2013
\u2013
\nExercised
(0.8)
(300,491)
\u2013
\u2013
\nAt 31 December
\u2013
27,146
0.8
239,283
\nHedging reserve
\nThe balance of \u00a36.6 million at 31 December 2022 (2021: (\u00a30.5 million)) re\ufb02ects the \u00a31.2 million (2021: \u00a32.5 million)
\nrecycled in the period, the fair value credit of \u00a38.1 million (2021: \u00a30.8 million credit) and the \u00a32.2 million tax charge
\non the pro\ufb01t (2021: \u00a30.6 million tax charge on the pro\ufb01t) to give a net movement of an increase of \u00a37.1 million
\nduring the year (2021: a decrease of \u00a32.7 million) on a hedged transaction. See note 22 for further information.
\n22. Borrowings
\nThe group has borrowings in two forms, bank borrowings and lease liabilities as disclosed on the consolidated
\nbalance sheet. Total borrowings at 31 December 2022 were \u00a31,190.8 million (2021: \u00a31,265.3 million). More
\ndetail in respect of these two forms of borrowings are set out below.
\nBank borrowings
\nThe bank loans are secured on \ufb01xed and \ufb02oating charges over both the present and future assets of material
\nsubsidiaries of the group. On 24 February 2022, the group successfully re\ufb01nanced its debt facilities with a
\nsyndicate of existing and new lenders. As part of the exercise and in recognition of the fact that the group
\nhad substantial cash reserves at 31 December 2021, the group repaid \u00a3100.0 million of the Senior Loan Facility.
\nThe new arrangement has a maturity of four years. The \ufb01nancial covenants relating to this new agreement
\nare materially unchanged. The loan is non-amortising and carries interest at a margin of 2.05% over SONIA
\n(2021: 2.25% over LIBOR).
\nFor accounting purposes the loan and associated deferred and amortised fees have been treated as an
\nextinguishment under IFRS 9, as a result \u00a33.1 million has been recognised within \ufb01nance costs in the
\nincome statement.
\n(\u00a3m)
2022
2021
\nAmount due for settlement within 12 months
2.9
5.7
\nAmount due for settlement after 12 months
321.4
421.8
\nTotal bank borrowings
324.3
427.5
\nTerms and debt repayment schedule
\nThe maturity date is the date on which the relevant bank loans are due to be fully repaid.
\n
\n\n
\n
The carrying amounts drawn (after issue costs and including interest accrued) under facilities in place at the
\nbalance sheet date were as follows:
\n(\u00a3m)
Maturity
Margin over SONIA
2022
2021
\nSenior finance facility
\n(1)
\nFebruary 2026
2.05%
324.3
\u2013
\nSenior finance facility
\n(1)
\nJuly 2023
2.25%
\n(2)
\n\u2013
428.2
\n1.
In the prior period the difference between the carrying amount of the facility and the value of the debt repayment schedule is
\na modi\ufb01cation fee on the loan extension and is deferred and amortised in accordance with IFRS 9 loan modi\ufb01cation accounting.
\nOn re\ufb01nancing in the current period, these amounts have been accelerated and recognised in the Income Statement as a result
\nof the re\ufb01nancing being treated as an extinguishment for accounting purposes.
\n2.
Margin over LIBOR.
\nNet debt for the purposes of the covenant test in respect of the Senior Loan Facility was \u00a3250.8 million
\n(December 2021: \u00a3222.4 million) and the net debt to EBITDA ratio was 2.2x (December 2021: 2.3x). The net
\ndebt for covenant purposes comprises the senior facility of \u00a3325.0 million less cash and cash equivalents of
\n\u00a374.2 million. EBITDA for covenant purposes comprises Adjusted EBITDA for Last Twelve Months (LTM) of
\npre-IFRS 16 Adjusted EBITDA of \u00a3123.9 million (December 2021: 106.0 million) less the rental of a \ufb01nance lease
\npre-IFRS 16 of \u00a39.5 million (2021: \u00a39.1 million).
\nThe interest cover for covenant purposes was 8.5x (2021: 4.5x 2020: 4.0x, 2019 4.8x) and is calculated as the
\npre-IFRS 16 EBITDA described above over pre-IFRS 16 \ufb01nance costs paid.
\nThe new facilities include a sustainability-linked element connected to environmental and quality factors.
\nThe group also has access to a further \u00a3100.0 million through a committed and undrawn revolving credit
\nfacility to February 2026.
\nLease liabilities
\nObligations under \ufb01nance leases
\nThe group has \ufb01nance in respect of hospital properties, vehicles, of\ufb01ce and medical equipment. The leases
\nare secured on \ufb01xed and \ufb02oating charges over both the present and future assets of material subsidiaries in
\nthe group. Leases, with a present value liability of \u00a3866.5 million (2021: \u00a3837.8 million), expire in various years
\nto 2046 and carry incremental borrowing rates in the range 3.1\u201314.6% (2021: 3.1\u201314.6%). Rent in respect of
\nhospital property leases are reviewed annually with reference to RPI or CPI, subject to assorted \ufb02oors and caps.
\nThe discount rates used are calculated on a lease by lease basis, and are based on estimates of incremental
\nborrowing rates. A movement in the incremental borrowing rate of 1% would result is an 8% movement in
\nlease liability.
\nIn the year, the group recognised charges of \u00a313.6 million (2021: \u00a312.3 million) of lease expenses relating to
\nshort term and low value leases for which the exemption under IFRS 16 has been taken. Cash out\ufb02ows in
\nrespect of these are materially in line with the expense recognised, resulting in a total cash out\ufb02ow of \u00a3105.6
\nmillion (2021: \u00a338.3 million). The group has not made any variable lease payments in the year. The group is not
\na lessor for any leases to external parties. There has been no (2021: one) sale and leaseback transaction in this
\nperiod. Where new leases have the right to extend and management is not reasonably certain to exercise the
\nextension option, those future cash \ufb02ows are not re\ufb02ected in the above. The new leases do not include any
\nrestrictions or covenants.
\nSome leases receive RPI increases on an annual basis which affects both the cash \ufb02ow and interest charged on
\nthose leases. Except for this increase, cash \ufb02ows and charges are expected to remain in line with current year.
\nThe cash \ufb02ows above do not re\ufb02ect any termination or extension options as management is reasonably certain
\nthat the options will not be exercised. There are no signi\ufb01cant restrictions or covenants which impact the cash
\n\ufb02ows in respect of these leases.
\nSee note 13 for more detail on the depreciation of the Right of Use (ROU) assets and note 8 for more detail on
\nthe interest expense relating to leases.
\nChanges in bank borrowings and lease liabilities arising from \ufb01nancing activities
\n(\u00a3m)
1 January
Cash flows
\nNon cash
\nchanges
\n1
\nAdditions
\n3
\n31 December
\n2022
\nBank loans
427.5
(121.1)
17.9
\u2013
324.3
\nLease liabilities
837.8
(93.7)
73.5
48.9
866.5
\nTotal
1,265.3
(214.8)
91.4
48.9
1,190.8
\n(\u00a3m)
1 January
Cash flows
\nNon cash
\nchanges
\n1
\nLoan
\nmodification
\n2
\nAdditions
\n3
\nDisposals
31 December
\n2021
\nBank loans
420.8
(13.2)
18.8
1.1
\u2013
\u2013
427.5
\nLease liabilities
749.5
(26.0)
67.7
\u2013
48.4
(1.8)
837.8
\nTotal
1,170.3
(39.2)
86.5
1.1
48.4
(1.8)
1,265.3
\n1.
Non-cash changes re\ufb02ect interest charged on the loan.
\n2.
The loan modi\ufb01cation relates to the fees incurred on the loan extensions, which are amortised in accordance with IFRS 9.
\n3.
Additions include both new leases entered into, indexation of existing leases, sale and leaseback transactions and acquisitions
\nof subsidiaries.
\nDerivatives
\nThe following derivatives were in place at 31 December:
\nInterest rate
Maturity date
Notional amount
\nCarrying value
\nliability/(Asset)
\n31 December 2022 (\u00a3m)
\nInterest rate swaps
2.7780%
Feb 2026
243.8
(8.6)
\n31 December 2021 (\u00a3m)
\nInterest rate swaps
1.2168%
July 2022
213.0
0.7
\n(\u00a3m)
2022
2021
\nAmount due for settlement within 12 months
(3.6)
0.7
\nAmount due for settlement after 12 months
(5.0)
\u2013
\nTotal derivatives (asset)/liability
(8.6)
0.7
\nThe interest rate swap from the prior year matured on 22 July 2022. The group entered into new interest
\nrate swaps on the 25 July 2022. The movement in respect of derivatives re\ufb02ects \u00a31.2 million (December 2021:
\n\u00a31.2 million) recycled in the period and a \u00a38.1 million credit (December 2021: \u00a30.4 million credit) in fair value.
\nAll movements are re\ufb02ected within other comprehensive income.
\n
\n\n\n
23. Deferred tax
\n(\u00a3m)
\nProperty,
\nplant and
\nequipment
\nIFRS 16
\nleases \u2013
\nspreading
IFRS 16
\nShare-
\nbased
\npayments
Losses
\nProvisions
\nand other
\ntemporary
\ndifferences
Total
\nAt 1 January 2021
73.3
(38.3)
25.0
(1.1)
(2.2)
(2.8)
53.9
\n(Credit)/charge to the profit or loss
(12.7)
1.9
(2.6)
\u2013
(1.9)
0.3
(15.0)
\n(Credit)/charge to other
\ncomprehensive income and equity
\u2013
\u2013
\u2013
(3.0)
\u2013
0.6
(2.4)
\nPrior year adjustment
4.1
0.2
(0.8)
\u2013
\u2013
\u2013
3.5
\nChange in tax rates
22.6
(10.8)
7.1
(0.1)
(0.7)
(0.4)
17.7
\nAt 1 January 2022
87.3
(47.0)
28.7
(4.2)
(4.8)
(2.3)
57.7
\n(Credit)/charge to the profit or loss
(7.1)
1.8
2.8
0.1
(0.8)
0.6
(2.6)
\n(Credit)/charge to other
\ncomprehensive income and equity
\u2013
\u2013
\u2013
0.1
\u2013
2.1
2.2
\nAdjustment in respect of prior year
(2.2)
\u2013
1.5
\u2013
(0.6)
0.2
(1.1)
\nAt 31 December 2022
78.0
(45.2)
33.0
(4.0)
(6.2)
0.6
56.2
\nDisclosed within liabilities
78.0
(45.2)
33.0
(4.0)
(6.2)
0.6
56.2
\nDeferred tax on property, plant and equipment has arisen on differences between the carrying value of the
\nrelevant assets and the tax base. Included in this amount is a one off credit to the pro\ufb01t and loss of \u00a39.0 million
\nin respect of the change in useful life and residual value of the freehold properties. The credit arises as a result
\nof the ability to take into account additional tax basis and indexation for future capital disposals when
\ncalculating the deferred tax liability on property.
\nDeferred tax assets and liabilities are measured at the tax rates that are expected to apply in the period when
\nthe asset is realised or the liability settled, based on tax rates that have been enacted, or substantively enacted,
\nat the balance sheet date. The group has separately calculated the tax rates applicable in respect of adjusting
\nitems for the period. The prior year change in tax rates re\ufb02ects the reassessment of deferred tax assets and
\nliabilities to 25% from 19%. Deferred tax in the current period continues to be measured at 25%.
\nDeferred tax assets are recognised on the basis that the deferred tax liabilities represent forecast pro\ufb01ts of the
\nappropriate type (either capital or trading) and therefore represent a suitable taxable pro\ufb01t against which the
\nreversal of the deferred tax assets can be offset. Deferred tax assets and liabilities in relation to property are
\nonly offset to the extent that they relate to the same site.
\nThe group has unrecognised deferred tax assets (which do not expire) as follows:
\n2022
2021
\n(\u00a3m)
Gross
Tax effected
Gross
Tax effected
\nTrading losses
8.0
2.0
9.9
2.5
\nCapital losses
\u2013
\u2013
1.2
0.3
\nTax basis for future capital disposals
11.6
2.9
34.4
8.6
\nTotal
19.6
4.9
45.5
11.4
\nThese amounts are the expected tax value of the gross temporary difference at the enacted long-term tax rate
\nof 25% (2021: 25%) following the substantive enactment of the increased corporation tax rate of 25% effective
\nfrom 1 April 2023. A deferred tax asset has not been recognised in respect of these amounts due to
\nuncertainties as to the timing of future pro\ufb01ts that the trading losses could be offset against and whether
\ncapital gains will arise against which the capital losses and tax basis for capital disposals could be utilised.
\n24. Provisions
\n(\u00a3m)
\nMedical
\nmalpractice
\nBusiness
\nrestructuring
\nand other
Total
\nAt 1 January 2022
42.0
2.8
44.8
\nIncrease in existing provisions
7.9
0.5
8.4
\nProvisions utilised
(30.1)
(1.0)
(31.1)
\nProvisions released
(0.4)
\u2013
(0.4)
\nAt 31 December 2022
19.4
2.3
21.7
\nMedical malpractice relates to estimated liabilities arising from claims for damages in respect of services
\npreviously supplied to patients. During the period \u00a36.4 million was added due to additional claims received,
\nand \u00a39.1 million utilised. Amounts are shown gross of insured liabilities. Any such insurance recoveries of
\n\u00a35.4 million (December 2021: \u00a37.4 million) are recognised in other receivables. This drives the majority of the
\nmovement in the medical malpractice provision with the exception of the insurer settlement and the Paterson
\nactions following the Public Inquiry. Following the Court of Appeal judgment in H2 2021, relating to the
\nongoing legal action between the group and its insurer, \ufb01nding in favour of the insurer, Spire Healthcare
\nprovided for \u00a313.0 million in the prior period, and settled \u00a313.0 million in the current period which is re\ufb02ecting
\nas utilised during the period.
\nFollowing the completion of the criminal proceedings against Ian Paterson, a consultant who previously had
\npracticing privileges at Spire Healthcare, management agreed settlement with all current and known civil
\nclaimants (and the other co-defendants) and made a provision for the expected remaining costs in FY20. The
\nprovision is being utilised, including \u00a35.3 million in patient claim settlements. The provision to complete the
\nreviews, settle any claims and costs in respect of other Paterson items has been increased by \u00a30.9 million. This
\nprovision remains subject to ongoing review following the publication of the Public Inquiry report on Paterson
\nissued on 4 February 2020, as the group continues to assess the potential impact of the recommendations. The
\nproject is complex and the process for review and settlement takes some time. It is possible that, as further
\ninformation becomes available, an adjustment to this provision will be required, but at this time, it re\ufb02ects
\nmanagement\u2019s best estimate of the costs and settlement of claims at this point. The variables include the
\nnumber of patients which are found to have been harmed following review, the level of harm, and the
\nassociated compensation claim, as well as the time to review each case can vary signi\ufb01cantly.
\nThe provision in relation to the Ian Paterson costs has been determined before taking account of any potential
\nfurther recoveries from insurers.
\nAs at 31 December 2022, the remaining business restructuring and other provisions primarily includes
\nnon-patient claims made against the group. The group is in the process of settling or defending such claims
\nas appropriate. Management have sought external counsel, where appropriate, to determine the appropriate
\nprovision levels.
\nProvisions as at 31 December 2022 are materially considered to be current and expected to be utilised at any
\ntime within the next twelve months, subject to external factors beyond the group\u2019s control.
\n
\n\n
\n
25. Trade and other payables
\n(\u00a3m)
2022
2021
\nTrade payables
67.2
51.7
\nAccrued expenses
58.4
52.6
\nSocial security and other taxes
9.7
8.3
\nOther payables
29.2
46.5
\nTrade and other payables
164.5
159.1
\nTrade and other payables of \u00a31.9 million have been added on the acquisition of The Doctors Clinic Group during
\nthe year (see Note 32)
\nAccrued expenses includes general operating expenses incurred but not invoiced as at the year end, as well
\nas holiday pay accrued of \u00a35.2 million (2021: \u00a39.1 million) due to staff deferring leave to maintain operations
\nthroughout the COVID-19 pandemic, and bonuses accrued during the year and paid during the following year
\nof \u00a37.0 million (FY21: \u00a36.4 million).
\nOther payables include an accrual for pensions and payments on account. Revenue is not recognised in respect
\nof payments on account until the performance obligation has been met. At year end the balance of payments
\non account was \u00a311.9 million (2021: \u00a39.9 million) partly, and other credit balances reclassed from trade debtors
\nwere \u00a328.2 million (2021: \u00a325.8 million), which largely relate to NHS credits. Payments on account are expected
\nto be utilised against patient procedures within the following 12 months. The balance of payments on account
\nas at 31 December 2021 have been fully utilised in the current year. However, this is subject to the patient
\nattending for the procedure, and not cancelling or deferring treatment, which could result in repayment to
\nthe patient should they request so.
\n26. Dividends
\nDuring the year Didsbury MSK Limited declared and paid an interim dividend of \u00a30.4 million to its shareholders
\nof which \u00a30.2 million was paid to the non-controlling interests. In addition \u00a30.1 million of dividends were paid
\nto the executive directors in respect of grants under the LTIP share scheme that have vested and are currently
\nsubject to a two-year holding period.
\nSince the end of the \ufb01nancial year, the directors have proposed a \ufb01nal dividend of approximately 0.5 pence per
\nshare. The dividend is subject to approval by shareholders at the Annual General Meeting and is therefore not
\nincluded in the balance sheet as a liability at 31 December 2022.
\n27. Share-based payments
\nThe group operates a number of share-based payment schemes for executive directors and other employees,
\nall of which are equity settled.
\nThe group has no legal or constructive obligation to repurchase or settle any of the options in cash. The total
\ncost in respect of LTIPs and SAYE recognised in the income statement was \u00a32.3 million in the year ended
\n31 December 2022 (2021: \u00a32.8 million). Employer\u2019s National Insurance is being accrued, where applicable, at
\nthe rate of 14.3%, which management expects to be the prevailing rate at the time the options are exercised,
\nbased on the share price at the reporting date. The total National Insurance charge for the year was \u00a30.3 million
\n(2021: \u00a30.4 million).
\nThe following table analyses the total cost between each of the relevant schemes, together with the number
\nof options outstanding:
\n2022
2021
\nCharge
\n\u00a3m
\nNumber of
\noptions
\n(thousands)
\nCharge
\n\u00a3m
\nNumber of
\noptions
\n(thousands)
\nLong Term Incentive Plan
1.8
12,787
2.5
11,449
\nDeferred Share Bonus Plan
\u2013
525
\u2013
383
\nSave As You Earn (SAYE)
0.5
3,652
0.3
3,114
\n2.3
16,964
2.8
14,946
\nA summary of the main features of the scheme is shown below:
\nLong Term Incentive Plan
\nThe Long Term Incentive Plan (\u2018LTIP\u2019) is open to executive directors and designated senior managers, and
\nawards are made at the discretion of the remuneration committee. Awards are subject to market and
\nnon-market performance criteria.
\nAwards granted under the LTIP vest subject to achievement of performance conditions measured over a period
\nof at least three years, unless the committee determines otherwise. Awards may be in the form of conditional
\nshare awards or nil-cost options or any other form allowed by the plan rules.
\nVesting of awards will be dependent on a range of \ufb01nancial, operational or share price measures, as set by
\nthe committee, which are aligned with the long-term strategic objectives of the group and shareholder value
\ncreation. No less than 30% of an award will be based on share price measures. The remainder will be based on
\neither \ufb01nancial and/or operational measures. At the threshold performance, no more than 25% of the award
\nwill vest, rising to 100% for maximum performance.
\nOn 6 April 2020, the company granted a total of 5,638,223 options to the executive directors and other senior
\nmanagement. The options will vest based on earnings per share (\u2018EPS\u2019) (20%) targets for the \ufb01nancial year
\nending 31 December 2022, relative total shareholder return (\u2018TSR\u2019) (40%) targets on performance over the
\nthree year period to 31 December 2022 and operational excellence (\u2018OE\u2019) (40%) targets based on employee
\nengagement targets and regulatory ratings for the current portfolio of hospitals, subject to continued
\nemployment. Upon vesting, the options will remain exercisable until 1 April 2030.
\nOn 18 March 2021, the company granted a total of 3,595,102 options to the executive directors and other
\nsenior management. The options will vest based on return on capital employed (\u2018ROCE\u2019) (35%) targets for the
\n\ufb01nancial year ending 31 December 2023, relative total shareholder return (\u2018TSR\u2019) (35%) targets on performance
\nover the three year period to 31 December 2023 and operational excellence (\u2018OE\u2019) (30%) targets based on
\nemployee engagement targets and regulatory ratings for the current portfolio of hospitals, subject to
\ncontinued employment. Upon vesting, the options will remain exercisable until March 2031. The executive
\ndirectors are subject to a 2 year holding period, whilst other senior management are not.
\nOn 14 March 2022, the company granted a total of 3,097,060 options to the executive directors and other
\nsenior management. The options will vest based on return on capital employed (\u2018ROCE\u2019) (35%) targets for the
\n\ufb01nancial year ending 31 December 2024, relative total shareholder return (\u2018TSR\u2019) (35%) targets on performance
\nover the three year period to 31 December 2024 and operational excellence (\u2018OE\u2019) (30%) targets based on
\nemployee engagement targets and regulatory ratings for the current portfolio of hospitals, subject to continued
\nemployment. Upon vesting, the options will remain exercisable until March 2032. The executive directors are
\nsubject to a two year holding period, whilst other senior management are not.
\n
\n\n
\n
Deferred Share Bonus Plan
\nThe Deferred Share Bonus Plan is a discretionary executive share bonus plan under which the remuneration
\ncommittee determines that a proportion of a participant\u2019s annual bonus will be deferred. The market value of
\nthe shares granted to any employee will be equal to one-third of the total annual bonus that would otherwise
\nhave been payable to the individual. The awards will be granted on the day after the announcement of the
\ngroup\u2019s annual results. The awards will normally vest over a three-year period.
\nOn 6 April 2020, the company granted a total of 243,973 options to executive directors, with a vesting date
\nof 6 April 2023. The options will vest based on a target EBITDA net debt leverage ratio for the year ending
\n31 December 2021, and subject to continued employment.
\nOn 18 March 2021, the company granted a total of 138,888 options to executive directors, with a vesting date
\nof 18 March 2024. The options will vest based on a target EBITDA net debt leverage ratio for the year ending
\n31 December 2022, and subject to continued employment.
\nOn 14 March 2022, the company granted a total of 142,427 options to executive directors, with a vesting
\ndate of 14 March 2025. There are no performance conditions in respect of the scheme and is subject to
\ncontinued employment.
\nSave As You Earn
\nThe Save As You Earn (\u2018SAYE\u2019) is open to all Spire Healthcare employees. Vesting will be dependent on continued
\nemployment for a period of 3 years from grant. The requirement to save is a non-vesting condition. On 3 May
\n2019, the company launched the SAYE scheme. There are no performance conditions in respect of the scheme
\nand the scheme vested on 1 June 2022. The options remained exercisable for 6 months to 31 December 2022.
\nOn the 24 April 2022, the company granted 3,800,557 options to employees with a vesting date of 1 June 2025.
\nThere are no performance conditions in respect of the scheme. Upon vesting, the options will remain
\nexercisable for six months. The IFRS 2 charge has been calculated using an adjusted Black Scholes model
\nwith judgements including leavers of the scheme (employees who may cease to save) and dividend yields.
\nThe aggregate number of share awards outstanding for the group and their weighted average contractual life
\nis shown below:
\n2022
\nLTIP (ROCE
\ncondition)
\n(thousands)
\nLTIP (TSR
\ncondition)
\n(thousands)
\nLTIP (EPS
\ncondition)
\n(thousands)
\nLTIP (OE
\ncondition)
\n(thousands)
\nDeferred Share
\nBonus Plan
\n(thousands)
\nSAYE
\n(thousands)
\nAt 1 January
1,133
4.175
1,975
4,166
383
3,114
\nGranted
1,084
1,079
\u2013
925
142
3,811
\nExercised
\u2013
(208)
\u2013
(93)
\u2013
(2,916)
\nSurrendered
\n1
\n(48)
(205)
(77)
(198)
\u2013
\u2013
\nCancelled
\n2
\n\u2013
(115)
(358)
(457)
\u2013
(357)
\nAt 31 December
2,169
4,731
1,540
4,347
525
3,652
\nExercisable at 31 December
\u2013
\u2013
\u2013
\u2013
\u2013
37
\nWeighted average contractual life
2.4 years
3.2 years
0.4 years
2.8 years
1.1 years
2.5 years
\n2021
\nLTIP (ROCE
\ncondition)
\n(thousands)
\nLTIP (TSR
\ncondition)
\n(thousands)
\nLTIP (EPS
\ncondition)
\n(thousands)
\nLTIP (OE
\ncondition)
\n(thousands)
\nDeferred Share
\nBonus Plan
\n(thousands)
\nSAYE
\n(thousands)
\nAt 1 January
\u2013
3,854
2,727
3,612
244
3,222
\nGranted
1,258
1,258
\u2013
1,079
139
\u2013
\nExercised
\u2013
\u2013
\u2013
\u2013
\u2013
(23)
\nSurrendered
\n1
\n(106)
(217)
(55)
(201)
\u2013
\u2013
\nCancelled
\n2
\n(19)
(720)
(697)
(324)
\u2013
(85)
\nAt 31 December
1,133
4,175
1,975
4,166
383
3,114
\nExercisable at 31 December
\u2013
39
\u2013
326
\u2013
37
\nWeighted average contractual life
2.2 years
2.2 years
1.2 years
2.2 years
3.0 years
0.9 years
\n1.
These are shares where the participants are considered to be good leavers and forfeit a proportion of their shares on pro-rata basis.
\n2.
These are shares where the participants forfeit all share options.
\nThe weighted average remaining contractual life for the share options outstanding as at 31 December 2022
\nwas 2.2 years (2021: 2.2 years) in respect of LTIPs, and 2.5 years for SAYE (2021: 0.9 years).
\n
\n\n
\n
Share options outstanding at the end of the year have the following expiry date:
\nGrant \u2013 vest
Expiry date
\nExercise price
\n(\u00a3)
\nShare options
\nthousands
\n2022
2021
\nLTIP grants
\n30/09/2014 \u2013 December 2016
30/09/2024
\u2013
32
32
\n30/03/2018 \u2013 March 2021
30/03/2028
\u2013
2
7
\n30/03/2018 \u2013 March 2021
30/03/2028
\u2013
326
326
\n30/03/2019 \u2013 March 2022
30/03/2029
\u2013
1,118
2,702
\n30/03/2020 \u2013 March 2023
30/03/2030
\u2013
5,112
5,145
\n30/03/2021 \u2013 March 2024
30/03/2031
\u2013
3,199
3,237
\n01/04/2022 \u2013 March 2025
01/01/2032
\u2013
2,997
\u2013
\nDeferred Share Bonus Plan
\n06/04/2020 \u2013 April 2023
05/04/2030
\u2013
244
244
\n18/03/2021 \u2013 March 2024
17/03/2031
\u2013
139
139
\n01/04/2022 \u2013 April 2025
01/04/2032
142
\u2013
\nSave As You Earn
\n03/05/2019 \u2013 June 2022
01/12/2022
1.09
18
3,114
\n26/04/2022 \u2013 May 2025
01/11/2025
1.98
3,634
\u2013
\nDuring the year, 300,491 shares, relating to LTIPs, were exercised from the company\u2019s Employee Bene\ufb01t Trust
\n(\u2018EBT\u2019), during the year (see note 21 for more information). Where considered the most appropriate use of
\nsurplus cash, the company will continue to fund the Spire Healthcare Employee Bene\ufb01t Trust (\u2018EBT\u2019), a
\ndiscretionary trust held for the bene\ufb01t of the group\u2019s employees, for the ongoing acquisition of shares to
\nsatisfy the exercise of share plan awards by employees.
\nThe following information is relevant to the determination of the fair value of the awards granted for the years
\nended 31 December 2022 and 2021, respectively, under the schemes:
\n2022
\nLTIP
\n(TSR condition)
\nLTIP
\n(ROCE condition)
\nLTIP
\n(OE condition)
\nDeferred Share
\nBonus Plan
Save as you Earn
\nOption pricing model
\nMonte Carlo
\nFair value
\nat grant date
\nFair value
\nat grant date
n/a
\nBlack-Sch\u00f6les
\nmodel
\nFair value at grant date (\u00a3)
1.75
2.44
2.44
n/a
0.71
\nFair value at grant date for
\nshares subject to holding
\nperiod(\u00a3)
1.48
2.06
2.06
n/a
n/a
\nWeighted average share price
\nat grant date (\u00a3)
2.44
2.44
2.44
n/a
2.21
\nExercise price (\u00a3)
Nil
Nil
Nil
Nil
1.98
\nWeighted average contractual
\nlife
2.2 years
2.2 years
0.2 years
3.0 years
2.5 years
\nExpected dividend yield
n/a
n/a
n/a
n/a
n/a
\nRisk-free interest rate
1.4%
n/a
n/a
n/a
n/a
\nVolatility
\n(1)
\n53%
53%
53%
n/a
n/a
\n2021
\nLTIP
\n(TSR condition)
\nLTIP
\n(EPS condition)
\nLTIP
\n(OE condition)
\nDeferred Share
\nBonus Plan
\nOption pricing model
\nMonte Carlo
\nFair value
\nat grant date
\nFair value
\nat grant date
n/a
\nFair value at grant date (\u00a3)
1.17
1.65
1.65
n/a
\nFair value at grant date for shares subject to
\nholding period(\u00a3)
1.00
1.41
1.41
n/a
\nWeighted average share price at grant date (\u00a3)
1.65
1.65
1.65
n/a
\nExercise price (\u00a3)
Nil
Nil
Nil
Nil
\nWeighted average contractual life
2.2 years
2.2 years
2.2 years
3.0 years
\nExpected dividend yield
n/a
n/a
n/a
n/a
\nRisk-free interest rate
0.2%
n/a
n/a
n/a
\nVolatility
\n(1)
\n49%
49%
49%
n/a
\n1.
The expected volatility is based on the historical volatility of the company and a comparator group of other international
\nhealthcare companies.
\n28. Commitments
\nConsignment stock
\nAt 31 December 2022, the group held consignment stock on sale or return of \u00a324.3 million (2021: \u00a323.5 million).
\nThe group is only required to pay for the equipment it chooses to use and therefore this stock is not recognised
\nas an asset.
\nCapital commitments
\nCapital commitments comprise amounts payable under capital contracts which are duly authorised and in
\nprogress at the consolidated balance sheet date. They include the full cost of goods and services to be provided
\nunder the contracts through to completion. The group has rights within its contracts to terminate at short
\nnotice and, therefore, cancellation payments are minimal.
\nCapital commitments at the end of the year were as follows:
\n(\u00a3m)
2022
2021
\nContracted but not provided for
27.0
29.1
\n29. Contingent liabilities
\nThe group had the following guarantees at 31 December 2022:
\n\u2013
The bankers to Spire Healthcare Limited have issued a letter of credit in the maximum amount of \u00a31.5 million
\n(2021: \u00a31.5 million) in relation to contractual pension obligations
\n\u2013
Under certain lease agreements entered into on 26 January 2010, the group has given undertakings relating
\nto obligations in the lease documentation and the assets of the group are subject to a \ufb01xed and \ufb02oating charge
\n\u2013
See note C11 for details of contingent liability in respect of lease arrangements and agreements
\n
\n\n
\n
30. Financial risk management and impairment of \ufb01nancial assets
\nThe group has exposure to the following risks from its use of \ufb01nancial instruments:
\n\u2013
Credit risk
\n\u2013
Liquidity risk
\n\u2013
Market risk
\nThis note presents information about the group\u2019s exposure to each of the above risks, the group\u2019s objectives,
\npolicies and processes for measuring and managing risk. Further quantitative disclosures are included
\nthroughout these \ufb01nancial statements.
\nThe directors have overall responsibility for the establishment and oversight of the group\u2019s risk management
\nframework.
\nThe group\u2019s risk management policies are established to identify and analyse the risks faced by the group,
\nto set appropriate risk limits and controls, and to monitor risks and adherence to limits.
\nCredit risk and impairment
\nCredit risk is the risk of \ufb01nancial loss to the group if a customer or counterparty to a \ufb01nancial instrument fails
\nto meet its contractual obligations, and arises principally from the group\u2019s receivables from customers and
\ninvestment securities.
\nTrade and other receivables
\nThe group\u2019s exposure to credit risk is in\ufb02uenced mainly by the individual characteristics of each customer.
\nThe group\u2019s exposure to credit risk from trade receivables is considered to be low because of the nature of
\nits customers and policies in place to prevent credit risk occurring in normal circumstances.
\nMost revenues arise from insured patients\u2019 business and the NHS. Insured revenues give rise to trade
\nreceivables which are mainly due from large insurance institutions, which have high credit worthiness.
\nThe remainder of revenues arise from individual self-pay patients and consultants.
\nDuring the period, trade receivables have increased as private work has increased as a result of COVID-19
\nrestrictions being removed, but aged debt has reduced. Individual self-pay patients continues to be the largest
\nrisk for the group given the current economic uncertainty. Given the COVID-19 induced economic uncertainty,
\nthe group has considered the provision required, speci\ufb01cally for self-pay patients, and maintained a provision
\naccordingly through the expected loss rate percentages. The Expected Credit Loss (ECL) as at year end is
\n\u00a35.0 million (December 2021: \u00a34.1 million).
\nThe group establishes an allowance for impairment that represents its ECL in respect of trade and other
\nreceivables.
\nThis allowance is composed of speci\ufb01c losses that relate to individual exposures and also an ECL component
\nestablished using rates re\ufb02ecting historical information for payor groups, and forward looking information.
\nGiven the continued economic uncertainty, the group has considered the provision required, speci\ufb01cally for
\nself-pay patients and maintained an adjustment to the provision accordingly, which is in line with the position
\nat December 2021.
\nNote 18 shows the ageing and customer pro\ufb01les of trade receivables outstanding at the year end.
\nUnbilled receivables are considered for expected credit losses, but these are not considered material and
\ntherefore not recognised.
\nInvestments
\nThe group limits its exposure to credit risk by only investing in short-term money market deposits with large
\n\ufb01nancial institutions, which must be rated at least Investment Grade by key rating agencies.
\nMarket risk
\nMarket risk is the risk that changes in market prices, such as interest rates, will affect the group\u2019s income or
\nthe value of its holdings of \ufb01nancial instruments. The objective of market risk management is to manage
\nand control market risk exposures within acceptable parameters, while optimising the return on risk.
\nInterest rate risk
\nThe group is exposed to interest rate risk arising from \ufb02uctuations in market rates. This affects future cash
\n\ufb02ows from money market investments and the cost of \ufb02oating rate borrowings.
\nFrom time-to-time, the group considers the cost bene\ufb01t of entering into derivative \ufb01nancial instruments to
\nhedge its exposure to interest rate volatility based on existing variable rates, current and predicted interest
\nyield curves and the cost of associated medium-term derivative \ufb01nancial instruments.
\nInterest rates on variable rate loans are determined by SONIA (2021: LIBOR) \ufb01xings on a quarterly basis.
\nInterest is settled on all loans in line with agreements and is settled at least annually.
\nVariable
Total
Undrawn facility
\n1
\n31 December 2022 (\u00a3m)
325.0
325.0
100.0
\nEffective interest rate (%)
4.85%
4.85%
\n31 December 2021 (\u00a3m)
425.0
425.0
100.0
\nEffective interest rate (%)
2.96%
2.96%
\n1.
If this facility was drawn the interest rate would be in line with the variable rate loans.
\nThe group has an interest rate swap derivative asset of \u00a38.6 million (2021: \u00a30.7 million liability) in place (refer
\nto note 22).
\nThe fair value of this instrument is considered the same as its carrying value and level 2 of the fair value
\nhierarchy is used to measure the fair value of the instrument. The variable rate consideration received by the
\ngroup is Sterling three month SONIA, being lower than the hedged rate, resulting in some exposure on the
\nhedged amount.
\nSensitivity analysis
\nA change of 25 basis points (\u2018bp\u2019) in interest rates at the reporting date would have increased/(decreased)
\nequity and reported results by the amounts shown below. This analysis assumes that all other variables
\nremain constant.
\n
\n\n
\n
(\u00a3m)
\nProfit or loss
Equity
\n25bp increase
25bp decrease
25bp increase
25bp decrease
\nAt 31 December 2022
\nVariable rate instruments
(0.2)
0.2
(0.2)
0.2
\nAt 31 December 2021
\nVariable rate instruments
(0.5)
0.5
(0.5)
0.5
\nLiquidity risk
\nLiquidity risk is the risk that the group will not be able to meet its \ufb01nancial obligations as they fall due.
\nThe group\u2019s approach to managing liquidity is to ensure, as far as possible, that it will always have suf\ufb01cient
\nliquidity to meet its liabilities when due, under both normal and stressed conditions, without incurring
\nunacceptable losses or risking damage to the group\u2019s reputation.
\nLiquidity is managed across the group and consideration is taken of the segregation of accounts for regulatory
\npurposes. Short-term operational working capital requirements are met by cash in hand and overdraft facilities.
\nTypically the group ensures that it has suf\ufb01cient cash on demand to meet expected operational expenses for
\na period of at least 90 days, including the servicing of \ufb01nancial obligations. In addition to cash on demand,
\nthe group has available the following line of credit:
\n\u2013
\u00a3100.0 million of revolving credit facility, which was undrawn as at 31 December 2022 (2021: \u00a3100.0 million
\nundrawn)
\nThe following are contractual maturities, at as the balance sheet date, of \ufb01nancial liabilities, including interest
\npayments and excluding the impact of netting agreements:
\nAt 31 December 2022
\n(\u00a3m)
\nMaturity analysis
\nCarrying
\namount
\nContractual
\ncash flows
\nWithin
\n1 year
\nBetween 1
\nand 2 years
\nBetween 2
\nand 3 years
\nBetween 3
\nand 4 years
\nBetween 4
\nand 5 years
\nMore than 5
\nyears
\nTrade and other payables
154.8
154.8
154.8
\u2013
\u2013
\u2013
\u2013
\u2013
\nBank borrowings
324.3
394.4
20.2
22.1
20.5
331.6
\u2013
\u2013
\nLease liabilities
866.5
1,819.1
92.8
93.2
93.6
92.2
92.2
1,355.1
\n1,345.6
2,368.3
267.8
115.3
114.1
423.8
92.2
1,355.1
\nDerivative financial assets
\nInterest rate swaps
(8.6)
(9.2)
(2.9)
(3.6)
(2.1)
(0.6)
\u2013
\u2013
\n(8.6)
(9.2)
(2.9)
(3.6)
(2.1)
(0.6)
\u2013
\u2013
\nAt 31 December 2021
\n(\u00a3m)
\nMaturity analysis
\nCarrying
\namount
\nContractual
\ncash flows
\nWithin 1
\nyear
\nBetween 1
\nand 2 years
\nBetween 2
\nand 3 years
\nBetween 3
\nand 4 years
\nBetween 4
\nand 5 years
\nMore than 5
\nyears
\nTrade and other payables
150.8
150.8
150.8
\u2013
\u2013
\u2013
\u2013
\u2013
\nBank borrowings
427.5
449.6
12.8
436.8
\u2013
\u2013
\u2013
\u2013
\nLease liabilities
837.8
1,819.3
86.8
87.0
87.7
87.9
86.5
1,383.4
\nFinancial liability
1.9
1.9
1.9
\u2013
\u2013
\u2013
\u2013
\u2013
\n1,418.0
2,421.6
252.3
523.8
87.7
87.9
86.5
1,383.4
\nDerivative financial
\nliabilities
\nIinterest rate swap
0.7
1.2
1.2
\u2013
\u2013
\u2013
\u2013
\u2013
\n0.7
1.2
1.2
\u2013
\u2013
\u2013
\u2013
\u2013
\nCapital management
\nThe group\u2019s objective is to maintain an appropriate balance of debt and equity \ufb01nancing to enable the group
\nto continue as a going concern, to continue the future development of the business and to optimise returns
\nto shareholders and bene\ufb01ts to other stakeholders.
\nThe board closely manages trading capital, de\ufb01ned as net assets plus net debt. The group\u2019s net assets at
\n31 December 2022 were \u00a3725.1 million (2021: \u00a3704.8 million) and net debt, calculated as borrowings, less cash
\nand cash equivalents and the amortised fees of \u00a33.6 million (2021: \u00a30.7 million) that was recorded at the date
\nof the loan extensions, amounted to \u00a3253.7 million (2021: \u00a3225.6 million).
\nThe principal focus of capital management revolves around working capital management and compliance
\nwith externally imposed \ufb01nancial covenants see note 22 for more detail.
\nMajor investment decisions are based on reviewing the expected future cash \ufb02ows and all major capital
\nexpenditure requires approval by the board.
\nAt the balance sheet date, the group\u2019s committed undrawn facilities, and cash and cash equivalents were
\nas follows:
\n(\u00a3m)
2022
2021
\nCommitted undrawn revolving credit facility
100.0
100.0
\nCash and cash equivalents
74.2
202.6
\nFair value measurement
\nAs of 31 December 2022, except for an interest rate swap and \ufb01nancial asset relating to a gross pro\ufb01t share,
\nthe group did not hold \ufb01nancial instruments that are included in level 1, 2 or 3 of the hierarchy.
\nManagement assessed that cash and short-term deposits, trade and other receivables, unbilled receivables,
\ntrade payables and other current liabilities approximate their carrying amounts largely due to the short-term
\nmaturities of these instruments. The carrying value of debt is approximately equal to its fair value. During the
\nyear ended 31 December 2022, there were no transfers between the levels in the fair value hierarchy.
\n
\n
\n
\n
In determining fair value measurement, the impact of potential climate-related matters, including legislation,
\nwhich may affect the fair value measurement of assets and liabilities in the \ufb01nancial statements has been
\nconsidered.
\nA derivative is a \ufb01nancial instrument whose value is based on one or more underlying variables. The group
\nuses derivative \ufb01nancial instruments to hedge its exposure to interest rate risk. Derivatives are not held for
\nspeculative reasons. Fair values are obtained from market observable pricing information including interest
\nrate yield curves and have been calculated as follows; fair value of interest rate swaps is determined as the
\npresent value of the estimated future cash \ufb02ows based on observable yield curves.
\nThe \ufb01nancial asset re\ufb02ects a pro\ufb01t share arrangement with a partner. There are no market observable prices
\nfor the valuation. Management therefore assesses forward looking information and appropriate discount rates
\nand risk factors to determine the fair value. Sensitivities are also taken into account when reviewing the fair
\nvalue (note 15).
\nAs at 31 December 2022, the group held the following \ufb01nancial instruments measured at fair value:
\nFinancial instruments measured at fair value
\n(\u00a3m)
\nMaturity analysis
\nValue as at
\n31 December
\n2022
Level 1
Level 2
Level 3
\nFinancial assets at fair value through profit and loss
\nProfit share arrangement (Note 15)
4.6
\u2013
\u2013
4.6
\nInterest rate swaps
8.6
\u2013
8.6
\u2013
\nFinancial assets measured at fair value
13.2
\u2013
8.6
4.6
\nDuring the year, Spire Healthcare received a pro\ufb01t share in respect of the \ufb01nancial asset of \u00a30.7 million (2021:
\n\u00a30.4 million). In addition an unrealised fair value movement of \u00a33.0 million (2021: \u00a31.1 million) was recognised
\nin income upon review of the \ufb01nancial asset to increase the value of the \ufb01nancial asset on the balance sheet.
\nAs at 31 December 2021, the group held the following \ufb01nancial instruments measured at fair value:
\nFinancial instruments measured at fair value
\n(\u00a3m)
\nMaturity analysis
\nValue as at
\n31 December
\n2022
Level 1
Level 2
Level 3
\nFinancial assets at fair value through profit and loss
\nProfit share arrangement (Note 15)
2.3
\u2013
\u2013
2.3
\nFinancial assets measured at fair value
2.3
\u2013
\u2013
2.3
\nFinancial liabilities at fair value through profit and
\nloss and using hedge accounting
\nInterest rate swaps
0.7
\u2013
0.7
\u2013
\nFinancial liabilities at fair value on acquisition of a
\nsubsidiary
\nShare put options
1.9
\u2013
\u2013
1.9
\nFinancial liabilities measured at fair value
2.6
\u2013
0.7
1.9
\nCash \ufb02ow hedge
\nThe group designate, as cash \ufb02ow hedges, interest rate swaps entered into with three counterparties maturing
\nin February 2026. These interest rate swaps convert \ufb02oating interest rate liabilities into \ufb01xed interest rate
\nliabilities. The swaps run concurrently with the hedged item, being the group\u2019s \ufb02oating rate liabilities under
\nthe senior \ufb01nance facility.
\nFor the years ended December 2022 and 2021, there were no signi\ufb01cant amounts recognised in the pro\ufb01t
\nor loss relating to the ineffective portion of hedges or portions excluded from the assessment of hedge
\neffectiveness. The movement in the interest rate swap relates to fair value movement and is recognised
\nthrough other comprehensive income.
\nFair value hierarchy
\nThe group uses the following hierarchy for determining and disclosing the fair value of \ufb01nancial instruments
\nby valuation technique:
\nLevel 1: quoted (unadjusted) prices in active markets for identical assets or liabilities;
\nLevel 2: other techniques for which all inputs which have a signi\ufb01cant effect on the recorded fair value are
\nobservable, either directly or indirectly; and
\nLevel 3: techniques which use inputs which have a signi\ufb01cant effect on the recorded fair value that are not
\nbased on observable market data.
\nAs at 31 December 2022, the group held \ufb01nancial instruments measured at fair value, being an asset of
\n\u00a313.2 million (2021: \u00a32.3 million) and a liabilities of nil (2021: \u00a32.6 million).
\n31. Related party transactions
\nKey management personnel
\nKey management personnel are those persons having authority and responsibility for planning, directing and
\ncontrolling the activities of the group, directly or indirectly. They include the board and executive committee,
\nas identi\ufb01ed on pages 91 to 95.
\nCompensation for key management personnel is set out in the table below:
\nKey management compensation
\n(\u00a3m)
2022
2021
\nSalaries and other short term employee benefits
5.0
4.5
\nPost-employment benefits
0.5
0.5
\nTermination benefits
\u2013
\u2013
\nShare-based payments
1.1
1.0
\n6.6
6.0
\nFurther information about the remuneration of individual directors is provided in the audited part of the
\ndirectors\u2019 remuneration report on pages 112 to 119.
\nThere were no transactions with related parties external to the group in the year to 31 December 2022
\n(2021: nil).
\n
\n\n
\n
32. Business combinations and acquisition of non-controlling interests
\nAcquisitions in 2022
\nAcquisition of The Doctors Clinic Group Limited (together \u2018Doctors Clinic Group\u2019)
\nOn 16 December 2022, the group acquired 100% of the voting shares of The Doctors Clinic Group Limited
\n(which in turn owns 100% of the shares of The London Doctors Clinic Limited, Maitland Medical Service Limited
\nand Soma Health Limited), a non-listed company based in England which operates GP and occupational health
\nservices in the UK, for \u00a311.6 million. The group acquired the companies to expand its offering for GP and
\noccupational health services in line with its strategic plan.
\nAssets acquired and liabilities assumed
\nThe fair values of the identi\ufb01able assets and liabilities of The Doctors Clinic Group Limited as at the date of
\nacquisition were:
\n(\u00a3m)
\nFair value
\nrecognised on
\nacquisition
\nAssets
\nPlant, property and equipment (Note 13)
0.6
\nTrade and other receivables (Note 18)
1.5
\nCash (Note 19)
0.3
\n2.4
\nLiabilities
\nPayables (Note 25)
(1.9)
\nTotal identifiable net assets at fair value
0.5
\nGoodwill arising on acquisition (Note 14)
11.1
\nPurchase consideration transferred
11.6
\nThe amounts recognised, are subject to adjustment in line with IFRS 3 for up to a 12 months from acquisition,
\nwith goodwill being adjusted accordingly.
\nThe fair value of the trade receivables amounts to \u00a31.5 million. The gross amount of trade receivables is
\n\u00a31.5 million and it is expected that the full contractual amounts can be collected.
\nFrom the date of acquisition, The Doctors Clinic Group contributed \u00a30.4 million of revenue and loss of \u00a30.1 to
\npro\ufb01t before tax from continuing operations of the group. If the combination had taken place at the beginning
\nof the year, revenue from continuing operations would have been \u00a310.0 million and loss before tax from
\ncontinuing operations for the group would have been \u00a32.5 million.
\nGoodwill has been recognised to re\ufb02ect the synergies which the group believes are available to expand its
\noffering for GP and occupational health services in line with its strategic plan which re\ufb02ect intangibles that
\ncannot be separately quanti\ufb01ed. This goodwill is not deductible for tax purposes.
\nPurchase consideration transferred
\n(\u00a3m)
\nCash flow on
\nacquisition
\nNet cash acquired with the subsidiary
0.3
\nCash paid
11.6
\nNet cash flow on acquisition
11.3
\nTransaction costs of \u00a31.7 million were expensed and are included within adjusting Items. The acquisition is
\nsubject to a completion accounts process which is due to take place during H1 2023. Following this, the \ufb01nal
\npurchase price adjustments will be agreed, and goodwill updated accordingly in line with IFRS 3, which allows
\n12 months from the acquisition date to \ufb01nalise the goodwill position.
\nPrior year Acquisition of Claremont Hospital Holdings Limited and Claremont Hospital LLP (together
\n\u2018Claremont Hospital\u2019)
\nDuring the year the group reviewed its goodwill position in respect of Claremont Hospital in line with IFRS 3
\nand adjustment of \u00a30.1 million has been recognised in respect of provisions originally recognised on acquisition
\n33. Events after the reporting period
\nThere have been no other events to disclose after the reporting date.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfNotesAndOtherExplanatoryInformationExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19846": {
"value": "1. General information Spire Healthcare group plc (the \u2018company\u2019) and its subsidiaries (collectively, the \u2018group\u2019) owns and operates
\nprivate hospitals and clinics in the UK and provides a range of private healthcare services.
\nThe \ufb01nancial statements for the year ended 31 December 2022 were authorised for issue by the board of
\ndirectors of the company on 1 March 2023.
\nThe company is a public limited company, which is listed on the London Stock Exchange, incorporated,
\nregistered and domiciled in England and Wales (registered number: 09084066). The address of its registered
\n3 Dorset Rise, London, EC4Y 8EN.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfGeneralInformationAboutFinancialStatementsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19850": {
"value": "Spire Healthcare group plc ",
"dimensions": {
"concept": "ifrs-full:NameOfReportingEntityOrOtherMeansOfIdentification",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19851": {
"value": "Spire Healthcare group plc ",
"dimensions": {
"concept": "ifrs-full:NameOfParentEntity",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19852": {
"value": "Spire Healthcare group plc",
"dimensions": {
"concept": "ifrs-full:NameOfUltimateParentOfGroup",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19853": {
"value": "owns and operatesprivate hospitals and clinics in the UK and provides a range of private healthcare services. ",
"dimensions": {
"concept": "ifrs-full:DescriptionOfNatureOfEntitysOperationsAndPrincipalActivities",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19856": {
"value": "UK",
"dimensions": {
"concept": "ifrs-full:PrincipalPlaceOfBusiness",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19858": {
"value": "2022-12-31",
"dimensions": {
"concept": "ifrs-full:DateOfEndOfReportingPeriod2013",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19861": {
"value": "public limited company",
"dimensions": {
"concept": "ifrs-full:LegalFormOfEntity",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19863": {
"value": "England and Wales",
"dimensions": {
"concept": "ifrs-full:CountryOfIncorporation",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19864": {
"value": "England and Wales",
"dimensions": {
"concept": "ifrs-full:DomicileOfEntity",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19866": {
"value": "3 Dorset Rise, London, EC4Y 8EN.",
"dimensions": {
"concept": "ifrs-full:AddressOfRegisteredOfficeOfEntity",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19869": {
"value": "2. Accounting policies The principal accounting policies applied in the preparation of these \ufb01nancial statements are set out below.
\nThese policies have been consistently applied to all the years presented, unless otherwise stated.
\nBasis of preparation
\nThe consolidated \ufb01nancial statements of the group have been prepared in accordance with UK-adopted
\nInternational Accounting Standards (\u2018UK-adopted IFRS\u2019) as issued by the International Accounting Standards
\nBoard (\u2018IASB\u2019) and in accordance with the Companies Act 2006.
\nThe consolidated \ufb01nancial statements have been prepared on a historical cost basis except for derivative
\n\ufb01nancial instruments and \ufb01nancial assets measured at fair value. The group \ufb01nancial statements are presented
\nin UK sterling and all values are rounded to the nearest million pounds (\u00a3m), except when otherwise indicated.
\nThe preparation of \ufb01nancial statements in accordance with UK-adopted IFRS requires the use of certain critical
\naccounting estimates. It also requires management to exercise its judgement in the process of applying the
\ngroup\u2019s accounting policies. Further details on the group\u2019s critical judgements and estimates are included in
\nnote 3.
\nThe group has considered the future potential environmental impact on its current and future \ufb01nancial
\nposition and considered the impact to below.
\nGoing concern
\nThe group assessed going concern risk for the period through to 31 March 2024. As at 31 December 2022 the
\ngroup had cash of \u00a374.2 million, a Senior Loan Facility of \u00a3325 million and an undrawn Revolving Credit Facility
\nof \u00a3100 million. On 24 February 2022, the group successfully re\ufb01nanced its debt facilities with a syndicate of
\nexisting and new Lenders. As part of the re\ufb01nancing exercise and in recognition of the fact that the group had
\nsubstantial cash reserves at 31 December 2021, the group repaid \u00a3100 million of the Senior Loan Facility. The
\nnew arrangement has a maturity of four years. The \ufb01nancial covenants relating to this new agreement are
\nmaterially unchanged.
\nThe group has undertaken extensive activity to identify plausible risks which may arise and mitigating actions,
\nwhich in the \ufb01rst instance would include management of working capital and constrained levels of capital
\ninvestment. Based on the current assessment of the likelihood of these risks arising by 31 March 2024, together
\nwith their assessment of the planned mitigating actions being successful, the directors have concluded it is
\nappropriate to prepare the accounts on a going concern basis. In arriving at their conclusion, the directors have
\nalso noted that, were three of the most likely speci\ufb01c risks to arise in combination, it could result in a liquidity
\nconstraint or breach of covenant, however, the risk of this is considered remote.
\nThe group has also assessed, as part of its reverse stress testing, what degree of downturn in trading it could
\nsustain before it no longer forecasts a positive cash balance. This stress testing was based on \ufb02exing revenue
\ndownwards with a consistent percentage decline in variable costs, whilst maintaining the forecast of \ufb01xed
\ncosts. The testing did not allow for the bene\ufb01t of any action that could be taken by management to preserve
\ncash. This testing suggested that there would have to be at least a 35% fall in annual revenue before the group
\nno longer forecast a positive cash balance. We do not believe that such a reduction of income revenue is a
\nplausible consequence of the group\u2019s identi\ufb01ed principal risks.
\nIt should be noted that we are in a period of unprecedented geo-political and macro-economic uncertainty.
\nWhilst the directors continue to closely monitor these risks and their plausible impact, their severity is hard
\nto predict and is dependent upon many external factors. Accordingly the actual \ufb01nancial impact of these risks
\nmay materially vary against the current view of their plausible impact.
\nFurther detail on both aacroeconomic related risk and COVID-19 is provided in the risk management and
\ninternal control section on pages 66 to 76.
\nOther speci\ufb01c scenarios covered by our testing were as follows:
\n\u2013
The group is subject to temporary suspension of trade, with a temporary adverse impact on revenue,
\nfor example, as a result of a successful cyber-attack on key business systems
\n\u2013
The downside modelling of a number of risks which result in a decline in earnings, including the loss of
\na contractual relationship with a key insurer
\n\u2013
Signi\ufb01cant change in government policy resulting in consultants going on payroll
\n\u2013
Short term disruption to trade at a sub-set of hospitals owing to an extreme weather event
\nThis review included the following key assumptions:
\n\u2013
No change in capital structure given the group has re\ufb01nanced its existing senior \ufb01nance facility and
\nrevolving credit facility since the 2022 year end
\n\u2013
The government will not make signi\ufb01cant change to its existing policy towards utilising private provision
\nof healthcare services to supplement the NHS
\nRevenue recognition
\nThe group derives its revenue primarily from providing private healthcare services to both the public sector
\nand private patients in the UK. Revenue from charges to patients is recognised when the treatment is provided.
\nRevenue from contracts with customers
\nThe criteria for revenue recognition are as follows; identify the contract with the customer, identify the
\nperformance obligation, determine the transaction price, allocate the transaction price to the performance
\nobligations, and satisfying the performance obligation. It applies to all contracts with customers, except those
\nin the scope of other standards.
\nRevenue is recorded as services are transferred to the patient, with the consideration based on the total
\namount the group expects to receive, taking account of discounts where they are quanti\ufb01able and probable.
\nApproximately 70% of the group\u2019s revenue is derived from inpatient and daycase admissions. Revenue is
\nrecognised day by day, as services are provided to patients. These services are typically provided over a short
\ntime frame, that is, one to three days. Outpatient cases and other revenue represent approximately 30% of the
\ngroup\u2019s revenue. Outpatient cases generally do not involve surgical procedures and revenue is recognised on
\nan individual component basis when performance obligations are satis\ufb01ed. Similarly, other revenue, which
\nincludes consultant revenue and other third-party revenue streams, is recognised when performance
\nobligations are satis\ufb01ed and the control of goods or services is transferred.
\n
\n
\n
\n\n\n
\n\n\nThe group reports disaggregated revenue by material revenue stream (ie type of payor: PMI, NHS and self-pay)
\nand other revenue which includes consultant revenue, third party revenue streams (eg pathology services)
\nand \u2018commissioning for quality and innovation payments\u2019 (CQUIN). Material revenue streams are consistent
\nin nature, being the consideration received in return for the provision of healthcare services to patients. The
\ntiming and uncertainty of cash \ufb02ows is similar for PMI and NHS business while self-pay revenue is received in
\nadvance or collected by credit card shortly after treatment. In addition, where possible and meaningful, Spire
\nHealthcare reports revenue split between inpatient/daycase, outpatient and other. As noted above, in all cases,
\nrevenue is recognised as performance obligations are completed in the form of services being provided to
\npatients. Unbilled revenue is accrued at period ends. Invoices for the combination of services provided to
\npatients are generally produced within three days of discharge.
\nRevenue recognition \u2013 the NHS contracts
\nApproximately 0.3% of the group\u2019s revenue is derived from the NHS COVID-19 contracts (2021: 5%). Revenue
\nfrom the NHS COVID-19 contracts is recognised as the services are transferred to the customer over the life
\nof the contract. In the prior year the contracts\u2019 transaction price is based on variable consideration, recognition
\nof revenue is constrained to the extent that it is probable that a signi\ufb01cant reversal will not occur when the
\nuncertainty is resolved.
\nInterest income
\nInterest is recognised on an effective interest rate basis.
\nCost of sales
\nCost of sales principally comprises salaries of clinical staff, consultant and clinical fees, medical services and
\ninventories, including drugs, consumables and prostheses.
\nOther operating costs
\nOther operating costs mainly comprise non-clinical staff costs, rent associated with short or low value leases,
\nthe depreciation of property, plant and equipment and right of use assets and the maintenance and running
\ncosts of properties and equipment. It also includes administrative expenses, including the provision of central
\nsupport services, IT and other administrative costs.
\nOther income
\nOther income comprises fair value movements on the \ufb01nancial asset, a pro\ufb01t share arrangement with Genesis
\nCare.
\nOperating pro\ufb01t
\nOperating pro\ufb01t is the pro\ufb01t arising from the normal, recurring operations of the business and after charging
\nadjusting items, as de\ufb01ned below. Operating pro\ufb01t is adjusted to exclude adjusting items to calculate the Key
\nPerformance Indicator (KPI) \u2018Operating pro\ufb01t before adjusting items (adjusted EBIT)\u2019.
\nAdjusting items
\nAdjusting items are those items which the directors believe, by virtue of their nature, size or incidence, either
\nindividually or in aggregate, should be disclosed separately to allow a full understanding and comparison of the
\nunderlying performance of the group. Examples of items which may be considered this way in nature include
\nsigni\ufb01cant write-downs of goodwill and other assets, restructuring costs relating to strategic review,
\nimpairments, hospital closures and set-up costs, business acquisition costs, medical malpractice provisions,
\naborted project costs and compliance set-up costs.
\nCash and cash equivalents
\nCash and cash equivalents comprise cash balances and call deposits. Bank overdrafts that are repayable on
\ndemand and form an integral part of the group\u2019s cash management are included as a component of cash and
\ncash equivalents for the purpose only of the statement of cash \ufb02ows. There are no bank overdrafts in either
\nyear presented.
\nTaxation including deferred taxation
\nTotal income tax on the result for the year comprises current and deferred tax. Income tax is recognised in
\nthe income statement except to the extent that it relates to items recognised directly in equity and other
\ncomprehensive income.
\nCurrent tax is the expected tax payable on the taxable result for the year, using tax rates enacted, or
\nsubstantively enacted, at the balance sheet date, and any adjustments to tax payable in respect of previous
\nyears.
\nWhere there is an uncertain tax position, a provision is recognised when it is not probable that the tax
\nauthority will accept the uncertain tax position, based on either the most likely amount where the range
\nof results is binary, or as a weighted average of possible outcomes where a range of outcomes is possible.
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\n\u2013
Goodwill not deductible for tax purposes
\n\u2013
The initial recognition of an asset or liability in a transaction that is not a business combination and which,
\nat the time of the transaction, affects neither the accounting pro\ufb01t nor the taxable pro\ufb01t or loss
\n\u2013
Investments in subsidiary companies where the timing of the reversal of the temporary difference is
\ncontrolled by the group and it is probable that the temporary difference will not reverse in the foreseeable
\nfuture
\nIt should be noted that the initial recognition exception does not apply to the majority of the group\u2019s freehold
\nproperty portfolio as these were acquired through the Bupa and Classics acquisitions in 2007 and 2008, which
\nwere accounted for as a business combination.
\nThe amount of deferred tax recognised is based on the expected manner of realisation or settlement of the
\ncarrying amounts of assets and liabilities, using tax rates enacted, or substantively enacted, at the balance
\nsheet date. The group offsets deferred tax assets and deferred tax liabilities if, and only if, it has a legally
\nenforceable right to set off current tax assets and current tax liabilities and the deferred tax assets and
\ndeferred tax liabilities relate to income taxes levied by the same taxation authority on either the same taxable
\nentity or different taxable entities which intend either to settle current tax liabilities and assets on a net basis,
\nor to realise the assets and settle the liabilities simultaneously, in each future period in which signi\ufb01cant
\namounts of deferred tax liabilities or assets are expected to be settled or recovered.
\nIn assessing the recoverability of deferred tax assets, the group relies on the same forecast assumptions used
\nelsewhere in the \ufb01nancial statements and in other management reports, which, among other things, re\ufb02ect
\nthe potential impact of climate-related development on the business, such as increased costs as a result of
\nmeasures to reduce carbon emission.
\nA deferred tax asset, subject to the offsetting above, is only recognised to the extent that it is probable that
\nfuture taxable pro\ufb01ts will be available against which the asset can be used.
\n
\n\n\n
\n
\n\nProperty, plant and equipment
\nProperty, plant and equipment is stated at cost less accumulated depreciation. Major projects are treated as
\nassets in the course of construction until completed when they are transferred to the appropriate asset class.
\nNo depreciation is charged on freehold land or assets in the course of construction. Other assets are depreciated
\nso as to write off the carrying amounts of the assets, less their estimated residual values, over their expected
\nuseful lives, as follows:
\nFreehold property and improvements
\u2013
5 to 60 years
\nLeasehold improvements
\u2013
lower of unexpired lease term or expected life, with a maximum
\nof 35 years
\nEquipment
\u2013
3 to 10 years
\nThe expected useful lives and residual values of property, plant and equipment are reviewed semi-annually and
\nrevised as appropriate. The review of the asset lives and residual values of properties takes into consideration
\nthe plans of the business and levels of expenditure incurred on an ongoing basis to maintain the properties
\nin a \ufb01t and proper state for their ongoing use as hospitals. In addition, the potential impact of future climate
\nchange is considered. In the case of major facilities opening in new locations, depreciation may be applied
\nto only those assets available for use at the of\ufb01cial opening date to re\ufb02ect that the site is not always fully
\noperational at this opening date. During the year management revised the useful life and residual value
\nof freehold land and buildings refer to changes in accounting estimates for further details.
\nConsolidation
\nThe results of all subsidiary undertakings are included in the consolidated \ufb01nancial statements. Assets,
\nliabilities, income and expenses of a subsidiary acquired or disposed of during the year are included in the
\nconsolidated \ufb01nancial statements from the date the group gains control until the date the group ceases
\nto control the subsidiary.
\nControl is achieved when the group is exposed, or has rights, to variable returns from its involvement with the
\ninvestee and has the ability to affect those returns through its power over the investee. Speci\ufb01cally, the group
\ncontrols an investee if, and only if, the group has:
\n\u2013
Power over the investee (ie existing rights that give it the current ability to direct the relevant activities
\nof the investee)
\n\u2013
Exposure, or rights, to variable returns from its involvement with the investee
\n\u2013
The ability to use its power over the investee to affect its returns
\nThe Employee Bene\ufb01t Trust (EBT) is treated as an extension of the group and the company.
\nBusiness combinations
\nBusiness combinations are accounted for using the acquisition method. The cost of an acquisition is measured
\nas the aggregate of the consideration transferred measured at acquisition date fair value and the amount of
\nany non-controlling interests in the acquiree. For each business combination, the group elects whether to
\nmeasure the non-controlling interests in the acquiree at fair value or at the proportionate share of the
\nacquiree\u2019s identi\ufb01able net assets. Acquisition-related costs are expensed as incurred and included in other
\noperating costs.
\nThe group determines that it has acquired a business when the acquired set of activities and assets include
\nan input and a substantive process that together signi\ufb01cantly contribute to the ability to create outputs.
\nThe acquired process is considered substantive if it is critical to the ability to continue producing outputs,
\nand the inputs acquired include an organised workforce with the necessary skills, knowledge, or experience
\nto perform that process or it signi\ufb01cantly contributes to the ability to continue producing outputs and is
\nconsidered unique or scarce or cannot be replaced without signi\ufb01cant cost, effort, or delay in the ability
\nto continue producing outputs.
\nWhen the group acquires a business, it assesses the \ufb01nancial assets and liabilities assumed for appropriate
\nclassi\ufb01cation and designation in accordance with the contractual terms, economic circumstances and
\npertinent conditions as at the acquisition date.
\nGoodwill
\nGoodwill represents the excess of the cost of acquisition (being the fair value of consideration transferred) over
\nthe fair value of the assets, liabilities and contingent liabilities of acquired businesses at the date of acquisition.
\nGoodwill is stated at cost less accumulated impairment losses.
\nGoodwill is allocated to one cash-generating unit and is not amortised but is tested annually for impairment,
\nor more frequently if there is an indication that the value of the goodwill may be impaired (see impairment
\npolicy).
\nFinancial Instruments
\nA \ufb01nancial instrument is any contract that gives rise to a \ufb01nancial asset of one entity and a \ufb01nancial liability
\nor equity instrument of another entity.
\ni) Financial assets other than derivatives
\nInitial recognition and measurement
\nFinancial assets are classi\ufb01ed as \ufb01nancial assets at fair value through pro\ufb01t or loss, amortised cost or fair value
\nthrough other comprehensive income (\u2018OCI\u2019).
\nThe classi\ufb01cation of \ufb01nancial assets at initial recognition depends on the \ufb01nancial asset\u2019s contractual cash \ufb02ow
\ncharacteristics and the group\u2019s business model for managing them. With the exception of trade receivables
\nthat do not contain a signi\ufb01cant \ufb01nancing component or for which the group has applied the practical expedient,
\nthe group initially measures a \ufb01nancial asset at its fair value plus, in the case of a \ufb01nancial asset not at fair value
\nthrough pro\ufb01t or loss, transaction costs. Trade receivables that do not contain a signi\ufb01cant \ufb01nancing component
\nor for which the group has applied the practical expedient are measured at the transaction price determined
\nunder IFRS 15.
\nIn order for a \ufb01nancial asset to be classi\ufb01ed and measured at amortised cost or fair value through OCI, it needs
\nto give rise to cash \ufb02ows that are \u2018solely payments of principal and interest (SPPI)\u2019 on the principal amount
\noutstanding. This assessment is referred to as the SPPI test and is performed at an instrument level.
\n
\n\n\n
\n
\n\n\nThe group\u2019s business model for managing \ufb01nancial assets refers to how it manages its \ufb01nancial assets in order
\nto generate cash \ufb02ows. The business model determines whether cash \ufb02ows will result from collecting
\ncontractual cash \ufb02ows, selling the \ufb01nancial assets, or both.
\nThe company\u2019s \ufb01nancial assets include cash and short-term deposits, trade and other receivables, unbilled
\nreceivables and receivables from pro\ufb01t share arrangements. Unbilled receivables may include contract assets
\nwhere the performance obligation has been met, but the invoice not raised due to agreement with the
\ncustomer being required in respect of the variable consideration. Unbilled receivables can also include
\namounts where the performance obligation has been met, but the invoice not yet raised due to the timing
\nof the reporting period.
\nSubsequent measurement
\nTrade receivables and unbilled receivables are accounted for at amortised cost. The group applies the IFRS 9
\nsimpli\ufb01ed approach to measuring expected credit losses, which uses a lifetime expected loss allowance for all
\ntrade receivables. At each reporting period, the group makes an assessment of the asset\u2019s recoverable amount
\nbased on forward looking information. Losses arising from impairment are recognised in the consolidated
\nincome statement in other operating costs.
\nLoans and receivables are non-derivative \ufb01nancial assets with \ufb01xed or determinable payments that are not
\nquoted in an active market. On initial recognition, loans and receivables are measured at fair value plus directly
\nattributable transaction costs. Subsequently, such assets are measured at amortised cost, using the effective
\ninterest rate (\u2018EIR\u2019) method, less any allowance for impairment.
\nAmortised cost is calculated by taking into account any discount or premium on acquisition and fees or costs
\nthat are an integral part of the EIR. The EIR amortisation is included in interest receivable in the consolidated
\nincome statement.
\nReceivables relating to pro\ufb01t share arrangements are recognised as fair value through pro\ufb01t and loss. At each
\nreporting period, the assets are revalued, with any movement in fair value being recognised in the consolidated
\nincome statement. Any cash received from pro\ufb01t share arrangements is presented within cash \ufb02ows from
\ninvesting activities within the Cash Flow statement.
\nDerecognition
\nA \ufb01nancial asset is derecognised when the rights to receive cash \ufb02ows from the asset have expired, or the
\ngroup has transferred its rights to receive cash \ufb02ows from the asset including transferring substantially all
\nthe risks and rewards of the asset.
\nImpairment
\nThe group recognises an allowance for expected credit losses (ECLs) for all debt instruments not held at fair
\nvalue through pro\ufb01t or loss. ECLs are based on the difference between the contractual cash \ufb02ows due in
\naccordance with the contract and all the cash \ufb02ows that the group expects to receive, discounted at an
\napproximation of the original effective interest rate. The expected cash \ufb02ows will include cash \ufb02ows from
\nthe sale of collateral held or other credit enhancements that are integral to the contractual terms.
\nFor trade receivables and contract assets (including unbilled receivables), the group applies a simpli\ufb01ed
\napproach in calculating ECLs. Therefore, the group does not track changes in credit risk, but instead recognises a
\nloss allowance based on lifetime ECLs at each reporting date. The group has established a provision matrix that
\nis based on its historical credit loss experience, adjusted for forward-looking factors speci\ufb01c to the receivables
\nand the economic environment. To measure the expected credit losses, trade receivables have been grouped
\nbased on shared characteristics and the days past due. The group has concluded that the expected loss rates
\nfor trade receivables, are a reasonable approximation of the loss rates for each ageing bucket based on
\nhistorical debt trends of our portfolio of customers for the last two reporting periods, with the exception
\nof patient debt. Patient debt is more susceptible to the economic environment. As a result, the group have
\nreviewed the expected loss rates for this payor group, as well as considering forward looking information
\n(speci\ufb01cally the cost of living and COVID-19) and increased the loss rates accordingly.
\nii) Financial liabilities other than derivatives
\nFinancial liabilities within the scope of IFRS 9 are classi\ufb01ed as \ufb01nancial liabilities at fair value through pro\ufb01t or
\nloss, or at amortised cost. The group determines the classi\ufb01cation of \ufb01nancial liabilities at initial recognition.
\nInitial recognition and measurement
\nAll \ufb01nancial liabilities are recognised initially at fair value and in the case of loans and borrowings, net of directly
\nattributable transaction costs.
\nThe group\u2019s \ufb01nancial liabilities include trade and other payables, loans and borrowings, and derivative \ufb01nancial
\ninstruments.
\nSubsequent measurement
\nAfter initial recognition, interest bearing loans and borrowings are subsequently measured at amortised cost
\nusing the effective interest rate (EIR) method. Gains and losses arising on the repurchase, settlement or
\notherwise cancellation of liabilities are recognised respectively in interest receivable and interest payable in the
\nconsolidated income statement. Amortised cost is calculated by taking in to account any discount or premium
\non acquisition and fees or costs that are an integral part of the EIR. The EIR amortisation is included as \ufb01nance
\ncosts in the consolidated income statement.
\nFinancial liabilities on business combination
\nOn acquisition of a business combination, a \ufb01nancial liability may be recognised at fair value through pro\ufb01t and
\nloss where there is an obligation on the group to settle a liability. In subsequent periods, the liability will be
\nremeasured based on its fair value, with movements being recognised in the income statement. Cash \ufb02ows
\nwill be discounts as appropriate.
\nTo determine the obligation, the group will review whether the liability arises as a result of an action or decision
\nof the group, or if an action by a third party would result in the obligation crystallising.
\nDerecognition
\nA \ufb01nancial liability is derecognised when the obligation under the liability is discharged or cancelled or expires.
\nWhen an existing \ufb01nancial liability is replaced by another from the same lender on substantially different
\nterms, or the terms of an existing liability are substantially modi\ufb01ed, such an exchange or modi\ufb01cation is
\ntreated as the derecognition of the original liability and the recognition of a new liability. The difference in the
\nrespective carrying amounts is recognised in the consolidated income statement.
\niii) Derivative \ufb01nancial instruments
\nThe group may enter into derivative \ufb01nancial instrument arrangements to manage its exposure to interest
\nrate risk. Derivatives are initially recognised at fair value on the date on which a derivative contract is entered
\nin to and subsequently remeasured at fair value at each balance sheet date. Derivatives are carried as \ufb01nancial
\nassets when the fair value is positive and as \ufb01nancial liabilities when the fair value is negative.
\nThe group applies cash \ufb02ow hedge accounting to such derivatives if the criteria for doing so are met. At the
\ninception of a hedge relationship, the group formally designates and documents the hedge relationship to
\nwhich it wishes to apply hedge accounting and the risk management objective and strategy for undertaking
\nthe hedge.
\n\n\n\n\n
\n\n\nThe effective portion of the changes in the fair value of derivatives that are designated and qualify as cash \ufb02ow
\nhedges is recognised in other comprehensive income. The gain or loss relating to the ineffective portion is
\nrecognised immediately in the income statement. The cash \ufb02ow hedge reserve is adjusted to the lower of the
\ncumulative gain or loss on the hedging instrument and the cumulative change in fair value of the hedged item.
\nAmounts deferred in equity are recycled in the income statement in the periods when the hedged item is
\nrecognised, in the same line of the income statement as the recognised hedged item. If cash \ufb02ow hedge
\naccounting is discontinued, the amount that has been accumulated in the consolidated statement of other
\ncomprehensive income is maintained if the hedged future cash \ufb02ows are still expected to occur. Otherwise,
\nthe amount is immediately reclassi\ufb01ed to pro\ufb01t or loss as a reclassi\ufb01cation adjustment.
\niv) Offsetting of \ufb01nancial instruments
\nFinancial assets and \ufb01nancial liabilities are offset and the net amount reported in the consolidated balance
\nsheet if, and only if, there is a currently enforceable legal right to offset the recognised amounts and there is
\nan intention to settle on a net basis, or to realise the assets and settle the liabilities simultaneously.
\nInventories
\nInventories are stated at the lower of cost and net realisable value. Cost means purchase price, less trade
\ndiscounts, calculated on an average basis. Net realisable value means estimated selling price less incremental
\ncosts including trade discounts and all costs to be incurred in marketing, selling and distribution.
\nThe group holds consignment stock on sale or return. The group is only required to pay for the equipment
\nit chooses to use and therefore this stock is not recognised as an asset.
\n2. Accounting policies
continued
\nBorrowing costs
\nBorrowing costs that are directly attributable to the acquisition and construction of qualifying assets, which
\nare assets that necessarily take a substantial period of time to get ready for their intended use or sale, are
\nadded to the cost of those assets, until such time as the assets are substantially ready for their intended
\nuse or sale.
\nAll other borrowing costs are recognised as an expense in the period in which they are incurred.
\nProvisions
\nA provision is recognised in the consolidated balance sheet when the group has a present legal or constructive
\nobligation as a result of a past event, and it is probable that an out\ufb02ow of economic bene\ufb01ts will be required
\nto settle the obligation. If the effect is material, provisions are determined by discounting the expected,
\nrisk-adjusted, future cash \ufb02ows at a pre-tax risk-free rate. Management consider their best estimate of the likely
\noutcomes of the obligation when determining the recognition. Where a material range of outcomes could arise,
\ndetails are disclosed accordingly. Provisions are measured gross of any expected insurance recovery. Any such
\ninsurance recoveries are recognised in other receivables when the receipt of them is judged virtually certain.
\nLeases
\nAt inception, the group assesses whether a contract is or contains a lease. This assessment involves the exercise
\nof judgement about whether the group obtains substantially all the economic bene\ufb01ts from the use of that
\nasset, and whether the group has the right to direct the use of the asset when considering whether the
\ncontract conveys the right to control the use of an identi\ufb01ed asset for a period of time in exchange for
\nconsideration. After initial recognition, the lease liability is measured at amortised cost using the effective
\ninterest method. A reassessment of the lease liability occurs when there is a change in lease payments. The
\nincremental borrowing rate is only revised where the change in payments is a result of a change in \ufb02oating
\ninterest rates, lease term change or a change in assessment relating to the exercise of purchase option charges.
\nThe group has elected not to separate lease and non-lease components for leases of vehicles or buildings.
\nThe group recognises a Right Of Use (ROU) asset and a lease liability at the commencement of the lease. The
\nROU is initially measured based on the present value of lease payments, less any incentives received. Initial
\ndirect costs and costs to dismantle or restore an asset are included. The ROU is depreciated over the shorter
\nof the lease term or the useful life of the underlying asset. The incremental borrowing rate is used to discount
\nthe assets over the relevant term. The ROU is subject to testing for impairment if there is an indicator for
\nimpairment.
\nLease payments generally include \ufb01xed payments and variable payments that depend on an index (such as
\nin\ufb02ation index) or rate. When the lease contains an extension or purchase option that the group considered
\nreasonably certain to be exercised, the cost of the option is included in the lease payments. The incremental
\nborrowing rate is used to discount the lease payments over the term of the lease.
\nROU assets are categorised to re\ufb02ect the nature of the underlying asset and to be consistent with the plant,
\nproperty and equipment (PPE) note. The assets are depreciated over the term of the lease, accounting for break
\nclauses or options to extend in line with the lease liability decision.
\nROU assets are disclosed as PPE on the balance sheet (non-current) with a separate disclosure within the
\nassociated note, and the lease liability is included in the headings lease liability (current and non-current)
\non the Consolidated balance sheet.
\nThe group has elected not to recognise ROU assets and liabilities for leases where the total lease term is less
\nthan 12 months, or for leases of low value equipment. The payments for such leases are recognised in the
\nConsolidated income statement on a straight line basis over the lease term.
\nSale and leaseback of properties
\nIn circumstances where the group sells a property to a third party and then enters into an agreement with the
\nbuyer to lease the asset back under a lease arrangement (a \u2018sale and leaseback transaction\u2019) which meets the
\ncriteria of a sale under IFRS 15, the group derecognises the underlying asset from PPE, and instead recognises a
\nROU asset measured at the retained portion of the previous carrying amount, recognising a gain or loss on the
\nrights transferred to the lessor. Values recognised will be adjusted where the sale is not completed at fair value,
\nor where lease payments do not re\ufb02ect market value.
\nWhere the sale of a property is not deemed a sale under IFRS 15, the group will continue to recognise the
\nunderlying asset within PPE, and will also recognise a \ufb01nancial liability for any amount received from the
\nbuyer/lessor.
\n
\n\n\n
\n
\n\nShare capital
\nOrdinary shares are classi\ufb01ed as equity. Incremental costs directly attributable to the issue of new shares
\nare deducted from share premium. Where the employee bene\ufb01t trust purchases the company\u2019s equity share
\ncapital, the consideration paid, including any directly attributable incremental costs, is deducted from equity
\nattributable to the company\u2019s equity holders in both the company and the consolidated balance sheet until
\nthe shares are cancelled or reissued.
\nDividend distribution
\nDividend distribution to the company\u2019s shareholders is recognised as a liability in the group\u2019s \ufb01nancial
\nstatements in the period in which the dividend is approved by the company\u2019s shareholders. Interim dividends
\nare recognised when paid.
\nPensions
\nThe group operates the Spire Healthcare Pension Plan, a de\ufb01ned contribution scheme. The assets of the
\nscheme are held separately from those of the group in independently administered funds.
\nObligations for contributions to de\ufb01ned contribution pension schemes are recognised as an expense in the
\nincome statement as incurred.
\nOther employee bene\ufb01ts
\nShort-term employee bene\ufb01t obligations are measured on an undiscounted basis and are expensed as the
\nrelated service is provided. A provision is recognised for the amount expected to be paid under short-term cash
\nbonuses if the group has a present legal or constructive obligation to pay this amount as a result of past service
\nprovided by the employee and the obligation can be estimated reliably.
\nShare based payments
\nThe group operates a number of equity-settled share-based payment schemes under which the group receives
\nservices from employees as consideration for equity instruments of the group. The fair value of the employee
\nservices received in exchange for the grant of the options is recognised as an expense. The group has estimated
\nthe relevant fair value of the share options and awards, which are subject to total shareholder return (\u2018TSR\u2019)
\nmarket-related performance criteria, using a Monte Carlo simulation model (see note 27). This applies to LTIP
\nAwards and Deferred Share Bonus Schemes.
\nThe group also operates a Save-As-You-Earn (\u2018SAYE\u2019) scheme, which is open to all employees. Employees are
\nrequired to save a \ufb01xed amount, up to a cap, every month for three years. At the end of the three year period
\nemployees are entitled to use their savings to purchase shares in the company at a stated exercise price.
\nEmployees are free to stop contributing to the scheme and obtain a refund of contributions at any time, but
\nforfeit their entitlement to exercise the options if they do so. Payment of contributions into a SAYE scheme is
\nnot a vesting condition; it does not meet the de\ufb01nition of a performance condition because it has no link to
\nservice. Failure to meet a non-vesting condition (eg by ceasing to contribute to an SAYE scheme) is accounted
\nfor as a cancellation of the options so that the expense is accelerated and recognised in the income statement,
\nwith a corresponding adjustment to equity as required. The IFRS 2 charge has been calculated using an
\nadjusted Black Scholes model with judgements including leavers of the scheme (employees who may cease
\nto save) and dividend yields.
\nAt the end of each year, the group revises its estimates of the number of options that are expected to vest
\nbased on the non-market conditions and recognises the impact of the revision to original estimates, if any,
\nin the income statement, with a corresponding adjustment to equity.
\nNon-current assets held for sale
\nNon-current assets and disposal groups are classi\ufb01ed as held for sale if their carrying amount will be recovered
\nprincipally through a sale transaction rather than through continuing use. This condition is regarded as met
\nonly when the sale is highly probable and the asset (or disposal group) is available for immediate sale in its
\npresent condition. Management must be committed to the sale, which should be expected to qualify for
\nrecognition as a completed sale within one year from the date of classi\ufb01cation.
\nNon-current assets (and disposal groups) classi\ufb01ed as held for sale are measured at the lower of their carrying
\namount and fair value less costs to sell.
\nImpairment
\nThe group applies its impairment policy to non-\ufb01nancial assets, being intangible assets (goodwill), plant,
\nproperty and equipment and right of use assets. The group assesses, at each reporting date, whether there
\nis an indication that an asset may be impaired. If any indication exists, or when annual impairment testing
\nfor an asset is required, the group estimates the asset\u2019s recoverable amount. An asset\u2019s recoverable amount
\nis the higher of an asset\u2019s or CGU\u2019s fair value less costs of disposal or its value in use. The recoverable amounts
\nis determined for an individual asset, unless the asset does not generate cash in\ufb02ows that are largely
\nindependent of those from other assets or groups of assets. When the carrying amount of an asset or CGU
\nexceeds its recoverable amount, the asset is considered impaired, and is written down to its recoverable
\namount.
\nIn assessing value in use, the estimated future cash \ufb02ows are discounted to their present value using a discount
\nrate that re\ufb02ects current market assessments of the time value of money and risks speci\ufb01c to the asset. As part
\nof this, the group assesses where climate risks could have a signi\ufb01cant impact, such as the introduction of
\nemission-reduction legislation that may increase costs. These risks in relation to climate-related matters are
\nincluded as key assumptions where they materially impact the measure of recoverable amount. The group
\nbases its impairment calculation on most recent budgets and forecast calculations, which are prepared for
\neach CGU. The forecasts generally cover a \ufb01ve year period. A long term growth rate is calculated and applies
\nto project future cash \ufb02ows after the \ufb01fth year.
\nImpairment losses of continuing operations are recognised in the consolidated income statement in other
\noperating costs. Impairment is likely to be considered an Adjusting item.
\nFor assets excluding goodwill, an assessment is made at each reporting date to determine whether there is an
\nindication that previously recognised impairment losses no longer exist or have decreased. If such indication
\nexists, the group estimates the asset\u2019s or CGU\u2019s recoverable amount. A previously recognised impairment
\nloss is reversed only if there has been a change in the assumptions used to determine the asset\u2019s recoverable
\namount since the last impairment loss was recognised. The reversal is limited so that the carrying amount
\nof the asset does not exceed its recoverable amount, nor exceed the carrying amount that would have been
\ndetermined, net of depreciation, had no impairment loss been recognised for the asset in prior years. Such
\nreversal is recognised in the statement of pro\ufb01t or loss.
\nGoodwill is tested for impairment annually as at 31 December and when circumstances indicate that the
\ncarrying value may be impaired.
\nImpairment is determined for goodwill by assessing the recoverable amount of each CGU (or group of CGUs)
\nto which the goodwill relates. When the recoverable amount of the CGU is less than its carrying amount, an
\nimpairment loss is recognised. Impairment losses relating to goodwill cannot be reversed in future periods.
\nIntangible assets with inde\ufb01nite useful lives are tested for impairment annually as at 31 December at the
\nCGU level, as appropriate, and when circumstances indicate that the carrying value may be impaired.
\n
\n\n\n
\n
\n\nChanges in accounting policy and estimates
\nNew standards, interpretations and amendments applied
\nThe following amendments to existing standards were effective for the group from 1 January 2022. Other than
\nsome additional disclosures, these amendments have not had a material impact.
\nEffective date*
\nAmendments to IFRS 3 Business Combinations \u2013 reference to the conceptual framework
1 January 2022
\nAmendments to IAS 16 \u2013 Property, Plant and Equipment: proceeds before intended use
1 January 2022
\nAmendments to IAS 37 \u2013 Onerous Contracts \u2013 costs of fulfilling a contract
1 January 2022
\nIFRS 9 Financial Instruments \u2013 Fees in the \u201810 per cent\u2019 test for derecognition of financial liabilities
1 January 2022
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations that are consistent with
\nthe endorsement process for use in the UK.
\nNew standards, interpretations and amendments in issue, but not yet effective
\nAs at date of approval of the group \ufb01nancial statements, the following new and amended standards,
\ninterpretations and amendments in issue are applicable to the group but not yet effective and thus, have not
\nbeen applied by the group:
\nEffective date*
\nAmendments to IAS 1 \u2013 Classification of liabilities as current or non-current
1 January 2023
\nAmendments to IAS 8 \u2013 Definition of accounting estimates
1 January 2023
\nAmendments to IAS 12 \u2013 Deferred tax related to assets and liabilities arising from a single
\ntransaction
1 January 2023
\nIFRS 17 \u2013 Insurance contracts
1 January 2023
\nAmendments to IFRS 16 \u2013 Lease Liability in a sale and leaseback
1 January 2024
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations. As the group prepares
\nits \ufb01nancial statements in accordance with IFRS as issued by the IASB as endorsed by the UK, the application of new standards
\nand interpretations will result in an effective date subject to that agreed by the UK Endorsement process.
\nIFRS 17 is under review by management and the impact if any is still to be quanti\ufb01ed. All other amendments
\nare not expected to have a material impact on the group.
\nChanges in accounting estimates
\nIn line with our accounting policy, management has reviewed the expected useful lives and residual values of
\nproperty, plant and equipment. This exercise included a detailed benchmarking exercise. As a result, the useful
\nlife and residual value for freehold land and buildings has been revised, and with effect from 1 July 2022 the
\ngroup changed its estimate for freehold buildings from 5-50 years to 5-60 years.
\nThe benchmarking exercise con\ufb01rmed that it would be appropriate to also revise the residual value on freehold
\nhospital buildings to 20% from a nil residual value and this change took place with effect from 1 July 2022.
\nManagement has therefore concluded that it would be appropriate to apply a 20% residual value to the original
\ncost of the freehold properties, and this change took effect on 1 July 2022.
\nManagement has concluded that the impact of climate-related risks would not have a material impact on the
\nextended useful life and residual value of its freehold land and buildings, as these risks have been mitigated.
\nThe depreciation charged to the pro\ufb01t and loss in the current year was \u00a397.9 million (2021:\u00a397.1 million).
\nThe change in accounting estimate has resulted in a reduction in depreciation of \u00a32.9 million in the current
\nyear. In addition this has given rise to a one-off deferred tax credit of \u00a39.0 million. The effect of the change
\nin future period is to decrease annual depreciation by c. \u00a36.0 million.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfSummaryOfSignificantAccountingPoliciesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19874": {
"value": "Basis of preparation The consolidated \ufb01nancial statements of the group have been prepared in accordance with UK-adopted
\nInternational Accounting Standards (\u2018UK-adopted IFRS\u2019) as issued by the International Accounting Standards
\nBoard (\u2018IASB\u2019) and in accordance with the Companies Act 2006.
\nThe consolidated \ufb01nancial statements have been prepared on a historical cost basis except for derivative
\n\ufb01nancial instruments and \ufb01nancial assets measured at fair value. The group \ufb01nancial statements are presented
\nin UK sterling and all values are rounded to the nearest million pounds (\u00a3m), except when otherwise indicated.
\nThe preparation of \ufb01nancial statements in accordance with UK-adopted IFRS requires the use of certain critical
\naccounting estimates. It also requires management to exercise its judgement in the process of applying the
\ngroup\u2019s accounting policies. Further details on the group\u2019s critical judgements and estimates are included in
\nnote 3.
\nThe group has considered the future potential environmental impact on its current and future \ufb01nancial
\nposition and considered the impact to below.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfBasisOfPreparationOfFinancialStatementsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19890": {
"value": "Going concern The group assessed going concern risk for the period through to 31 March 2024. As at 31 December 2022 the
\ngroup had cash of \u00a374.2 million, a Senior Loan Facility of \u00a3325 million and an undrawn Revolving Credit Facility
\nof \u00a3100 million. On 24 February 2022, the group successfully re\ufb01nanced its debt facilities with a syndicate of
\nexisting and new Lenders. As part of the re\ufb01nancing exercise and in recognition of the fact that the group had
\nsubstantial cash reserves at 31 December 2021, the group repaid \u00a3100 million of the Senior Loan Facility. The
\nnew arrangement has a maturity of four years. The \ufb01nancial covenants relating to this new agreement are
\nmaterially unchanged.
\nThe group has undertaken extensive activity to identify plausible risks which may arise and mitigating actions,
\nwhich in the \ufb01rst instance would include management of working capital and constrained levels of capital
\ninvestment. Based on the current assessment of the likelihood of these risks arising by 31 March 2024, together
\nwith their assessment of the planned mitigating actions being successful, the directors have concluded it is
\nappropriate to prepare the accounts on a going concern basis. In arriving at their conclusion, the directors have
\nalso noted that, were three of the most likely speci\ufb01c risks to arise in combination, it could result in a liquidity
\nconstraint or breach of covenant, however, the risk of this is considered remote.
\nThe group has also assessed, as part of its reverse stress testing, what degree of downturn in trading it could
\nsustain before it no longer forecasts a positive cash balance. This stress testing was based on \ufb02exing revenue
\ndownwards with a consistent percentage decline in variable costs, whilst maintaining the forecast of \ufb01xed
\ncosts. The testing did not allow for the bene\ufb01t of any action that could be taken by management to preserve
\ncash. This testing suggested that there would have to be at least a 35% fall in annual revenue before the group
\nno longer forecast a positive cash balance. We do not believe that such a reduction of income revenue is a
\nplausible consequence of the group\u2019s identi\ufb01ed principal risks.
\nIt should be noted that we are in a period of unprecedented geo-political and macro-economic uncertainty.
\nWhilst the directors continue to closely monitor these risks and their plausible impact, their severity is hard
\nto predict and is dependent upon many external factors. Accordingly the actual \ufb01nancial impact of these risks
\nmay materially vary against the current view of their plausible impact.
\nFurther detail on both aacroeconomic related risk and COVID-19 is provided in the risk management and
\ninternal control section on pages 66 to 76.
\nOther speci\ufb01c scenarios covered by our testing were as follows:
\n\u2013
The group is subject to temporary suspension of trade, with a temporary adverse impact on revenue,
\nfor example, as a result of a successful cyber-attack on key business systems
\n\u2013
The downside modelling of a number of risks which result in a decline in earnings, including the loss of
\na contractual relationship with a key insurer
\n\u2013
Signi\ufb01cant change in government policy resulting in consultants going on payroll
\n\u2013
Short term disruption to trade at a sub-set of hospitals owing to an extreme weather event
\nThis review included the following key assumptions:
\n\u2013
No change in capital structure given the group has re\ufb01nanced its existing senior \ufb01nance facility and
\nrevolving credit facility since the 2022 year end
\n\u2013
The government will not make signi\ufb01cant change to its existing policy towards utilising private provision
\nof healthcare services to supplement the NHS",
"dimensions": {
"concept": "ifrs-full:DisclosureOfGoingConcernExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19939": {
"value": "Revenue recognition The group derives its revenue primarily from providing private healthcare services to both the public sector
\nand private patients in the UK. Revenue from charges to patients is recognised when the treatment is provided.
\nRevenue from contracts with customers
\nThe criteria for revenue recognition are as follows; identify the contract with the customer, identify the
\nperformance obligation, determine the transaction price, allocate the transaction price to the performance
\nobligations, and satisfying the performance obligation. It applies to all contracts with customers, except those
\nin the scope of other standards.
\nRevenue is recorded as services are transferred to the patient, with the consideration based on the total
\namount the group expects to receive, taking account of discounts where they are quanti\ufb01able and probable.
\nApproximately 70% of the group\u2019s revenue is derived from inpatient and daycase admissions. Revenue is
\nrecognised day by day, as services are provided to patients. These services are typically provided over a short
\ntime frame, that is, one to three days. Outpatient cases and other revenue represent approximately 30% of the
\ngroup\u2019s revenue. Outpatient cases generally do not involve surgical procedures and revenue is recognised on
\nan individual component basis when performance obligations are satis\ufb01ed. Similarly, other revenue, which
\nincludes consultant revenue and other third-party revenue streams, is recognised when performance
\nobligations are satis\ufb01ed and the control of goods or services is transferred.
\n
\n
\n
\n\n\n
\n\n\nThe group reports disaggregated revenue by material revenue stream (ie type of payor: PMI, NHS and self-pay)
\nand other revenue which includes consultant revenue, third party revenue streams (eg pathology services)
\nand \u2018commissioning for quality and innovation payments\u2019 (CQUIN). Material revenue streams are consistent
\nin nature, being the consideration received in return for the provision of healthcare services to patients. The
\ntiming and uncertainty of cash \ufb02ows is similar for PMI and NHS business while self-pay revenue is received in
\nadvance or collected by credit card shortly after treatment. In addition, where possible and meaningful, Spire
\nHealthcare reports revenue split between inpatient/daycase, outpatient and other. As noted above, in all cases,
\nrevenue is recognised as performance obligations are completed in the form of services being provided to
\npatients. Unbilled revenue is accrued at period ends. Invoices for the combination of services provided to
\npatients are generally produced within three days of discharge.
\nRevenue recognition \u2013 the NHS contracts
\nApproximately 0.3% of the group\u2019s revenue is derived from the NHS COVID-19 contracts (2021: 5%). Revenue
\nfrom the NHS COVID-19 contracts is recognised as the services are transferred to the customer over the life
\nof the contract. In the prior year the contracts\u2019 transaction price is based on variable consideration, recognition
\nof revenue is constrained to the extent that it is probable that a signi\ufb01cant reversal will not occur when the
\nuncertainty is resolved.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForRecognitionOfRevenue",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f19944": {
"value": "Revenue from contracts with customers The criteria for revenue recognition are as follows; identify the contract with the customer, identify the
\nperformance obligation, determine the transaction price, allocate the transaction price to the performance
\nobligations, and satisfying the performance obligation. It applies to all contracts with customers, except those
\nin the scope of other standards.
\nRevenue is recorded as services are transferred to the patient, with the consideration based on the total
\namount the group expects to receive, taking account of discounts where they are quanti\ufb01able and probable.
\nApproximately 70% of the group\u2019s revenue is derived from inpatient and daycase admissions. Revenue is
\nrecognised day by day, as services are provided to patients. These services are typically provided over a short
\ntime frame, that is, one to three days. Outpatient cases and other revenue represent approximately 30% of the
\ngroup\u2019s revenue. Outpatient cases generally do not involve surgical procedures and revenue is recognised on
\nan individual component basis when performance obligations are satis\ufb01ed. Similarly, other revenue, which
\nincludes consultant revenue and other third-party revenue streams, is recognised when performance
\nobligations are satis\ufb01ed and the control of goods or services is transferred.
\n
\n
\n
\n\n\n
\n\n\nThe group reports disaggregated revenue by material revenue stream (ie type of payor: PMI, NHS and self-pay)
\nand other revenue which includes consultant revenue, third party revenue streams (eg pathology services)
\nand \u2018commissioning for quality and innovation payments\u2019 (CQUIN). Material revenue streams are consistent
\nin nature, being the consideration received in return for the provision of healthcare services to patients. The
\ntiming and uncertainty of cash \ufb02ows is similar for PMI and NHS business while self-pay revenue is received in
\nadvance or collected by credit card shortly after treatment. In addition, where possible and meaningful, Spire
\nHealthcare reports revenue split between inpatient/daycase, outpatient and other. As noted above, in all cases,
\nrevenue is recognised as performance obligations are completed in the form of services being provided to
\npatients. Unbilled revenue is accrued at period ends. Invoices for the combination of services provided to
\npatients are generally produced within three days of discharge.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfRevenueFromContractsWithCustomersExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20035": {
"value": "Interest income Interest is recognised on an effective interest rate basis.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfInterestIncomeExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20039": {
"value": "Cost of sales Cost of sales principally comprises salaries of clinical staff, consultant and clinical fees, medical services and
\ninventories, including drugs, consumables and prostheses.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfCostOfSalesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20045": {
"value": "Other operating costs Other operating costs mainly comprise non-clinical staff costs, rent associated with short or low value leases,
\nthe depreciation of property, plant and equipment and right of use assets and the maintenance and running
\ncosts of properties and equipment. It also includes administrative expenses, including the provision of central
\nsupport services, IT and other administrative costs.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfOtherOperatingExpenseExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20067": {
"value": "Cash and cash equivalents Cash and cash equivalents comprise cash balances and call deposits. Bank overdrafts that are repayable on
\ndemand and form an integral part of the group\u2019s cash management are included as a component of cash and
\ncash equivalents for the purpose only of the statement of cash \ufb02ows. There are no bank overdrafts in either
\nyear presented.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyToDetermineComponentsOfCashAndCashEquivalents",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20075": {
"value": "Taxation including deferred taxation Total income tax on the result for the year comprises current and deferred tax. Income tax is recognised in
\nthe income statement except to the extent that it relates to items recognised directly in equity and other
\ncomprehensive income.
\nCurrent tax is the expected tax payable on the taxable result for the year, using tax rates enacted, or
\nsubstantively enacted, at the balance sheet date, and any adjustments to tax payable in respect of previous
\nyears.
\nWhere there is an uncertain tax position, a provision is recognised when it is not probable that the tax
\nauthority will accept the uncertain tax position, based on either the most likely amount where the range
\nof results is binary, or as a weighted average of possible outcomes where a range of outcomes is possible.
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\n\u2013
Goodwill not deductible for tax purposes
\n\u2013
The initial recognition of an asset or liability in a transaction that is not a business combination and which,
\nat the time of the transaction, affects neither the accounting pro\ufb01t nor the taxable pro\ufb01t or loss
\n\u2013
Investments in subsidiary companies where the timing of the reversal of the temporary difference is
\ncontrolled by the group and it is probable that the temporary difference will not reverse in the foreseeable
\nfuture
\nIt should be noted that the initial recognition exception does not apply to the majority of the group\u2019s freehold
\nproperty portfolio as these were acquired through the Bupa and Classics acquisitions in 2007 and 2008, which
\nwere accounted for as a business combination.
\nThe amount of deferred tax recognised is based on the expected manner of realisation or settlement of the
\ncarrying amounts of assets and liabilities, using tax rates enacted, or substantively enacted, at the balance
\nsheet date. The group offsets deferred tax assets and deferred tax liabilities if, and only if, it has a legally
\nenforceable right to set off current tax assets and current tax liabilities and the deferred tax assets and
\ndeferred tax liabilities relate to income taxes levied by the same taxation authority on either the same taxable
\nentity or different taxable entities which intend either to settle current tax liabilities and assets on a net basis,
\nor to realise the assets and settle the liabilities simultaneously, in each future period in which signi\ufb01cant
\namounts of deferred tax liabilities or assets are expected to be settled or recovered.
\nIn assessing the recoverability of deferred tax assets, the group relies on the same forecast assumptions used
\nelsewhere in the \ufb01nancial statements and in other management reports, which, among other things, re\ufb02ect
\nthe potential impact of climate-related development on the business, such as increased costs as a result of
\nmeasures to reduce carbon emission.
\nA deferred tax asset, subject to the offsetting above, is only recognised to the extent that it is probable that
\nfuture taxable pro\ufb01ts will be available against which the asset can be used.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForDeferredIncomeTaxExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20076": {
"value": "Taxation including deferred taxation Total income tax on the result for the year comprises current and deferred tax. Income tax is recognised in
\nthe income statement except to the extent that it relates to items recognised directly in equity and other
\ncomprehensive income.
\nCurrent tax is the expected tax payable on the taxable result for the year, using tax rates enacted, or
\nsubstantively enacted, at the balance sheet date, and any adjustments to tax payable in respect of previous
\nyears.
\nWhere there is an uncertain tax position, a provision is recognised when it is not probable that the tax
\nauthority will accept the uncertain tax position, based on either the most likely amount where the range
\nof results is binary, or as a weighted average of possible outcomes where a range of outcomes is possible.
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\nDeferred tax is provided on all temporary differences between the carrying amounts of assets and liabilities
\nfor \ufb01nancial reporting purposes and the amounts used for taxation purposes, except for:
\n\u2013
Goodwill not deductible for tax purposes
\n\u2013
The initial recognition of an asset or liability in a transaction that is not a business combination and which,
\nat the time of the transaction, affects neither the accounting pro\ufb01t nor the taxable pro\ufb01t or loss
\n\u2013
Investments in subsidiary companies where the timing of the reversal of the temporary difference is
\ncontrolled by the group and it is probable that the temporary difference will not reverse in the foreseeable
\nfuture
\nIt should be noted that the initial recognition exception does not apply to the majority of the group\u2019s freehold
\nproperty portfolio as these were acquired through the Bupa and Classics acquisitions in 2007 and 2008, which
\nwere accounted for as a business combination.
\nThe amount of deferred tax recognised is based on the expected manner of realisation or settlement of the
\ncarrying amounts of assets and liabilities, using tax rates enacted, or substantively enacted, at the balance
\nsheet date. The group offsets deferred tax assets and deferred tax liabilities if, and only if, it has a legally
\nenforceable right to set off current tax assets and current tax liabilities and the deferred tax assets and
\ndeferred tax liabilities relate to income taxes levied by the same taxation authority on either the same taxable
\nentity or different taxable entities which intend either to settle current tax liabilities and assets on a net basis,
\nor to realise the assets and settle the liabilities simultaneously, in each future period in which signi\ufb01cant
\namounts of deferred tax liabilities or assets are expected to be settled or recovered.
\nIn assessing the recoverability of deferred tax assets, the group relies on the same forecast assumptions used
\nelsewhere in the \ufb01nancial statements and in other management reports, which, among other things, re\ufb02ect
\nthe potential impact of climate-related development on the business, such as increased costs as a result of
\nmeasures to reduce carbon emission.
\nA deferred tax asset, subject to the offsetting above, is only recognised to the extent that it is probable that
\nfuture taxable pro\ufb01ts will be available against which the asset can be used.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForIncomeTaxExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20161": {
"value": "Property, plant and equipment Property, plant and equipment is stated at cost less accumulated depreciation. Major projects are treated as
\nassets in the course of construction until completed when they are transferred to the appropriate asset class.
\nNo depreciation is charged on freehold land or assets in the course of construction. Other assets are depreciated
\nso as to write off the carrying amounts of the assets, less their estimated residual values, over their expected
\nuseful lives, as follows:
\nFreehold property and improvements
\u2013
5 to 60 years
\nLeasehold improvements
\u2013
lower of unexpired lease term or expected life, with a maximum
\nof 35 years
\nEquipment
\u2013
3 to 10 years
\nThe expected useful lives and residual values of property, plant and equipment are reviewed semi-annually and
\nrevised as appropriate. The review of the asset lives and residual values of properties takes into consideration
\nthe plans of the business and levels of expenditure incurred on an ongoing basis to maintain the properties
\nin a \ufb01t and proper state for their ongoing use as hospitals. In addition, the potential impact of future climate
\nchange is considered. In the case of major facilities opening in new locations, depreciation may be applied
\nto only those assets available for use at the of\ufb01cial opening date to re\ufb02ect that the site is not always fully
\noperational at this opening date. During the year management revised the useful life and residual value
\nof freehold land and buildings refer to changes in accounting estimates for further details.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForPropertyPlantAndEquipmentExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20166": {
"value": "No depreciation is charged on freehold land or assets in the course of construction. Other assets are depreciated so as to write off the carrying amounts of the assets, less their estimated residual values, over their expected
\nuseful lives, as follows:
\nFreehold property and improvements
\u2013
5 to 60 years
\nLeasehold improvements
\u2013
lower of unexpired lease term or expected life, with a maximum
\nof 35 years
\nEquipment
\u2013
3 to 10 years",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForDepreciationExpenseExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20191": {
"value": "Consolidation The results of all subsidiary undertakings are included in the consolidated \ufb01nancial statements. Assets,
\nliabilities, income and expenses of a subsidiary acquired or disposed of during the year are included in the
\nconsolidated \ufb01nancial statements from the date the group gains control until the date the group ceases
\nto control the subsidiary.
\nControl is achieved when the group is exposed, or has rights, to variable returns from its involvement with the
\ninvestee and has the ability to affect those returns through its power over the investee. Speci\ufb01cally, the group
\ncontrols an investee if, and only if, the group has:
\n\u2013
Power over the investee (ie existing rights that give it the current ability to direct the relevant activities
\nof the investee)
\n\u2013
Exposure, or rights, to variable returns from its involvement with the investee
\n\u2013
The ability to use its power over the investee to affect its returns
\nThe Employee Bene\ufb01t Trust (EBT) is treated as an extension of the group and the company.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfBasisOfConsolidationExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20210": {
"value": "Business combinations Business combinations are accounted for using the acquisition method. The cost of an acquisition is measured
\nas the aggregate of the consideration transferred measured at acquisition date fair value and the amount of
\nany non-controlling interests in the acquiree. For each business combination, the group elects whether to
\nmeasure the non-controlling interests in the acquiree at fair value or at the proportionate share of the
\nacquiree\u2019s identi\ufb01able net assets. Acquisition-related costs are expensed as incurred and included in other
\noperating costs.
\nThe group determines that it has acquired a business when the acquired set of activities and assets include
\nan input and a substantive process that together signi\ufb01cantly contribute to the ability to create outputs.
\nThe acquired process is considered substantive if it is critical to the ability to continue producing outputs,
\nand the inputs acquired include an organised workforce with the necessary skills, knowledge, or experience
\nto perform that process or it signi\ufb01cantly contributes to the ability to continue producing outputs and is
\nconsidered unique or scarce or cannot be replaced without signi\ufb01cant cost, effort, or delay in the ability
\nto continue producing outputs.
\nWhen the group acquires a business, it assesses the \ufb01nancial assets and liabilities assumed for appropriate
\nclassi\ufb01cation and designation in accordance with the contractual terms, economic circumstances and
\npertinent conditions as at the acquisition date.
\nGoodwill
\nGoodwill represents the excess of the cost of acquisition (being the fair value of consideration transferred) over
\nthe fair value of the assets, liabilities and contingent liabilities of acquired businesses at the date of acquisition.
\nGoodwill is stated at cost less accumulated impairment losses.
\nGoodwill is allocated to one cash-generating unit and is not amortised but is tested annually for impairment,
\nor more frequently if there is an indication that the value of the goodwill may be impaired (see impairment
\npolicy).",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForBusinessCombinationsAndGoodwillExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20211": {
"value": "Business combinations Business combinations are accounted for using the acquisition method. The cost of an acquisition is measured
\nas the aggregate of the consideration transferred measured at acquisition date fair value and the amount of
\nany non-controlling interests in the acquiree. For each business combination, the group elects whether to
\nmeasure the non-controlling interests in the acquiree at fair value or at the proportionate share of the
\nacquiree\u2019s identi\ufb01able net assets. Acquisition-related costs are expensed as incurred and included in other
\noperating costs.
\nThe group determines that it has acquired a business when the acquired set of activities and assets include
\nan input and a substantive process that together signi\ufb01cantly contribute to the ability to create outputs.
\nThe acquired process is considered substantive if it is critical to the ability to continue producing outputs,
\nand the inputs acquired include an organised workforce with the necessary skills, knowledge, or experience
\nto perform that process or it signi\ufb01cantly contributes to the ability to continue producing outputs and is
\nconsidered unique or scarce or cannot be replaced without signi\ufb01cant cost, effort, or delay in the ability
\nto continue producing outputs.
\nWhen the group acquires a business, it assesses the \ufb01nancial assets and liabilities assumed for appropriate
\nclassi\ufb01cation and designation in accordance with the contractual terms, economic circumstances and
\npertinent conditions as at the acquisition date.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForBusinessCombinationsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20232": {
"value": "Goodwill Goodwill represents the excess of the cost of acquisition (being the fair value of consideration transferred) over
\nthe fair value of the assets, liabilities and contingent liabilities of acquired businesses at the date of acquisition.
\nGoodwill is stated at cost less accumulated impairment losses.
\nGoodwill is allocated to one cash-generating unit and is not amortised but is tested annually for impairment,
\nor more frequently if there is an indication that the value of the goodwill may be impaired (see impairment
policy).",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForGoodwillExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20243": {
"value": "Financial Instruments A \ufb01nancial instrument is any contract that gives rise to a \ufb01nancial asset of one entity and a \ufb01nancial liability
\nor equity instrument of another entity.
\ni) Financial assets other than derivatives
\nInitial recognition and measurement
\nFinancial assets are classi\ufb01ed as \ufb01nancial assets at fair value through pro\ufb01t or loss, amortised cost or fair value
\nthrough other comprehensive income (\u2018OCI\u2019).
\nThe classi\ufb01cation of \ufb01nancial assets at initial recognition depends on the \ufb01nancial asset\u2019s contractual cash \ufb02ow
\ncharacteristics and the group\u2019s business model for managing them. With the exception of trade receivables
\nthat do not contain a signi\ufb01cant \ufb01nancing component or for which the group has applied the practical expedient,
\nthe group initially measures a \ufb01nancial asset at its fair value plus, in the case of a \ufb01nancial asset not at fair value
\nthrough pro\ufb01t or loss, transaction costs. Trade receivables that do not contain a signi\ufb01cant \ufb01nancing component
\nor for which the group has applied the practical expedient are measured at the transaction price determined
\nunder IFRS 15.
\nIn order for a \ufb01nancial asset to be classi\ufb01ed and measured at amortised cost or fair value through OCI, it needs
\nto give rise to cash \ufb02ows that are \u2018solely payments of principal and interest (SPPI)\u2019 on the principal amount
\noutstanding. This assessment is referred to as the SPPI test and is performed at an instrument level.
\n
\n\n
\n
\n\n\nThe group\u2019s business model for managing \ufb01nancial assets refers to how it manages its \ufb01nancial assets in order
\nto generate cash \ufb02ows. The business model determines whether cash \ufb02ows will result from collecting
\ncontractual cash \ufb02ows, selling the \ufb01nancial assets, or both.
\nThe company\u2019s \ufb01nancial assets include cash and short-term deposits, trade and other receivables, unbilled
\nreceivables and receivables from pro\ufb01t share arrangements. Unbilled receivables may include contract assets
\nwhere the performance obligation has been met, but the invoice not raised due to agreement with the
\ncustomer being required in respect of the variable consideration. Unbilled receivables can also include
\namounts where the performance obligation has been met, but the invoice not yet raised due to the timing
\nof the reporting period.
\nSubsequent measurement
\nTrade receivables and unbilled receivables are accounted for at amortised cost. The group applies the IFRS 9
\nsimpli\ufb01ed approach to measuring expected credit losses, which uses a lifetime expected loss allowance for all
\ntrade receivables. At each reporting period, the group makes an assessment of the asset\u2019s recoverable amount
\nbased on forward looking information. Losses arising from impairment are recognised in the consolidated
\nincome statement in other operating costs.
\nLoans and receivables are non-derivative \ufb01nancial assets with \ufb01xed or determinable payments that are not
\nquoted in an active market. On initial recognition, loans and receivables are measured at fair value plus directly
\nattributable transaction costs. Subsequently, such assets are measured at amortised cost, using the effective
\ninterest rate (\u2018EIR\u2019) method, less any allowance for impairment.
\nAmortised cost is calculated by taking into account any discount or premium on acquisition and fees or costs
\nthat are an integral part of the EIR. The EIR amortisation is included in interest receivable in the consolidated
\nincome statement.
\nReceivables relating to pro\ufb01t share arrangements are recognised as fair value through pro\ufb01t and loss. At each
\nreporting period, the assets are revalued, with any movement in fair value being recognised in the consolidated
\nincome statement. Any cash received from pro\ufb01t share arrangements is presented within cash \ufb02ows from
\ninvesting activities within the Cash Flow statement.
\nDerecognition
\nA \ufb01nancial asset is derecognised when the rights to receive cash \ufb02ows from the asset have expired, or the
\ngroup has transferred its rights to receive cash \ufb02ows from the asset including transferring substantially all
\nthe risks and rewards of the asset.
\nImpairment
\nThe group recognises an allowance for expected credit losses (ECLs) for all debt instruments not held at fair
\nvalue through pro\ufb01t or loss. ECLs are based on the difference between the contractual cash \ufb02ows due in
\naccordance with the contract and all the cash \ufb02ows that the group expects to receive, discounted at an
\napproximation of the original effective interest rate. The expected cash \ufb02ows will include cash \ufb02ows from
\nthe sale of collateral held or other credit enhancements that are integral to the contractual terms.
\nFor trade receivables and contract assets (including unbilled receivables), the group applies a simpli\ufb01ed
\napproach in calculating ECLs. Therefore, the group does not track changes in credit risk, but instead recognises a
\nloss allowance based on lifetime ECLs at each reporting date. The group has established a provision matrix that
\nis based on its historical credit loss experience, adjusted for forward-looking factors speci\ufb01c to the receivables
\nand the economic environment. To measure the expected credit losses, trade receivables have been grouped
\nbased on shared characteristics and the days past due. The group has concluded that the expected loss rates
\nfor trade receivables, are a reasonable approximation of the loss rates for each ageing bucket based on
\nhistorical debt trends of our portfolio of customers for the last two reporting periods, with the exception
\nof patient debt. Patient debt is more susceptible to the economic environment. As a result, the group have
\nreviewed the expected loss rates for this payor group, as well as considering forward looking information
\n(speci\ufb01cally the cost of living and COVID-19) and increased the loss rates accordingly.
\nii) Financial liabilities other than derivatives
\nFinancial liabilities within the scope of IFRS 9 are classi\ufb01ed as \ufb01nancial liabilities at fair value through pro\ufb01t or
\nloss, or at amortised cost. The group determines the classi\ufb01cation of \ufb01nancial liabilities at initial recognition.
\nInitial recognition and measurement
\nAll \ufb01nancial liabilities are recognised initially at fair value and in the case of loans and borrowings, net of directly
\nattributable transaction costs.
\nThe group\u2019s \ufb01nancial liabilities include trade and other payables, loans and borrowings, and derivative \ufb01nancial
\ninstruments.
\nSubsequent measurement
\nAfter initial recognition, interest bearing loans and borrowings are subsequently measured at amortised cost
\nusing the effective interest rate (EIR) method. Gains and losses arising on the repurchase, settlement or
\notherwise cancellation of liabilities are recognised respectively in interest receivable and interest payable in the
\nconsolidated income statement. Amortised cost is calculated by taking in to account any discount or premium
\non acquisition and fees or costs that are an integral part of the EIR. The EIR amortisation is included as \ufb01nance
\ncosts in the consolidated income statement.
\nFinancial liabilities on business combination
\nOn acquisition of a business combination, a \ufb01nancial liability may be recognised at fair value through pro\ufb01t and
\nloss where there is an obligation on the group to settle a liability. In subsequent periods, the liability will be
\nremeasured based on its fair value, with movements being recognised in the income statement. Cash \ufb02ows
\nwill be discounts as appropriate.
\nTo determine the obligation, the group will review whether the liability arises as a result of an action or decision
\nof the group, or if an action by a third party would result in the obligation crystallising.
\nDerecognition
\nA \ufb01nancial liability is derecognised when the obligation under the liability is discharged or cancelled or expires.
\nWhen an existing \ufb01nancial liability is replaced by another from the same lender on substantially different
\nterms, or the terms of an existing liability are substantially modi\ufb01ed, such an exchange or modi\ufb01cation is
\ntreated as the derecognition of the original liability and the recognition of a new liability. The difference in the
\nrespective carrying amounts is recognised in the consolidated income statement.
\niii) Derivative \ufb01nancial instruments
\nThe group may enter into derivative \ufb01nancial instrument arrangements to manage its exposure to interest
\nrate risk. Derivatives are initially recognised at fair value on the date on which a derivative contract is entered
\nin to and subsequently remeasured at fair value at each balance sheet date. Derivatives are carried as \ufb01nancial
\nassets when the fair value is positive and as \ufb01nancial liabilities when the fair value is negative.
\nThe group applies cash \ufb02ow hedge accounting to such derivatives if the criteria for doing so are met. At the
\ninception of a hedge relationship, the group formally designates and documents the hedge relationship to
\nwhich it wishes to apply hedge accounting and the risk management objective and strategy for undertaking
\nthe hedge.
\n\n\n\n\n
\n\n\nThe effective portion of the changes in the fair value of derivatives that are designated and qualify as cash \ufb02ow
\nhedges is recognised in other comprehensive income. The gain or loss relating to the ineffective portion is
\nrecognised immediately in the income statement. The cash \ufb02ow hedge reserve is adjusted to the lower of the
\ncumulative gain or loss on the hedging instrument and the cumulative change in fair value of the hedged item.
\nAmounts deferred in equity are recycled in the income statement in the periods when the hedged item is
\nrecognised, in the same line of the income statement as the recognised hedged item. If cash \ufb02ow hedge
\naccounting is discontinued, the amount that has been accumulated in the consolidated statement of other
\ncomprehensive income is maintained if the hedged future cash \ufb02ows are still expected to occur. Otherwise,
\nthe amount is immediately reclassi\ufb01ed to pro\ufb01t or loss as a reclassi\ufb01cation adjustment.
\niv) Offsetting of \ufb01nancial instruments
\nFinancial assets and \ufb01nancial liabilities are offset and the net amount reported in the consolidated balance
\nsheet if, and only if, there is a currently enforceable legal right to offset the recognised amounts and there is
\nan intention to settle on a net basis, or to realise the assets and settle the liabilities simultaneously.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForFinancialInstrumentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20248": {
"value": "i) Financial assets other than derivatives Initial recognition and measurement
\nFinancial assets are classi\ufb01ed as \ufb01nancial assets at fair value through pro\ufb01t or loss, amortised cost or fair value
\nthrough other comprehensive income (\u2018OCI\u2019).
\nThe classi\ufb01cation of \ufb01nancial assets at initial recognition depends on the \ufb01nancial asset\u2019s contractual cash \ufb02ow
\ncharacteristics and the group\u2019s business model for managing them. With the exception of trade receivables
\nthat do not contain a signi\ufb01cant \ufb01nancing component or for which the group has applied the practical expedient,
\nthe group initially measures a \ufb01nancial asset at its fair value plus, in the case of a \ufb01nancial asset not at fair value
\nthrough pro\ufb01t or loss, transaction costs. Trade receivables that do not contain a signi\ufb01cant \ufb01nancing component
\nor for which the group has applied the practical expedient are measured at the transaction price determined
\nunder IFRS 15.
\nIn order for a \ufb01nancial asset to be classi\ufb01ed and measured at amortised cost or fair value through OCI, it needs
\nto give rise to cash \ufb02ows that are \u2018solely payments of principal and interest (SPPI)\u2019 on the principal amount
\noutstanding. This assessment is referred to as the SPPI test and is performed at an instrument level.
\n
\n\n
\n
\n\n\nThe group\u2019s business model for managing \ufb01nancial assets refers to how it manages its \ufb01nancial assets in order
\nto generate cash \ufb02ows. The business model determines whether cash \ufb02ows will result from collecting
\ncontractual cash \ufb02ows, selling the \ufb01nancial assets, or both.
\nThe company\u2019s \ufb01nancial assets include cash and short-term deposits, trade and other receivables, unbilled
\nreceivables and receivables from pro\ufb01t share arrangements. Unbilled receivables may include contract assets
\nwhere the performance obligation has been met, but the invoice not raised due to agreement with the
\ncustomer being required in respect of the variable consideration. Unbilled receivables can also include
\namounts where the performance obligation has been met, but the invoice not yet raised due to the timing
\nof the reporting period.
\nSubsequent measurement
\nTrade receivables and unbilled receivables are accounted for at amortised cost. The group applies the IFRS 9
\nsimpli\ufb01ed approach to measuring expected credit losses, which uses a lifetime expected loss allowance for all
\ntrade receivables. At each reporting period, the group makes an assessment of the asset\u2019s recoverable amount
\nbased on forward looking information. Losses arising from impairment are recognised in the consolidated
\nincome statement in other operating costs.
\nLoans and receivables are non-derivative \ufb01nancial assets with \ufb01xed or determinable payments that are not
\nquoted in an active market. On initial recognition, loans and receivables are measured at fair value plus directly
\nattributable transaction costs. Subsequently, such assets are measured at amortised cost, using the effective
\ninterest rate (\u2018EIR\u2019) method, less any allowance for impairment.
\nAmortised cost is calculated by taking into account any discount or premium on acquisition and fees or costs
\nthat are an integral part of the EIR. The EIR amortisation is included in interest receivable in the consolidated
\nincome statement.
\nReceivables relating to pro\ufb01t share arrangements are recognised as fair value through pro\ufb01t and loss. At each
\nreporting period, the assets are revalued, with any movement in fair value being recognised in the consolidated
\nincome statement. Any cash received from pro\ufb01t share arrangements is presented within cash \ufb02ows from
\ninvesting activities within the Cash Flow statement.
\nDerecognition
\nA \ufb01nancial asset is derecognised when the rights to receive cash \ufb02ows from the asset have expired, or the
\ngroup has transferred its rights to receive cash \ufb02ows from the asset including transferring substantially all
\nthe risks and rewards of the asset.
\nImpairment
\nThe group recognises an allowance for expected credit losses (ECLs) for all debt instruments not held at fair
\nvalue through pro\ufb01t or loss. ECLs are based on the difference between the contractual cash \ufb02ows due in
\naccordance with the contract and all the cash \ufb02ows that the group expects to receive, discounted at an
\napproximation of the original effective interest rate. The expected cash \ufb02ows will include cash \ufb02ows from
\nthe sale of collateral held or other credit enhancements that are integral to the contractual terms.
\nFor trade receivables and contract assets (including unbilled receivables), the group applies a simpli\ufb01ed
\napproach in calculating ECLs. Therefore, the group does not track changes in credit risk, but instead recognises a
\nloss allowance based on lifetime ECLs at each reporting date. The group has established a provision matrix that
\nis based on its historical credit loss experience, adjusted for forward-looking factors speci\ufb01c to the receivables
\nand the economic environment. To measure the expected credit losses, trade receivables have been grouped
\nbased on shared characteristics and the days past due. The group has concluded that the expected loss rates
\nfor trade receivables, are a reasonable approximation of the loss rates for each ageing bucket based on
\nhistorical debt trends of our portfolio of customers for the last two reporting periods, with the exception
\nof patient debt. Patient debt is more susceptible to the economic environment. As a result, the group have
\nreviewed the expected loss rates for this payor group, as well as considering forward looking information
\n(speci\ufb01cally the cost of living and COVID-19) and increased the loss rates accordingly.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForFinancialAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20340": {
"value": "Derecognition
\nA \ufb01nancial asset is derecognised when the rights to receive cash \ufb02ows from the asset have expired, or the
\ngroup has transferred its rights to receive cash \ufb02ows from the asset including transferring substantially all
\nthe risks and rewards of the asset.
Derecognition
\nA \ufb01nancial liability is derecognised when the obligation under the liability is discharged or cancelled or expires.
\nWhen an existing \ufb01nancial liability is replaced by another from the same lender on substantially different
\nterms, or the terms of an existing liability are substantially modi\ufb01ed, such an exchange or modi\ufb01cation is
\ntreated as the derecognition of the original liability and the recognition of a new liability. The difference in the
\nrespective carrying amounts is recognised in the consolidated income statement.
",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForDerecognitionOfFinancialInstrumentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20346": {
"value": "Impairment The group recognises an allowance for expected credit losses (ECLs) for all debt instruments not held at fair
\nvalue through pro\ufb01t or loss. ECLs are based on the difference between the contractual cash \ufb02ows due in
\naccordance with the contract and all the cash \ufb02ows that the group expects to receive, discounted at an
\napproximation of the original effective interest rate. The expected cash \ufb02ows will include cash \ufb02ows from
\nthe sale of collateral held or other credit enhancements that are integral to the contractual terms.
\nFor trade receivables and contract assets (including unbilled receivables), the group applies a simpli\ufb01ed
\napproach in calculating ECLs. Therefore, the group does not track changes in credit risk, but instead recognises a
\nloss allowance based on lifetime ECLs at each reporting date. The group has established a provision matrix that
\nis based on its historical credit loss experience, adjusted for forward-looking factors speci\ufb01c to the receivables
\nand the economic environment. To measure the expected credit losses, trade receivables have been grouped
\nbased on shared characteristics and the days past due. The group has concluded that the expected loss rates
\nfor trade receivables, are a reasonable approximation of the loss rates for each ageing bucket based on
\nhistorical debt trends of our portfolio of customers for the last two reporting periods, with the exception
\nof patient debt. Patient debt is more susceptible to the economic environment. As a result, the group have
\nreviewed the expected loss rates for this payor group, as well as considering forward looking information
(speci\ufb01cally the cost of living and COVID-19) and increased the loss rates accordingly.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForImpairmentOfFinancialAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20367": {
"value": "ii) Financial liabilities other than derivatives Financial liabilities within the scope of IFRS 9 are classi\ufb01ed as \ufb01nancial liabilities at fair value through pro\ufb01t or
\nloss, or at amortised cost. The group determines the classi\ufb01cation of \ufb01nancial liabilities at initial recognition.
\nInitial recognition and measurement
\nAll \ufb01nancial liabilities are recognised initially at fair value and in the case of loans and borrowings, net of directly
\nattributable transaction costs.
\nThe group\u2019s \ufb01nancial liabilities include trade and other payables, loans and borrowings, and derivative \ufb01nancial
\ninstruments.
\nSubsequent measurement
\nAfter initial recognition, interest bearing loans and borrowings are subsequently measured at amortised cost
\nusing the effective interest rate (EIR) method. Gains and losses arising on the repurchase, settlement or
\notherwise cancellation of liabilities are recognised respectively in interest receivable and interest payable in the
\nconsolidated income statement. Amortised cost is calculated by taking in to account any discount or premium
\non acquisition and fees or costs that are an integral part of the EIR. The EIR amortisation is included as \ufb01nance
\ncosts in the consolidated income statement.
\nFinancial liabilities on business combination
\nOn acquisition of a business combination, a \ufb01nancial liability may be recognised at fair value through pro\ufb01t and
\nloss where there is an obligation on the group to settle a liability. In subsequent periods, the liability will be
\nremeasured based on its fair value, with movements being recognised in the income statement. Cash \ufb02ows
\nwill be discounts as appropriate.
\nTo determine the obligation, the group will review whether the liability arises as a result of an action or decision
\nof the group, or if an action by a third party would result in the obligation crystallising.
\nDerecognition
\nA \ufb01nancial liability is derecognised when the obligation under the liability is discharged or cancelled or expires.
\nWhen an existing \ufb01nancial liability is replaced by another from the same lender on substantially different
\nterms, or the terms of an existing liability are substantially modi\ufb01ed, such an exchange or modi\ufb01cation is
\ntreated as the derecognition of the original liability and the recognition of a new liability. The difference in the
\nrespective carrying amounts is recognised in the consolidated income statement.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForFinancialLiabilitiesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20400": {
"value": "iii) Derivative \ufb01nancial instruments The group may enter into derivative \ufb01nancial instrument arrangements to manage its exposure to interest
\nrate risk. Derivatives are initially recognised at fair value on the date on which a derivative contract is entered
\nin to and subsequently remeasured at fair value at each balance sheet date. Derivatives are carried as \ufb01nancial
\nassets when the fair value is positive and as \ufb01nancial liabilities when the fair value is negative.
\nThe group applies cash \ufb02ow hedge accounting to such derivatives if the criteria for doing so are met. At the
\ninception of a hedge relationship, the group formally designates and documents the hedge relationship to
\nwhich it wishes to apply hedge accounting and the risk management objective and strategy for undertaking
\nthe hedge.
\n\n\n\n
\n\n\nThe effective portion of the changes in the fair value of derivatives that are designated and qualify as cash \ufb02ow
\nhedges is recognised in other comprehensive income. The gain or loss relating to the ineffective portion is
\nrecognised immediately in the income statement. The cash \ufb02ow hedge reserve is adjusted to the lower of the
\ncumulative gain or loss on the hedging instrument and the cumulative change in fair value of the hedged item.
\nAmounts deferred in equity are recycled in the income statement in the periods when the hedged item is
\nrecognised, in the same line of the income statement as the recognised hedged item. If cash \ufb02ow hedge
\naccounting is discontinued, the amount that has been accumulated in the consolidated statement of other
\ncomprehensive income is maintained if the hedged future cash \ufb02ows are still expected to occur. Otherwise,
\nthe amount is immediately reclassi\ufb01ed to pro\ufb01t or loss as a reclassi\ufb01cation adjustment.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForDerivativeFinancialInstrumentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20472": {
"value": "iv) Offsetting of \ufb01nancial instruments Financial assets and \ufb01nancial liabilities are offset and the net amount reported in the consolidated balance
\nsheet if, and only if, there is a currently enforceable legal right to offset the recognised amounts and there is
an intention to settle on a net basis, or to realise the assets and settle the liabilities simultaneously.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForOffsettingOfFinancialInstrumentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20480": {
"value": "Inventories Inventories are stated at the lower of cost and net realisable value. Cost means purchase price, less trade
\ndiscounts, calculated on an average basis. Net realisable value means estimated selling price less incremental
\ncosts including trade discounts and all costs to be incurred in marketing, selling and distribution.
\nThe group holds consignment stock on sale or return. The group is only required to pay for the equipment
\nit chooses to use and therefore this stock is not recognised as an asset. ",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForMeasuringInventories",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20491": {
"value": "Borrowing costs Borrowing costs that are directly attributable to the acquisition and construction of qualifying assets, which
\nare assets that necessarily take a substantial period of time to get ready for their intended use or sale, are
\nadded to the cost of those assets, until such time as the assets are substantially ready for their intended
\nuse or sale.
\nAll other borrowing costs are recognised as an expense in the period in which they are incurred.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForBorrowingCostsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20500": {
"value": "Provisions A provision is recognised in the consolidated balance sheet when the group has a present legal or constructive
\nobligation as a result of a past event, and it is probable that an out\ufb02ow of economic bene\ufb01ts will be required
\nto settle the obligation. If the effect is material, provisions are determined by discounting the expected,
\nrisk-adjusted, future cash \ufb02ows at a pre-tax risk-free rate. Management consider their best estimate of the likely
\noutcomes of the obligation when determining the recognition. Where a material range of outcomes could arise,
\ndetails are disclosed accordingly. Provisions are measured gross of any expected insurance recovery. Any such
\ninsurance recoveries are recognised in other receivables when the receipt of them is judged virtually certain.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForProvisionsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20511": {
"value": "Leases At inception, the group assesses whether a contract is or contains a lease. This assessment involves the exercise
\nof judgement about whether the group obtains substantially all the economic bene\ufb01ts from the use of that
\nasset, and whether the group has the right to direct the use of the asset when considering whether the
\ncontract conveys the right to control the use of an identi\ufb01ed asset for a period of time in exchange for
\nconsideration. After initial recognition, the lease liability is measured at amortised cost using the effective
\ninterest method. A reassessment of the lease liability occurs when there is a change in lease payments. The
\nincremental borrowing rate is only revised where the change in payments is a result of a change in \ufb02oating
\ninterest rates, lease term change or a change in assessment relating to the exercise of purchase option charges.
\nThe group has elected not to separate lease and non-lease components for leases of vehicles or buildings.
\nThe group recognises a Right Of Use (ROU) asset and a lease liability at the commencement of the lease. The
\nROU is initially measured based on the present value of lease payments, less any incentives received. Initial
\ndirect costs and costs to dismantle or restore an asset are included. The ROU is depreciated over the shorter
\nof the lease term or the useful life of the underlying asset. The incremental borrowing rate is used to discount
\nthe assets over the relevant term. The ROU is subject to testing for impairment if there is an indicator for
\nimpairment.
\nLease payments generally include \ufb01xed payments and variable payments that depend on an index (such as
\nin\ufb02ation index) or rate. When the lease contains an extension or purchase option that the group considered
\nreasonably certain to be exercised, the cost of the option is included in the lease payments. The incremental
\nborrowing rate is used to discount the lease payments over the term of the lease.
\nROU assets are categorised to re\ufb02ect the nature of the underlying asset and to be consistent with the plant,
\nproperty and equipment (PPE) note. The assets are depreciated over the term of the lease, accounting for break
\nclauses or options to extend in line with the lease liability decision.
\nROU assets are disclosed as PPE on the balance sheet (non-current) with a separate disclosure within the
\nassociated note, and the lease liability is included in the headings lease liability (current and non-current)
\non the Consolidated balance sheet.
\nThe group has elected not to recognise ROU assets and liabilities for leases where the total lease term is less
\nthan 12 months, or for leases of low value equipment. The payments for such leases are recognised in the
\nConsolidated income statement on a straight line basis over the lease term.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForLeasesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20593": {
"value": "Share capital Ordinary shares are classi\ufb01ed as equity. Incremental costs directly attributable to the issue of new shares
\nare deducted from share premium. Where the employee bene\ufb01t trust purchases the company\u2019s equity share
\ncapital, the consideration paid, including any directly attributable incremental costs, is deducted from equity
\nattributable to the company\u2019s equity holders in both the company and the consolidated balance sheet until
\nthe shares are cancelled or reissued.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForIssuedCapitalExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20602": {
"value": "Dividend distribution Dividend distribution to the company\u2019s shareholders is recognised as a liability in the group\u2019s \ufb01nancial
\nstatements in the period in which the dividend is approved by the company\u2019s shareholders. Interim dividends
\nare recognised when paid.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForDividendsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20609": {
"value": "Pensions The group operates the Spire Healthcare Pension Plan, a de\ufb01ned contribution scheme. The assets of the
\nscheme are held separately from those of the group in independently administered funds.
\nObligations for contributions to de\ufb01ned contribution pension schemes are recognised as an expense in the
\nincome statement as incurred.
\nOther employee bene\ufb01ts
\nShort-term employee bene\ufb01t obligations are measured on an undiscounted basis and are expensed as the
\nrelated service is provided. A provision is recognised for the amount expected to be paid under short-term cash
\nbonuses if the group has a present legal or constructive obligation to pay this amount as a result of past service
\nprovided by the employee and the obligation can be estimated reliably.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForEmployeeBenefitsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20622": {
"value": "Share based payments The group operates a number of equity-settled share-based payment schemes under which the group receives
\nservices from employees as consideration for equity instruments of the group. The fair value of the employee
\nservices received in exchange for the grant of the options is recognised as an expense. The group has estimated
\nthe relevant fair value of the share options and awards, which are subject to total shareholder return (\u2018TSR\u2019)
\nmarket-related performance criteria, using a Monte Carlo simulation model (see note 27). This applies to LTIP
\nAwards and Deferred Share Bonus Schemes.
\nThe group also operates a Save-As-You-Earn (\u2018SAYE\u2019) scheme, which is open to all employees. Employees are
\nrequired to save a \ufb01xed amount, up to a cap, every month for three years. At the end of the three year period
\nemployees are entitled to use their savings to purchase shares in the company at a stated exercise price.
\nEmployees are free to stop contributing to the scheme and obtain a refund of contributions at any time, but
\nforfeit their entitlement to exercise the options if they do so. Payment of contributions into a SAYE scheme is
\nnot a vesting condition; it does not meet the de\ufb01nition of a performance condition because it has no link to
\nservice. Failure to meet a non-vesting condition (eg by ceasing to contribute to an SAYE scheme) is accounted
\nfor as a cancellation of the options so that the expense is accelerated and recognised in the income statement,
\nwith a corresponding adjustment to equity as required. The IFRS 2 charge has been calculated using an
\nadjusted Black Scholes model with judgements including leavers of the scheme (employees who may cease
\nto save) and dividend yields.
\nAt the end of each year, the group revises its estimates of the number of options that are expected to vest
\nbased on the non-market conditions and recognises the impact of the revision to original estimates, if any,
\nin the income statement, with a corresponding adjustment to equity.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForSharebasedPaymentTransactionsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20646": {
"value": "Non-current assets held for sale Non-current assets and disposal groups are classi\ufb01ed as held for sale if their carrying amount will be recovered
\nprincipally through a sale transaction rather than through continuing use. This condition is regarded as met
\nonly when the sale is highly probable and the asset (or disposal group) is available for immediate sale in its
\npresent condition. Management must be committed to the sale, which should be expected to qualify for
\nrecognition as a completed sale within one year from the date of classi\ufb01cation.
\nNon-current assets (and disposal groups) classi\ufb01ed as held for sale are measured at the lower of their carrying
\namount and fair value less costs to sell.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForNoncurrentAssetsOrDisposalGroupsClassifiedAsHeldForSaleExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20657": {
"value": "Impairment The group applies its impairment policy to non-\ufb01nancial assets, being intangible assets (goodwill), plant,
\nproperty and equipment and right of use assets. The group assesses, at each reporting date, whether there
\nis an indication that an asset may be impaired. If any indication exists, or when annual impairment testing
\nfor an asset is required, the group estimates the asset\u2019s recoverable amount. An asset\u2019s recoverable amount
\nis the higher of an asset\u2019s or CGU\u2019s fair value less costs of disposal or its value in use. The recoverable amounts
\nis determined for an individual asset, unless the asset does not generate cash in\ufb02ows that are largely
\nindependent of those from other assets or groups of assets. When the carrying amount of an asset or CGU
\nexceeds its recoverable amount, the asset is considered impaired, and is written down to its recoverable
\namount.
\nIn assessing value in use, the estimated future cash \ufb02ows are discounted to their present value using a discount
\nrate that re\ufb02ects current market assessments of the time value of money and risks speci\ufb01c to the asset. As part
\nof this, the group assesses where climate risks could have a signi\ufb01cant impact, such as the introduction of
\nemission-reduction legislation that may increase costs. These risks in relation to climate-related matters are
\nincluded as key assumptions where they materially impact the measure of recoverable amount. The group
\nbases its impairment calculation on most recent budgets and forecast calculations, which are prepared for
\neach CGU. The forecasts generally cover a \ufb01ve year period. A long term growth rate is calculated and applies
\nto project future cash \ufb02ows after the \ufb01fth year.
\nImpairment losses of continuing operations are recognised in the consolidated income statement in other
\noperating costs. Impairment is likely to be considered an Adjusting item.
\nFor assets excluding goodwill, an assessment is made at each reporting date to determine whether there is an
\nindication that previously recognised impairment losses no longer exist or have decreased. If such indication
\nexists, the group estimates the asset\u2019s or CGU\u2019s recoverable amount. A previously recognised impairment
\nloss is reversed only if there has been a change in the assumptions used to determine the asset\u2019s recoverable
\namount since the last impairment loss was recognised. The reversal is limited so that the carrying amount
\nof the asset does not exceed its recoverable amount, nor exceed the carrying amount that would have been
\ndetermined, net of depreciation, had no impairment loss been recognised for the asset in prior years. Such
\nreversal is recognised in the statement of pro\ufb01t or loss.
\nGoodwill is tested for impairment annually as at 31 December and when circumstances indicate that the
\ncarrying value may be impaired.
\nImpairment is determined for goodwill by assessing the recoverable amount of each CGU (or group of CGUs)
\nto which the goodwill relates. When the recoverable amount of the CGU is less than its carrying amount, an
\nimpairment loss is recognised. Impairment losses relating to goodwill cannot be reversed in future periods.
\nIntangible assets with inde\ufb01nite useful lives are tested for impairment annually as at 31 December at the
\nCGU level, as appropriate, and when circumstances indicate that the carrying value may be impaired.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForImpairmentOfNonfinancialAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20658": {
"value": "Impairment The group applies its impairment policy to non-\ufb01nancial assets, being intangible assets (goodwill), plant,
\nproperty and equipment and right of use assets. The group assesses, at each reporting date, whether there
\nis an indication that an asset may be impaired. If any indication exists, or when annual impairment testing
\nfor an asset is required, the group estimates the asset\u2019s recoverable amount. An asset\u2019s recoverable amount
\nis the higher of an asset\u2019s or CGU\u2019s fair value less costs of disposal or its value in use. The recoverable amounts
\nis determined for an individual asset, unless the asset does not generate cash in\ufb02ows that are largely
\nindependent of those from other assets or groups of assets. When the carrying amount of an asset or CGU
\nexceeds its recoverable amount, the asset is considered impaired, and is written down to its recoverable
\namount.
\nIn assessing value in use, the estimated future cash \ufb02ows are discounted to their present value using a discount
\nrate that re\ufb02ects current market assessments of the time value of money and risks speci\ufb01c to the asset. As part
\nof this, the group assesses where climate risks could have a signi\ufb01cant impact, such as the introduction of
\nemission-reduction legislation that may increase costs. These risks in relation to climate-related matters are
\nincluded as key assumptions where they materially impact the measure of recoverable amount. The group
\nbases its impairment calculation on most recent budgets and forecast calculations, which are prepared for
\neach CGU. The forecasts generally cover a \ufb01ve year period. A long term growth rate is calculated and applies
\nto project future cash \ufb02ows after the \ufb01fth year.
\nImpairment losses of continuing operations are recognised in the consolidated income statement in other
\noperating costs. Impairment is likely to be considered an Adjusting item.
\nFor assets excluding goodwill, an assessment is made at each reporting date to determine whether there is an
\nindication that previously recognised impairment losses no longer exist or have decreased. If such indication
\nexists, the group estimates the asset\u2019s or CGU\u2019s recoverable amount. A previously recognised impairment
\nloss is reversed only if there has been a change in the assumptions used to determine the asset\u2019s recoverable
\namount since the last impairment loss was recognised. The reversal is limited so that the carrying amount
\nof the asset does not exceed its recoverable amount, nor exceed the carrying amount that would have been
\ndetermined, net of depreciation, had no impairment loss been recognised for the asset in prior years. Such
\nreversal is recognised in the statement of pro\ufb01t or loss.
\nGoodwill is tested for impairment annually as at 31 December and when circumstances indicate that the
\ncarrying value may be impaired.
\nImpairment is determined for goodwill by assessing the recoverable amount of each CGU (or group of CGUs)
\nto which the goodwill relates. When the recoverable amount of the CGU is less than its carrying amount, an
\nimpairment loss is recognised. Impairment losses relating to goodwill cannot be reversed in future periods.
\nIntangible assets with inde\ufb01nite useful lives are tested for impairment annually as at 31 December at the
\nCGU level, as appropriate, and when circumstances indicate that the carrying value may be impaired.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfAccountingPolicyForImpairmentOfAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20739": {
"value": "Changes in accounting policy and estimates New standards, interpretations and amendments applied
\nThe following amendments to existing standards were effective for the group from 1 January 2022. Other than
\nsome additional disclosures, these amendments have not had a material impact.
\nEffective date*
\nAmendments to IFRS 3 Business Combinations \u2013 reference to the conceptual framework
1 January 2022
\nAmendments to IAS 16 \u2013 Property, Plant and Equipment: proceeds before intended use
1 January 2022
\nAmendments to IAS 37 \u2013 Onerous Contracts \u2013 costs of fulfilling a contract
1 January 2022
\nIFRS 9 Financial Instruments \u2013 Fees in the \u201810 per cent\u2019 test for derecognition of financial liabilities
1 January 2022
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations that are consistent with
\nthe endorsement process for use in the UK.
\nNew standards, interpretations and amendments in issue, but not yet effective
\nAs at date of approval of the group \ufb01nancial statements, the following new and amended standards,
\ninterpretations and amendments in issue are applicable to the group but not yet effective and thus, have not
\nbeen applied by the group:
\nEffective date*
\nAmendments to IAS 1 \u2013 Classification of liabilities as current or non-current
1 January 2023
\nAmendments to IAS 8 \u2013 Definition of accounting estimates
1 January 2023
\nAmendments to IAS 12 \u2013 Deferred tax related to assets and liabilities arising from a single
\ntransaction
1 January 2023
\nIFRS 17 \u2013 Insurance contracts
1 January 2023
\nAmendments to IFRS 16 \u2013 Lease Liability in a sale and leaseback
1 January 2024
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations. As the group prepares
\nits \ufb01nancial statements in accordance with IFRS as issued by the IASB as endorsed by the UK, the application of new standards
\nand interpretations will result in an effective date subject to that agreed by the UK Endorsement process.
\nIFRS 17 is under review by management and the impact if any is still to be quanti\ufb01ed. All other amendments
\nare not expected to have a material impact on the group.
\nChanges in accounting estimates
\nIn line with our accounting policy, management has reviewed the expected useful lives and residual values of
\nproperty, plant and equipment. This exercise included a detailed benchmarking exercise. As a result, the useful
\nlife and residual value for freehold land and buildings has been revised, and with effect from 1 July 2022 the
\ngroup changed its estimate for freehold buildings from 5-50 years to 5-60 years.
\nThe benchmarking exercise con\ufb01rmed that it would be appropriate to also revise the residual value on freehold
\nhospital buildings to 20% from a nil residual value and this change took place with effect from 1 July 2022.
\nManagement has therefore concluded that it would be appropriate to apply a 20% residual value to the original
\ncost of the freehold properties, and this change took effect on 1 July 2022.
\nManagement has concluded that the impact of climate-related risks would not have a material impact on the
\nextended useful life and residual value of its freehold land and buildings, as these risks have been mitigated.
\nThe depreciation charged to the pro\ufb01t and loss in the current year was \u00a397.9 million (2021:\u00a397.1 million).
\nThe change in accounting estimate has resulted in a reduction in depreciation of \u00a32.9 million in the current
\nyear. In addition this has given rise to a one-off deferred tax credit of \u00a39.0 million. The effect of the change
in future period is to decrease annual depreciation by c. \u00a36.0 million.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfChangesInAccountingPoliciesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20742": {
"value": "New standards, interpretations and amendments applied The following amendments to existing standards were effective for the group from 1 January 2022. Other than
\nsome additional disclosures, these amendments have not had a material impact.
\nEffective date*
\nAmendments to IFRS 3 Business Combinations \u2013 reference to the conceptual framework
1 January 2022
\nAmendments to IAS 16 \u2013 Property, Plant and Equipment: proceeds before intended use
1 January 2022
\nAmendments to IAS 37 \u2013 Onerous Contracts \u2013 costs of fulfilling a contract
1 January 2022
\nIFRS 9 Financial Instruments \u2013 Fees in the \u201810 per cent\u2019 test for derecognition of financial liabilities
1 January 2022
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations that are consistent with
\nthe endorsement process for use in the UK.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfInitialApplicationOfStandardsOrInterpretations",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20760": {
"value": "New standards, interpretations and amendments in issue, but not yet effective As at date of approval of the group \ufb01nancial statements, the following new and amended standards,
\ninterpretations and amendments in issue are applicable to the group but not yet effective and thus, have not
\nbeen applied by the group:
\nEffective date*
\nAmendments to IAS 1 \u2013 Classification of liabilities as current or non-current
1 January 2023
\nAmendments to IAS 8 \u2013 Definition of accounting estimates
1 January 2023
\nAmendments to IAS 12 \u2013 Deferred tax related to assets and liabilities arising from a single
\ntransaction
1 January 2023
\nIFRS 17 \u2013 Insurance contracts
1 January 2023
\nAmendments to IFRS 16 \u2013 Lease Liability in a sale and leaseback
1 January 2024
\n*
The effective dates stated above are those given in the original IASB/IFRIC standards and interpretations. As the group prepares
\nits \ufb01nancial statements in accordance with IFRS as issued by the IASB as endorsed by the UK, the application of new standards
\nand interpretations will result in an effective date subject to that agreed by the UK Endorsement process.
\nIFRS 17 is under review by management and the impact if any is still to be quanti\ufb01ed. All other amendments
\nare not expected to have a material impact on the group.",
"dimensions": {
"concept": "ifrs-full:DescriptionOfExpectedImpactOfInitialApplicationOfNewStandardsOrInterpretations",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20802": {
"value": "3. Critical accounting judgements and estimates In the application of the group\u2019s accounting policies, the directors are required to make judgements and
\nestimates about the carrying amounts of assets and liabilities that are not readily apparent from other sources.
\nThe estimates and associated assumptions are based on historical experience and other factors that are
\nconsidered to be relevant. Actual results may differ from these estimates.
\nJudgements
\nAdjusting items
\nJudgements are required as to whether items that are material in size, unusual or infrequent in nature should
\nbe disclosed as adjusting items. Deciding which items meet the respective de\ufb01nitions requires the group to
\nexercise its judgement. Details of these items categorised as adjusting items are outlined in note 10.
\nLeases
\nThe application of IFRS 16 requires the group to make certain judgements which affect the value of the ROU
\nasset and lease liability, and these include: determining contracts in the scope of IFRS 16 and the contract term.
\nThe lease term is determined by the group and includes the non-cancellable period of lease contracts, periods
\ncovered by an option to extend the lease if the group is reasonably certain to exercise that option and period
\ncovered by an option to terminate the lease if the group is reasonably certain not to exercise that option. The
\ngroup reviews the business plan, investment in leasehold improvements and market conditions when
\nconsidering the certainty of options to extend or terminate. For lease contracts with an inde\ufb01nite term, the
\ngroup determines the length of the contract to be equal to the average or typical market contract term of the
\nparticular type of lease. The same life is then applied to determine the depreciation rate of ROU assets.
\nIn the prior period, the group undertook a sale and leaseback. The group determined that the sale criteria had
\nbeen met. There was no option to purchase, and any option to extend would be completed at fair value at the
\npoint of exercise of such option.
\nSigni\ufb01cant accounting estimates
\nThe preparation of the group\u2019s consolidated \ufb01nancial statements includes the use of estimates and
\nassumptions. The signi\ufb01cant accounting estimates with a signi\ufb01cant risk of a material change to the carrying
\nvalue of assets and liabilities within the next year in terms of IAS 1, \u2018Presentation of Financial Statements\u2019, are:
\nGoodwill
\nGoodwill is tested for impairment at least annually or more frequently if there is an indication that goodwill
\nmay be impaired. This is achieved by comparing the carrying value in the accounts with the recoverable
\namount (being the value-in-use), as set out in the impairment policy. The value-in-use calculations require
\nthe group to estimate future cash \ufb02ows expected to arise in the future, taking into account market conditions.
\nThe current value of goodwill is underpinned by these forecasts. The present value of these cash \ufb02ows is
\ndetermined using an appropriate discount rate.
\nThe assumptions are considered to be most critical in reviewing goodwill for impairment are contained in
\nnote 14.
\n
\n\n
\n
\n\nProperty impairment
\nProperty, including property ROU assets, is considered for indicators of impairment at each reporting date, or
\nearlier if a trigger indicates, as set out in the impairment policy. The recoverable amount, being the value-in-use,
\nrequire the group to estimate cash \ufb02ows expected to arise in the future, taking into account market conditions.
\nThe variables in the cash \ufb02ows are interdependent and re\ufb02ect management\u2019s expectations based on past
\nexperience and current market trends, it takes into account both current business and committed initiatives.
\nThe present value of these cash \ufb02ows is determined using an appropriate discount rate.
\nThe assumptions are considered to be most critical in reviewing properties for impairment are contained
\nin note 13.
\nOther areas of accounting estimates
\nThe consolidated \ufb01nancial statements include other areas of judgement and accounting estimates. While
\nthese areas do not meet the de\ufb01nition under IAS 1 of signi\ufb01cant accounting estimates and critical accounting
\njudgements, the recognition and measurement of certain material assets and liabilities are based on
\nassumptions and/or are subject to longer term uncertainties. The other areas of accounting estimates
\nand judgement are:
\nLeases
\nThe present value of the lease payment is determined using the discount factor (incremental borrowing rate)
\nwhich is based on a risk free UK gilt rate plus an applicable credit spread or margin to re\ufb02ect the credit standing
\nof the group observed in the period when the lease contract commences or is modi\ufb01ed. The incremental
\nborrowing rate applied re\ufb02ects a rate for a similar term and security to that of the lease and is determined
\nat inception.
\nDetails of incremental borrowing rates can be found in note 22.
\nExpected credit losses
\nThe group has not changed the methodology in respect of the expected credit loss (ECL) calculations. The
\ngroup\u2019s customer pro\ufb01le includes large organisations that have stable credit ratings, and the payment pro\ufb01les
\nhave remained stable for historical debts. The exception to this is patient debt where economic circumstances
\ncan have a signi\ufb01cant impact and, given the current economic uncertainty, remains the highest risk for the
\ngroup. The ECL as at December 2022 is \u00a35.0 million (December 2021: \u00a34.1 million). See note 18.
\nClimate-related risk and opportunities on the \ufb01nancial statements
\nTo date, the board has not identi\ufb01ed any climate-related risks or opportunities that would have a material
\nimpact on the assets or liabilities of the group, and therefore has not adjusted \ufb01nancial balances for climate-
\nrelated risks or opportunities.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfAccountingJudgementsAndEstimatesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20831": {
"value": "Goodwill Goodwill is tested for impairment at least annually or more frequently if there is an indication that goodwill
\nmay be impaired. This is achieved by comparing the carrying value in the accounts with the recoverable
\namount (being the value-in-use), as set out in the impairment policy. The value-in-use calculations require
\nthe group to estimate future cash \ufb02ows expected to arise in the future, taking into account market conditions.
\nThe current value of goodwill is underpinned by these forecasts. The present value of these cash \ufb02ows is
\ndetermined using an appropriate discount rate.
\nThe assumptions are considered to be most critical in reviewing goodwill for impairment are contained in
\nnote 14.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfGoodwillExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20907": {
"value": "Expected credit losses The group has not changed the methodology in respect of the expected credit loss (ECL) calculations. The
\ngroup\u2019s customer pro\ufb01le includes large organisations that have stable credit ratings, and the payment pro\ufb01les
\nhave remained stable for historical debts. The exception to this is patient debt where economic circumstances
\ncan have a signi\ufb01cant impact and, given the current economic uncertainty, remains the highest risk for the
\ngroup. The ECL as at December 2022 is \u00a35.0 million (December 2021: \u00a34.1 million). See note 18.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfAllowanceForCreditLossesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20921": {
"value": "4. Auditor\u2019s remuneration During the year, the group (including its subsidiary undertakings) obtained the following services from the
\ngroup\u2019s external auditor as detailed below:
\n(\u00a3m)
2022
2021
\nAudit of these financial statements
1.0
0.6
\nAudit of the financial statements of subsidiaries of the company pursuant to
\nlegislation
0.3
0.2
\nAudit-related assurance services
0.1
0.1
\nTotal
1.4
0.9 ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfAuditorsRemunerationExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f20943": {
"value": "5. Segmental reporting In determining the group\u2019s operating segment, management has primarily considered the \ufb01nancial information
\nin internal reports that are reviewed and used by the executive management team and board of directors
\n(who together are the chief operating decision maker of Spire Healthcare) in assessing performance and in
\ndetermining the allocation of resources. The \ufb01nancial information in those internal reports in respect of
\nrevenue and expenses has led management to conclude that the group has a single operating segment,
\nbeing the provision of healthcare services. All revenue is attributable to, and all non-current assets are located
\nin, the United Kingdom.
\nThe nature of the NHS COVID-19 speci\ufb01c contracts in Q1 2021, and speci\ufb01c agreement with one hospital in
\nFY22, means that not all of the detail of revenue by location (inpatient, daycase or outpatient) is available. In Q1
\n2021, where a patient was admitted, this revenue has been recorded within the revenue by location. Amounts
\nrelating to the minimum income guarantee over and above admitted patients, or any other elements are
\nre\ufb02ected in the NHS COVID-19 line.
\nRevenue by location (inpatient, daycase or outpatient) and wider customer (payor) group is shown below:
\n(\u00a3m)
2022
2021
\nInpatient
487.5
414.2
\nDaycase
348.0
307.0
\nOutpatient
333.1
300.9
\nOther
\n1
\n26.4
26.0
\nNHS \u2013 COVID-19
3.5
58.1
\nTotal revenue
1,198.5
1,106.2
\nInsured
538.7
473.7
\nSelf-pay
338.0
292.0
\nNHS
295.4
314.5
\nOther
\n1
\n26.4
26.0
\nTotal revenue
1,198.5
1,106.2
\n1.
Other revenue includes fees paid to the group by consultants (eg for the use of group facilities and services) and third-party
\nrevenue (eg pathology services to third-parties).
\nGroup revenues increased 8.3% to \u00a31,198.5 million (2021: \u00a31,106.2 million). The increase in revenue driven
\nby the ongoing strong demand for private treatment with the continued growth in self-pay seen during the
\nprior period, but also the recovery by Insured patients. NHS revenue of \u00a3295.4 million includes \u00a33.5 million
\n(2021: \u00a3314.5 million and \u00a358.1 million respectively) revenue from speci\ufb01c COVID-19 contracts. In the prior
\nyear (Q1 2021) the group operated under an NHS volume based contract with a minimum income guarantee,
\nincluded in the \u00a358.1 million was \u00a347.4 million re\ufb02ecting the \u2018top up\u2019 to minimum income guaranteed under
\nthe contract. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfEntitysReportableSegmentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21047": {
"value": "6. Other income (\u00a3m)
2022
2021
\nFair value movement on financial asset
2.3
0.7
\nRealised profit in respect of financial asset
0.7
0.4
\nProfit on disposal relating to sale and leaseback, net of costs (adjusting item)
\n(see note 10)
\u2013
23.3
\nTotal other income
3.0
24.4
\nThe fair value movement and realised pro\ufb01t in respect of the \ufb01nancial asset re\ufb02ect the on-going pro\ufb01t share
\narrangement with Genesis Care which arose as part of the sale of the Bristol Cancer Centre sold in 2019.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfOtherOperatingIncomeExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21069": {
"value": "7. Operating pro\ufb01t Arrived at after charging/(crediting):
\n(\u00a3m)
2022
2021
\nDepreciation of property, plant and equipment (see note 13)
64.2
67.4
\nDepreciation of right of use assets (see note 13)
33.7
29.7
\nAcquisition-related transaction costs (adjusting Item) (see note 10)
1.8
1.5
\nLease payments made in respect of low value and short leases
13.6
12.3
\nProvision following a court judgment related to Ian Paterson (adjusting Item)
\n(see note 10)
0.3
12.2
\nImpairment on assets held for sale (see note 20)
0.5
\u2013
\nMovement on the provision for expected credit losses of trade receivables
\n(see note 18)
0.9
(1.2)
\nLoss on disposal of property, plant and equipment
0.3
\u2013
\nFair value adjustment on financial liability
0.8
\u2013
\nStaff restructuring costs (see notes 9)
4.5
1.2
\nStaff costs (net of staff restructuring costs and including share based payment
\ncharge) (see note 9 and 27)
413.9
396.4
\nProfit on disposal relating to sale and leaseback (adjusting Item) (see note 10)
\u2013
(23.5)
\nProfit on disposal relating to a lease modification at Spire Sussex (adjusting Item)
\n(see note 10)
\u2013
(0.4)
\nProfit on the early termination of a lease (adjusting Item) (see note 10)
\u2013
(0.2)
\nImpairment losses and reversals of impairment are included in other operating costs.
\nInventory recognised as an expense in the current year is disclosed in note 17. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfProfitLossFromOperatingActivitiesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21125": {
"value": "8. Finance income and costs (\u00a3m)
2022
2021
\nFinance cost
\nInterest on bank facilities
12.4
18.8
\nInterest on the RSA judgement repayable (included in adjusting items)
\u2013
0.8
\nRefinancing fees
1.0
\u2013
\nAmortisation of fee arising on facilities extensions/borrowing costs
\n1
\n1.5
1.0
\nAccelerated amortisation and loss on extinguishment of loan
\n1
\n3.1
\u2013
\nIFRS 9 release arising on facilities extension
\n1
\n\u2013
0.1
\nInterest on obligations under leases
73.5
68.2
\nTotal finance costs
91.5
88.9
\nTotal net finance costs
91.5
88.9
\n1.
\u00a35.0 million of borrowing costs were capitalised on the re\ufb01nancing of the senior facility, these are being amortised. In the prior
\nyear \u00a33.3 million that was recorded at the date of the 2018 extension and \u00a30.3 million recorded at the date of the 2020 extension.
\nThe remaining balance of these fees were changed to the pro\ufb01t and loss in the year on the extinguishment of the old loan. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfFinanceCostExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21126": {
"value": "8. Finance income and costs (\u00a3m)
2022
2021
\nFinance cost
\nInterest on bank facilities
12.4
18.8
\nInterest on the RSA judgement repayable (included in adjusting items)
\u2013
0.8
\nRefinancing fees
1.0
\u2013
\nAmortisation of fee arising on facilities extensions/borrowing costs
\n1
\n1.5
1.0
\nAccelerated amortisation and loss on extinguishment of loan
\n1
\n3.1
\u2013
\nIFRS 9 release arising on facilities extension
\n1
\n\u2013
0.1
\nInterest on obligations under leases
73.5
68.2
\nTotal finance costs
91.5
88.9
\nTotal net finance costs
91.5
88.9
\n1.
\u00a35.0 million of borrowing costs were capitalised on the re\ufb01nancing of the senior facility, these are being amortised. In the prior
\nyear \u00a33.3 million that was recorded at the date of the 2018 extension and \u00a30.3 million recorded at the date of the 2020 extension.
\nThe remaining balance of these fees were changed to the pro\ufb01t and loss in the year on the extinguishment of the old loan.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfFinanceIncomeExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21127": {
"value": "8. Finance income and costs (\u00a3m)
2022
2021
\nFinance cost
\nInterest on bank facilities
12.4
18.8
\nInterest on the RSA judgement repayable (included in adjusting items)
\u2013
0.8
\nRefinancing fees
1.0
\u2013
\nAmortisation of fee arising on facilities extensions/borrowing costs
\n1
\n1.5
1.0
\nAccelerated amortisation and loss on extinguishment of loan
\n1
\n3.1
\u2013
\nIFRS 9 release arising on facilities extension
\n1
\n\u2013
0.1
\nInterest on obligations under leases
73.5
68.2
\nTotal finance costs
91.5
88.9
\nTotal net finance costs
91.5
88.9
\n1.
\u00a35.0 million of borrowing costs were capitalised on the re\ufb01nancing of the senior facility, these are being amortised. In the prior
\nyear \u00a33.3 million that was recorded at the date of the 2018 extension and \u00a30.3 million recorded at the date of the 2020 extension.
\nThe remaining balance of these fees were changed to the pro\ufb01t and loss in the year on the extinguishment of the old loan.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfFinanceIncomeExpenseExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21173": {
"value": "9. Staff costs (No.)
2022
\nRestated
\n1
\n2021
\nThe average number of persons employed by the group (including directors) during
\nthe year:
\nClinical
7,388
7,280
\nNon-clinical
5,227
5,426
\nCentral
614
596
\nTotal
13,229
13,302
\n(No.)
2022
2021
\nThe average number of full-time equivalent persons employed by the group during
\nthe year:
\nClinical
5,539
5,476
\nNon-clinical
4,017
4,134
\nCentral
538
521
\nTotal
10,094
10,131
\n1.
The prior year average number of persons employed by the group was restated to include bank staff. The average number of
\npersons employed by the group disclosed in the prior year was 11,220. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfInformationAboutEmployeesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21174": {
"value": "9. Staff costs (No.)
2022
\nRestated
\n1
\n2021
\nThe average number of persons employed by the group (including directors) during
\nthe year:
\nClinical
7,388
7,280
\nNon-clinical
5,227
5,426
\nCentral
614
596
\nTotal
13,229
13,302
\n(No.)
2022
2021
\nThe average number of full-time equivalent persons employed by the group during
\nthe year:
\nClinical
5,539
5,476
\nNon-clinical
4,017
4,134
\nCentral
538
521
\nTotal
10,094
10,131
\n1.
The prior year average number of persons employed by the group was restated to include bank staff. The average number of
\npersons employed by the group disclosed in the prior year was 11,220.
\nThe aggregate payroll costs of these persons were as follows:
\n(\u00a3m)
2022
2021
\nWages and salaries
350.3
336.8
\nSocial security costs
34.7
31.1
\nPension costs, defined contribution scheme
33.4
29.7
\n418.4
397.6
\n
\n\n\n
\n\nThere were \u00a34.7 million wages and salaries and social security costs for year ended 31 December 2022 in
\nAdjusting items (2021: \u00a31.3 million) of which \u00a34.5 million relate to business restructuring costs and which
\nare included in staff costs (2021: \u00a31.2 million), and are set out in note 7.
\nPension costs are in respect of the de\ufb01ned contribution scheme; unpaid contributions at 31 December 2022
\nwere \u00a32.7 million (2021: \u00a32.8 million).",
"dimensions": {
"concept": "ifrs-full:DisclosureOfEmployeeBenefitsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21350": {
"value": "11. Taxation (\u00a3m)
2022
2021
\nCurrent tax
\nUK corporation tax expense
0.1
0.8
\nAdjustments in respect of prior years
(0.7)
\u2013
\nTotal current tax (credit)/charge
(0.6)
0.8
\nDeferred tax
\nOrigination and reversal of temporary differences
(2.6)
(15.0)
\nEffect of change in tax rate
\u2013
17.7
\nAdjustments in respect of prior years
(1.1)
3.5
\nTotal deferred tax (credit)/charge
(3.7)
6.2
\nTotal tax (credit)/charge
(4.3)
7.0
\nIn addition to the above, a charge of \u00a32.1 million has been recognised in Other Comprehensive income
\n(2021: \u00a30.6 million charge) and \u00a30.1 million charge (2021: \u00a33.0 million credit) through equity.
\nCorporation tax is calculated at 19.0% (2021: 19.0%) of the estimated taxable pro\ufb01t or loss for the year. The
\neffective tax rate on pro\ufb01t before taxation for the year was not meaningful (2021: not meaningful) as a result
\nof adjustments in respect of prior years and movements on deferred tax which are not directly linked to pro\ufb01t.
\nDuring the period, the group has reassessed the useful life and residual value of its freehold property portfolio.
\nThis has results in a one-off deferred tax credit of \u00a39.0 million. The prior year deferred tax charge was largely
\ndriven by the effects of revaluing deferred tax assets and liabilities from 19% to 25% due in April 2023, and
\nthe deferred tax movement as a result of the sale and leaseback of Spire Cheshire. Deferred tax is detailed
\nin note 23.
\n
\n\n
\n
\n\nThe effective tax assessed for the year, all of which arises in the UK, differs from the standard weighted rate
\nof corporation tax in the UK. The reconciliation of the actual tax charge to that at the domestic corporation tax
\nrate is as follows:
\n(\u00a3m)
2022
2021
\nProfit/(loss) before taxation
3.9
(1.9)
\nTax at the standard rate
0.7
(0.4)
\nEffects of:
\nExpenses and income not deductible or taxable
8.2
4.5
\nTax adjustment for the super-deduction allowance
(2.6)
(2.2)
\nTax adjustment in respect of sale and leaseback
\u2013
(16.0)
\nImpairment charge in respect of held for sale assets (not tax deductible)
0.1
\u2013
\nOne-off impact of revision to useful economic life and residual value of freehold
\nproperty portfolio
(9.0)
\u2013
\nAdjustments to prior year
(1.8)
3.5
\nDifference in tax rates
0.1
17.7
\nDeferred tax not previously recognised
\u2013
(0.1)
\nTotal tax (credit)/charge
(4.3)
7.0
\nExpenses and income not deductible or taxable relate mostly to depreciation on non-qualifying \ufb01xed assets,
\ndisallowable entertaining and legal and professional fees. The one-off impact of revision to useful life and
\nresidual value of the freehold property portfolio is described in note 23.
\nThe charge above in the prior year was driven mainly by the revaluation of deferred tax assets and liabilities
\nto 25% from 19% as a result of the substantive enactment of the government\u2019s decision to increase the
\ncorporation tax rate from 1 April 2023, as well as the deferred tax movement as a result of the sale and
\nleaseback of Spire Cheshire. The current year charge driven by expenses not deductible for tax purposes, offset
\nby the one-off deferred tax credit of \u00a39.0 million as a result in the revision to the useful life and residual value
\nof the freehold property portfolio, an adjustment in respect of prior year and the claim of the super deduction
\nfor capital allowance purposes.
\nThe group does not hold any uncertain tax positions under IFRIC 23 at the year-end (2021: none). ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfIncomeTaxExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21487": {
"value": "12. Earnings per share (EPS) Basic EPS is calculated by dividing the pro\ufb01t for the year attributable to ordinary equity holders of the parent
\nby the weighted average number of ordinary shares outstanding during the year.
\n2022
2021
\nProfit/(loss) for the year attributable to ordinary equity holders of the parent (\u00a3m)
8.6
(9.7)
\nWeighted average number of ordinary shares for basic EPS (No.)
402,756,797
401,087,547
\nAdjustment for weighted average number of shares held in EBT
(77,501)
(239,283)
\nWeighted average number of ordinary shares in issue (No.)
402,679,296
400,848,264
\nBasic earnings per share (in pence per share)
2.1
(2.4)
\nFor dilutive EPS, the weighted average number of ordinary shares in issue is adjusted to include all dilutive
\npotential ordinary shares arising from share options. Refer to the remuneration committee report for the terms
\nand conditions of instruments generating potential ordinary shares that affect the measurement of diluted
\nEPS.
\n2022
2021
\nProfit/(loss) for the year attributable to ordinary equity holders of the parent (\u00a3m)
8.6
(9.7)
\nWeighted average number of ordinary shares in issue (No.)
402,679,296
400,848,264
\nAdjustment for weighted average number of contingently issuable shares
9,363,470
\u2013
\nDiluted weighted average number of ordinary shares in issue (No.)
412,042,766
400,848,264
\nDiluted earnings per share (in pence per share)
2.1
(2.4)
\nIn the prior year the weighted average number for contingently issuable shares would be anti-dilutive, they are
\nexcluded from the above. However 8,891,739 shares are potentially dilutive.
\nThe directors believe that EPS excluding adjusting items (\u2018adjusted EPS\u2019) better re\ufb02ects the underlying
\nperformance of the business and assists in providing a clearer view of the performance of the group.
\nReconciliation of pro\ufb01t after taxation to pro\ufb01t after taxation excluding adjusting items (\u2018adjusted pro\ufb01t\u2019):
\n2022
2021
\nProfit/(loss) for the year attributable to owners of the parent (\u00a3m)
8.6
(9.7)
\nAdjusting items (see note 10)
8.4
(18.9)
\nAdjusted profit/(loss) (\u00a3m)
17.0
(28.6)
\nWeighted average number of Ordinary Shares in issue
402,679,296
400,848,264
\nWeighted average number of dilutive Ordinary Shares
412,042,766
400,848,264
\nAdjusted basic earnings per share (in pence per share)
4.2
(7.1)
\nAdjusted diluted earnings per share (in pence per share)
4.1
(7.1)
\nIn the prior year the weighted average number for contingently issuable shares would be anti-dilutive, they are
\nexcluded from the above. However 8,891,739 shares are potentially dilutive.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfEarningsPerShareExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21602": {
"value": "13. Property, plant and equipment (\u00a3m)
\nFreehold
\nproperty
\nLeasehold
\nimprovements
Equipment
\nAssets in the
\ncourse of
\nconstruction
\nRight of use
\n(ROU)
Total
\nCost:
\nAt 1 January 2021
870.5
164.0
447.4
9.2
763.9
2,255.0
\nAdditions
11.4
11.9
47.6
6.2
\u2013
77.1
\nAcquisition of a subsidiary (Note 32)
\u2013
0.1
4.7
25.5
30.3
\nAdditions to ROU assets
\u2013
\u2013
\u2013
\u2013
32.6
32.6
\nAdjustments to existing assets (eg
\nindexation)
\u2013
\u2013
\u2013
\u2013
9.7
9.7
\nDisposals
(35.9)
(1.7)
(20.9)
\u2013
(5.8)
(64.3)
\nTransfers
\n1
\n(0.7)
3.4
1.8
(4.5)
\u2013
\u2013
\nAt 1 January 2022
845.3
177.7
480.6
10.9
825.9
2,340.4
\nAdditions
8.5
6.4
55.9
19.3
\u2013
90.1
\nAcquisition of a subsidiary (Note 32)
\u2013
\u2013
0.6
\u2013
\u2013
0.6
\nAdditions to ROU assets
\u2013
\u2013
\u2013
\u2013
4.9
4.9
\nAdjustments to existing assets (eg
\nindexation)
\u2013
\u2013
\u2013
\u2013
34.0
34.0
\nDisposals
(3.6)
(3.7)
(71.8)
\u2013
(0.9)
(80.0)
\nTransfer
\u2013
\u2013
(10.0)
\u2013
10.0
\u2013
\nAt 31 December 2022
850.2
180.4
455.3
30.2
873.9
2,390.0
\nAccumulated depreciation and
\nimpairment:
\nAt 1 January 2021
180.3
46.9
295.3
\u2013
197.2
719.7
\nCharge for the year
17.9
8.4
41.1
\u2013
29.7
97.1
\nAcquisition of a subsidiary (Note 32)
\u2013
\u2013
4.1
\u2013
\u2013
4.1
\nDisposals
(9.2)
(0.9)
(19.7)
\u2013
(4.2)
(34.0)
\nAt 1 January 2022
189.0
54.4
320.8
\u2013
222.7
786.9
\nCharge for the year
12.3
9.3
42.6
\u2013
33.7
97.9
\nDisposals
(3.1)
(3.6)
(71.6)
\u2013
(0.9)
(79.2)
\nAt 31 December 2022
198.2
60.1
291.8
\u2013
255.5
805.6
\nNet book value:
\nAt 31 December 2022
652.0
120.3
163.5
30.2
618.4
1,584.4
\nAt 31 December 2021
656.3
123.3
159.8
10.9
603.2
1,553.5
\nThe net book value of land is \u00a3156.3 million (2021: \u00a3156.3 million). During the year the group re\ufb01nanced
\nits senior \ufb01nance facility and pledged nine of its freehold properties as security, the net book value of these
\nproperties are \u00a3157.6 million as at 31 December 2022. No assets in the prior year were subject to restriction
\non title or pledged as security for liabilities. There were no borrowing costs capitalised during the year ended
\n31 December 2022 (2021: Nil).
\nImpairment testing
\nThe directors consider property and property right-of-use assets for indicators of impairment semi-annually.
\nAs equipment and leasehold improvements do not generate independent cash \ufb02ows, they are considered
\nalongside the property as a single cash-generating unit (\u2018CGU\u2019). When making the assessment, the value-in-use
\nof the property is compared with its carrying value in the accounts. Where headroom is signi\ufb01cant, no further
\nwork is undertaken. Where headroom is minimal, a detailed assessment is performed for the property, which
\nincludes identifying the factors resulting in limited headroom and undertaking \ufb01nancial forecasts to assess the
\nlevel of sensitivity this has to key assumptions.
\nIn order to estimate the value-in-use, management has used trading projections covering the period to
\nDecember 2027 from the most recent board approved strategic plan. The variables in the cash \ufb02ows are
\ninterdependent and re\ufb02ect management\u2019s expectations based on past experience and current market trends,
\nit takes into account both current business and committed initiatives. To the extent that there was a shortfall
\nbetween the recent actual cash \ufb02ows and forecast, the future cash \ufb02ows have been adjusted to re\ufb02ect any
\ninitiatives implemented by management to address the underlying cause. In addition, management consider
\nthe potential \ufb01nancial impact from short term climate change scenarios, and the cost of initiatives by the
\ngroup to manage the longer term climate impacts.
\nKey assumptions
\nManagement identi\ufb01ed a number of key assumptions relevant to the value-in-use calculations, being EBITDA
\ngrowth over the \ufb01ve year period, capital maintenance spend, discount rates and long term growth rates. The
\nassumptions are based on past experience and external sources of information.
\nThere were three properties triggered for detailed review in the period owing to the relatively lower level of
\nheadroom. Management has performed a sensitivity analysis on these properties using reasonably possible
\nchanges for each key assumption, keeping all other assumptions constant. The sensitivity analysis included
\nan assessment of the break-even point for each of the key assumptions.
\nThe trading projections for the \ufb01ve-year period underlying the value in use re\ufb02ect a growth in EBITDA. EBITDA
\nis based on a number of elements of the operating model over the longer-term, including pricing trends,
\nvolume growth and the mix and complexity of procedures and assumptions regarding cost in\ufb02ation. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible change that would result the elimination of headroom
\nfor each property as shown in the table below.
\nThe group has used a pre-tax discount rate of 10.6% (2021: 8.5%), adjusted for the effect of IFRS 16. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible change in the pre-tax discount rate, would result in the
\nelimination of headroom as shown in the table below.
\nFor the properties triggered for review the table below provides the headroom and the reasonably possible
\nchange identi\ufb01ed in the sensitivity analysis mentioned above which would result in the elimination of headroom.
\nHeadroom (the amount
\nthat recoverable amount
\nexceeded the carrying
\namount)
\nEBITDA growth over
\nthe five year period
\nSensitivity for
\ndecrease of EBITDA
\ngrowth per annum
\nSensitivity for increase
\nof the pre-tax discount
\nrate sensitivity
\nProperty CGU 1
\u00a35.7m
2%\u201362%
8.6%
270 bps
\nProperty CGU 2
\u00a35.0m
2%\u201370%
4.5%
299 bps
\nProperty CGU 3
\u00a37.4m
0%\u201379%
2.6%
135 bps
\n
\n\n
\n
\n\nImpairment
\nA long-term growth rate of 2.0% has been applied to cash \ufb02ows beyond 2027 based on long term view of
\nin\ufb02ation, revenue growth and market conditions. Capital maintenance spend is based on historic run rates and
\nour expectations of the group\u2019s requirements. The sensitivity testing identi\ufb01ed no reasonably possible changes
\nin the capital maintenance and long term growth rates that would cause the carrying amount of any CGU to
\nexceed its recoverable amount.
\nAs a result, management believe that some of the key impairment review assumptions constitute a major
\nsource of estimation uncertainty as they consider that there is a signi\ufb01cant risk of a material change to its
\nestimate of these assumptions within the next 12 months.
\nRight of use (ROU) assets
\n(\u00a3m)
\nLeasehold
\nproperty
\nEquipment and
\nmotor vehicles
Total
\nCost:
\nAt 1 January 2021
760.4
3.5
763.9
\nNew leases entered
25.5
7.1
32.6
\nAcquisition of a subsidiary (Note 32)
25.5
\u2013
25.5
\nAdjustments to existing assets (eg indexation)
9.7
\u2013
9.7
\nDisposals
(5.6)
(0.2)
(5.8)
\nTransfers
\u2013
\u2013
\u2013
\nAt 1 January 2022
815.5
10.4
825.9
\nNew leases entered
0.4
4.5
4.9
\nAdjustments to existing assets (eg indexation)
34.0
\u2013
34.0
\nDisposals
(0.1)
(0.8)
(0.9)
\nTransfers
\u2013
10.0
10.0
\nAt 31 December 2022
849.8
24.1
873.9
\nAccumulated depreciation and impairment:
\nAt 1 January 2021
194.8
2.4
197.2
\nCharge for year
27.4
2.3
29.7
\nDisposals
(4.0)
(0.2)
(4.2)
\nAt 1 January 2022
218.2
4.5
222.7
\nCharge for the year
29.9
3.8
33.7
\nDisposals
(0.1)
(0.8)
(0.9)
\nAt 31 December 2022
248.0
7.5
255.5
\nNet book value:
\nAt 31 December 2022
601.8
16.6
618.4
\nAt 31 December 2021
597.3
5.9
603.2",
"dimensions": {
"concept": "ifrs-full:DisclosureOfPropertyPlantAndEquipmentExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21604": {
"value": "(\u00a3m)
\nFreehold
\nproperty
\nLeasehold
\nimprovements
Equipment
\nAssets in the
\ncourse of
\nconstruction
\nRight of use
\n(ROU)
Total
\nCost:
\nAt 1 January 2021
870.5
164.0
447.4
9.2
763.9
2,255.0
\nAdditions
11.4
11.9
47.6
6.2
\u2013
77.1
\nAcquisition of a subsidiary (Note 32)
\u2013
0.1
4.7
25.5
30.3
\nAdditions to ROU assets
\u2013
\u2013
\u2013
\u2013
32.6
32.6
\nAdjustments to existing assets (eg
\nindexation)
\u2013
\u2013
\u2013
\u2013
9.7
9.7
\nDisposals
(35.9)
(1.7)
(20.9)
\u2013
(5.8)
(64.3)
\nTransfers
\n1
\n(0.7)
3.4
1.8
(4.5)
\u2013
\u2013
\nAt 1 January 2022
845.3
177.7
480.6
10.9
825.9
2,340.4
\nAdditions
8.5
6.4
55.9
19.3
\u2013
90.1
\nAcquisition of a subsidiary (Note 32)
\u2013
\u2013
0.6
\u2013
\u2013
0.6
\nAdditions to ROU assets
\u2013
\u2013
\u2013
\u2013
4.9
4.9
\nAdjustments to existing assets (eg
\nindexation)
\u2013
\u2013
\u2013
\u2013
34.0
34.0
\nDisposals
(3.6)
(3.7)
(71.8)
\u2013
(0.9)
(80.0)
\nTransfer
\u2013
\u2013
(10.0)
\u2013
10.0
\u2013
\nAt 31 December 2022
850.2
180.4
455.3
30.2
873.9
2,390.0
\nAccumulated depreciation and
\nimpairment:
\nAt 1 January 2021
180.3
46.9
295.3
\u2013
197.2
719.7
\nCharge for the year
17.9
8.4
41.1
\u2013
29.7
97.1
\nAcquisition of a subsidiary (Note 32)
\u2013
\u2013
4.1
\u2013
\u2013
4.1
\nDisposals
(9.2)
(0.9)
(19.7)
\u2013
(4.2)
(34.0)
\nAt 1 January 2022
189.0
54.4
320.8
\u2013
222.7
786.9
\nCharge for the year
12.3
9.3
42.6
\u2013
33.7
97.9
\nDisposals
(3.1)
(3.6)
(71.6)
\u2013
(0.9)
(79.2)
\nAt 31 December 2022
198.2
60.1
291.8
\u2013
255.5
805.6
\nNet book value:
\nAt 31 December 2022
652.0
120.3
163.5
30.2
618.4
1,584.4
\nAt 31 December 2021
656.3
123.3
159.8
10.9
603.2
1,553.5
(\u00a3m)
\nLeasehold
\nproperty
\nEquipment and
\nmotor vehicles
Total
\nCost:
\nAt 1 January 2021
760.4
3.5
763.9
\nNew leases entered
25.5
7.1
32.6
\nAcquisition of a subsidiary (Note 32)
25.5
\u2013
25.5
\nAdjustments to existing assets (eg indexation)
9.7
\u2013
9.7
\nDisposals
(5.6)
(0.2)
(5.8)
\nTransfers
\u2013
\u2013
\u2013
\nAt 1 January 2022
815.5
10.4
825.9
\nNew leases entered
0.4
4.5
4.9
\nAdjustments to existing assets (eg indexation)
34.0
\u2013
34.0
\nDisposals
(0.1)
(0.8)
(0.9)
\nTransfers
\u2013
10.0
10.0
\nAt 31 December 2022
849.8
24.1
873.9
\nAccumulated depreciation and impairment:
\nAt 1 January 2021
194.8
2.4
197.2
\nCharge for year
27.4
2.3
29.7
\nDisposals
(4.0)
(0.2)
(4.2)
\nAt 1 January 2022
218.2
4.5
222.7
\nCharge for the year
29.9
3.8
33.7
\nDisposals
(0.1)
(0.8)
(0.9)
\nAt 31 December 2022
248.0
7.5
255.5
\nNet book value:
\nAt 31 December 2022
601.8
16.6
618.4
\nAt 31 December 2021
597.3
5.9
603.2
",
"dimensions": {
"concept": "ifrs-full:DisclosureOfDepreciationAndAmortisationExpenseExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21804": {
"value": "Impairment testing The directors consider property and property right-of-use assets for indicators of impairment semi-annually.
\nAs equipment and leasehold improvements do not generate independent cash \ufb02ows, they are considered
\nalongside the property as a single cash-generating unit (\u2018CGU\u2019). When making the assessment, the value-in-use
\nof the property is compared with its carrying value in the accounts. Where headroom is signi\ufb01cant, no further
\nwork is undertaken. Where headroom is minimal, a detailed assessment is performed for the property, which
\nincludes identifying the factors resulting in limited headroom and undertaking \ufb01nancial forecasts to assess the
\nlevel of sensitivity this has to key assumptions.
\nIn order to estimate the value-in-use, management has used trading projections covering the period to
\nDecember 2027 from the most recent board approved strategic plan. The variables in the cash \ufb02ows are
\ninterdependent and re\ufb02ect management\u2019s expectations based on past experience and current market trends,
\nit takes into account both current business and committed initiatives. To the extent that there was a shortfall
\nbetween the recent actual cash \ufb02ows and forecast, the future cash \ufb02ows have been adjusted to re\ufb02ect any
\ninitiatives implemented by management to address the underlying cause. In addition, management consider
\nthe potential \ufb01nancial impact from short term climate change scenarios, and the cost of initiatives by the
\ngroup to manage the longer term climate impacts.
\nKey assumptions
\nManagement identi\ufb01ed a number of key assumptions relevant to the value-in-use calculations, being EBITDA
\ngrowth over the \ufb01ve year period, capital maintenance spend, discount rates and long term growth rates. The
\nassumptions are based on past experience and external sources of information.
\nThere were three properties triggered for detailed review in the period owing to the relatively lower level of
\nheadroom. Management has performed a sensitivity analysis on these properties using reasonably possible
\nchanges for each key assumption, keeping all other assumptions constant. The sensitivity analysis included
\nan assessment of the break-even point for each of the key assumptions.
\nThe trading projections for the \ufb01ve-year period underlying the value in use re\ufb02ect a growth in EBITDA. EBITDA
\nis based on a number of elements of the operating model over the longer-term, including pricing trends,
\nvolume growth and the mix and complexity of procedures and assumptions regarding cost in\ufb02ation. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible change that would result the elimination of headroom
\nfor each property as shown in the table below.
\nThe group has used a pre-tax discount rate of 10.6% (2021: 8.5%), adjusted for the effect of IFRS 16. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible change in the pre-tax discount rate, would result in the
\nelimination of headroom as shown in the table below.
\nFor the properties triggered for review the table below provides the headroom and the reasonably possible
\nchange identi\ufb01ed in the sensitivity analysis mentioned above which would result in the elimination of headroom.
\nHeadroom (the amount
\nthat recoverable amount
\nexceeded the carrying
\namount)
\nEBITDA growth over
\nthe five year period
\nSensitivity for
\ndecrease of EBITDA
\ngrowth per annum
\nSensitivity for increase
\nof the pre-tax discount
\nrate sensitivity
\nProperty CGU 1
\u00a35.7m
2%\u201362%
8.6%
270 bps
\nProperty CGU 2
\u00a35.0m
2%\u201370%
4.5%
299 bps
\nProperty CGU 3
\u00a37.4m
0%\u201379%
2.6%
135 bps
\n
\n\n
\n
\n\nImpairment
\nA long-term growth rate of 2.0% has been applied to cash \ufb02ows beyond 2027 based on long term view of
\nin\ufb02ation, revenue growth and market conditions. Capital maintenance spend is based on historic run rates and
\nour expectations of the group\u2019s requirements. The sensitivity testing identi\ufb01ed no reasonably possible changes
\nin the capital maintenance and long term growth rates that would cause the carrying amount of any CGU to
\nexceed its recoverable amount.
\nAs a result, management believe that some of the key impairment review assumptions constitute a major
\nsource of estimation uncertainty as they consider that there is a signi\ufb01cant risk of a material change to its
\nestimate of these assumptions within the next 12 months.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfImpairmentOfAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f21923": {
"value": "Right of use (ROU) assets (\u00a3m)
\nLeasehold
\nproperty
\nEquipment and
\nmotor vehicles
Total
\nCost:
\nAt 1 January 2021
760.4
3.5
763.9
\nNew leases entered
25.5
7.1
32.6
\nAcquisition of a subsidiary (Note 32)
25.5
\u2013
25.5
\nAdjustments to existing assets (eg indexation)
9.7
\u2013
9.7
\nDisposals
(5.6)
(0.2)
(5.8)
\nTransfers
\u2013
\u2013
\u2013
\nAt 1 January 2022
815.5
10.4
825.9
\nNew leases entered
0.4
4.5
4.9
\nAdjustments to existing assets (eg indexation)
34.0
\u2013
34.0
\nDisposals
(0.1)
(0.8)
(0.9)
\nTransfers
\u2013
10.0
10.0
\nAt 31 December 2022
849.8
24.1
873.9
\nAccumulated depreciation and impairment:
\nAt 1 January 2021
194.8
2.4
197.2
\nCharge for year
27.4
2.3
29.7
\nDisposals
(4.0)
(0.2)
(4.2)
\nAt 1 January 2022
218.2
4.5
222.7
\nCharge for the year
29.9
3.8
33.7
\nDisposals
(0.1)
(0.8)
(0.9)
\nAt 31 December 2022
248.0
7.5
255.5
\nNet book value:
\nAt 31 December 2022
601.8
16.6
618.4
\nAt 31 December 2021
597.3
5.9
603.2",
"dimensions": {
"concept": "ifrs-full:DisclosureOfQuantitativeInformationAboutRightofuseAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22023": {
"value": "14. Intangible assets (\u00a3m)
Goodwill
\nCost or valuation:
\nAt 1 January 2021
518.8
\nAcquisition of a subsidiary
17.0
\nAt 31 December 2021
535.8
\nAcquisition of a subsidiary
11.1
\nAdjustment to prior year goodwill acquired
(0.1)
\nAt 31 December 2022
546.8
\nImpairment:
\nAt 31 December 2021 and 31 December 2022
201.0
\nCarrying amount:
\nAt 31 December 2022
345.8
\nAt 31 December 2021
334.8
\nAcquisition during the year
\nOn 16 December 2022, the group acquired 100% of the voting shares of The Doctors Clinic Group, a non-listed
\ncompany based in England who are an integrated provider of occupational health services and private GP
\nservices, for \u00a312 million generating goodwill of \u00a311.1 million.
\nImpairment testing
\nThe directors treat the business as a single cash-generating unit for the purposes of testing goodwill for
\nimpairment prior to the acquisition of The Doctors Clinic Group. The recoverable amount of goodwill is
\ncalculated by reference to its estimated value-in-use. In order to estimate the value-in-use, management has
\nused trading projections covering the period to December 2027 from the most recent board approved strategic
\nplan. The variables in the cash \ufb02ows are interdependent and re\ufb02ect management\u2019s expectations based on past
\nexperience and current market trends, it takes into account both current business and committed initiatives. In
\naddition, management consider the potential \ufb01nancial impact from short term climate change scenarios, and
\nthe cost of initiatives by the group to manage the longer term climate impacts. The recoverable amount
\nexceeded the carrying amount by c\u00a3400 million.
\nKey assumptions
\nManagement identi\ufb01ed a number of key assumptions relevant to the value-in-use calculations, being EBITDA
\nmargin growth over the \ufb01ve year period, capital maintenance spend, discount rates and long term growth
\nrates. The assumptions are based on past experience and external sources of information.
\nManagement has performed a sensitivity analysis using reasonably possible changes for each key assumption,
\nkeeping all other assumptions constant. The sensitivity analysis included an assessment of the break-even
\npoint for each of the key assumptions.
\nThe trading projections for the \ufb01ve year period underlying the value in use re\ufb02ect a growth in EBITDA margin.
\nEBITDA Margin is dependent on a number of elements of the operating model over the longer-term, including
\npricing trends, volume growth and the mix and complexity of procedures and assumptions regarding cost
\nin\ufb02ation. The growth in EBITDA margin over the next 5 years ranges between 0.5% and 1.8% per annum. The
\nsensitivity analysis identi\ufb01ed that a reasonably possible decrease of 12% in the annual EBITDA forecast within
\nthe trading projection (2023-2027) would result in the elimination of headroom.
\n
\n\n\n
\n\n\nThe group has used a pre-tax discount of 10.6% (2021: 8.5%), adjusted for the effect of IFRS 16. The sensitivity
\nanalysis identi\ufb01ed that a reasonably possible increase of 250 bps in the pre-tax discount rate, would result in
\nthe elimination of headroom.
\nA long-term growth rate of 2.0% has been applied to cash \ufb02ows beyond 2027 based on long term view of
\nin\ufb02ation and market conditions. Capital maintenance spend is based on historic run rates and our expectation
\nof the group\u2019s requirements. The sensitivity testing identi\ufb01ed no reasonably possible changes in the capital
\nmaintenance and long term growth rates that would cause the carrying amount of any CGU to exceed its
\nrecoverable amount.
\nAs a result, management believe that some of the key impairment review assumptions constitute a major
\nsource of estimation uncertainty as they consider that there is a signi\ufb01cant risk of a material change to its
\nestimate of these assumptions within the next 12 months. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfIntangibleAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22134": {
"value": "15. Financial assets On 31 October 2019, the group entered into a pro\ufb01t share arrangement with Genesis Care. The agreement
\nprovides the group with an entitlement to a gross pro\ufb01t share relating to the chemotherapy business
\ntransferred to Genesis Care as part of the sale of the Bristol Cancer Centre in perpetuity.
\nThe group has recognised a \ufb01nancial asset in respect of this gross pro\ufb01t share and the asset is classed as a fair
\nvalue through pro\ufb01t and loss asset. The \ufb01nancial asset is valued using forward looking information to establish
\ncash \ufb02ows and is discounted back to net present value. This valuation is reviewed at each reporting date,
\nwith movements in fair value being recognised through the consolidated income statement. Cash received
\nis adjusted against the \ufb01nancial asset, and is included within cash \ufb02ows from investing activities on the
\nconsolidated statement of cash \ufb02ows.
\n(\u00a3m)
2022
2021
\nValuation at 1 January
2.3
1.6
\nRealised
(0.7)
(0.4)
\nUnrealised fair value adjustments
3.0
1.1
\nCarrying amount at 31 December (Note 30)
4.6
2.3
\nManagement completes relevant sensitivities on the inputs when assessing the fair value.
\nWith all other inputs remaining constant:
\n\u2013
A 1.2% increase (decrease) in the discount rate used, would see a decrease (increase) in fair value of \u00a30.6
\nmillion (\u00a30.3 million) (2021: 1.3% increase (decrease) \u00a30.3 million (\u00a30.4 million))
\n\u2013
A 20% increase (decrease) in the forecast annual cash \ufb02ow of \u00a30.14 million (2021: \u00a30.36 million), would see
\nan increase (decrease) in fair value of \u00a30.6 million (\u00a31.1 million) (2021: \u00a30.4 million (\u00a30.4 million)) ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfFinancialAssetsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22170": {
"value": "16. Subsidiary undertakings and non-controlling interest As at 31 December 2022, these consolidated \ufb01nancial statements of the group comprise the company and the
\nfollowing companies, most of which are incorporated in, and whose operations are conducted in, the United
\nKingdom. All subsidiaries are 100% owned unless otherwise indicated.
\nIncorporated in England and Wales and registered at 3 Dorset Rise, London, EC4Y 8EN,
\nunless otherwise stated
Principal activity
Class of share
\nClaremont Hospital Holdings Limited
Holding company
Ordinary
\nClaremont Hospital LLP
\n!^
\nHealth provision
N/A
\nClassic Hospitals Group Limited
\n#
\nHolding company
Ordinary
\nClassic Hospitals Limited
\n#
\nNon-trading company
Ordinary
\nClassic Hospitals Property Limited
Property company
Ordinary
\nDidsbury MSK Limited\u00b0
Health provision
Ordinary
\nFox Healthcare Acquisitions Limited
Leasing company
Ordinary
\nFox Healthcare Holdco 2 Limited
\n#
\nHolding company
Ordinary
\nLifescan Limited
\n#
\nNon-trading company
Ordinary
\nMaitland Medical Service Limited
Health provision
Ordinary
\nMedicainsure Limited
Non-trading company
Ordinary
\nMontefiore House Limited
\n+
\nHealth provision
Ordinary
\nSHC Holdings Limited
\n#
\nHolding company
Ordinary
\nSoma Health Limited
Health provision
Ordinary
\nSpire Cambridge (Disposal) Limited
\n#
\nNon-trading company
Ordinary
\nSpire Fertility (Disposal) Limited
\n#
\nNon-trading company
Ordinary
\nSpire Healthcare (Holdings) Limited
Holding company
Ordinary
\nSpire Healthcare Finance Limited*
Holding company
Ordinary
\nSpire Healthcare Group UK Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 1
\n&#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 2 Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 3 Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Limited
Health provision
Ordinary
\nSpire Healthcare Properties Limited
Property company
Ordinary
\nSpire Healthcare Property Developments Limited
Development company
Ordinary
\nSpire Property 1 Limited
Property company
Ordinary
\nSpire Property 4 Limited
Property company
Ordinary
\nSpire Property 5 Limited
Property company
Ordinary
\nSpire Property 6 Limited
Property company
Ordinary
\nSpire Property 13 Limited
Property company
Ordinary
\nSpire Property 16 Limited
Property company
Ordinary
\nSpire Property 18 Limited
Property company
Ordinary
\nSpire Property 19 Limited
Property company
Ordinary
\nSpire Property 23 Limited
Property company
Ordinary
\nSpire Thames Valley Hospital Limited
\n#
\nNon-trading company
Ordinary
\nSpire Thames Valley Hospital Propco Limited
Property company
Ordinary
\nSpire UK Holdco 2A Limited
\n#
\nHolding company
Ordinary
\nSpire UK Holdco 4 Limited
Holding company
Ordinary
\nThe Doctors Clinic Group Ltd
Holding company and
\nhealth provision
\nOrdinary
\nThe London Doctors Clinic Ltd
Non-trading company
Ordinary
\n\u00b0
Ownership interest is 51.0%.
\n+
Ownership interest is 50.1%.
\n*
Direct shareholding of the company.
\n&
Spire Healthcare Holdings 1 is an undertaking with unlimited liability.
\n!
The LLP has \u2018Members\u2019 capital classi\ufb01ed as equity\u2019 in lieu of \u2018Class of shares\u2019.
\n#
In liquidation and expected to be dissolved during 2023.
\n
\n\n
\n
\n\nIn the prior year, in order to simplify the structure of the group and reduce costs, the group undertook a
\nprocess in which a number of companies within the group were identi\ufb01ed for members\u2019 voluntary liquidation.
\nThe entities in members\u2019 voluntary liquidation at year end are shown above and they are expected to be
\nformally dissolved at Companies House during 2023.
\nNon-controlling interest
\nFinancial information of subsidiaries that have a material non-controlling interest is provided below. The
\nentities, as set out above, are Monte\ufb01ore House Limited, Didsbury MSK Limited and Claremont Hospital LLP.
\nOn the initial acquisition of Claremont Hospital LLP on 30 November 2021, the group owned c 88%. Following
\nthe exercise of a put option during the period, Spire Healthcare acquired the remaining interest in the LLP on
\n31 March 2022, and now owns 100% of this entity. The accumulated interest relating to Claremont has
\ntherefore been reclassi\ufb01ed to retained earnings.
\nAccumulated balances of material non-controlling interest:
\n(\u00a3m)
2022
2021
\nProfit/(loss) allocated to material non-controlling interests:
\nMontefiore House Limited
(0.8)
0.3
\nDidsbury MSK Limited
0.4
0.5
\nClaremont Hospital LLP
\u2013
\u2013
\nAccumulated balances of material non-controlling interest:
\nMontefiore House Limited
(6.4)
(5.6)
\nDidsbury MSK Limited
0.5
0.3
\nClaremont Hospital LLP
\u2013
0.5
\nWithin the entities, the most material assets and liabilities relate to right of use assets and lease liabilities in
\nrespect of property. Except for the lease rental payments, the majority of cash \ufb02ows are generated through
\noperations.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfNoncontrollingInterestsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22171": {
"value": "16. Subsidiary undertakings and non-controlling interest As at 31 December 2022, these consolidated \ufb01nancial statements of the group comprise the company and the
\nfollowing companies, most of which are incorporated in, and whose operations are conducted in, the United
\nKingdom. All subsidiaries are 100% owned unless otherwise indicated.
\nIncorporated in England and Wales and registered at 3 Dorset Rise, London, EC4Y 8EN,
\nunless otherwise stated
Principal activity
Class of share
\nClaremont Hospital Holdings Limited
Holding company
Ordinary
\nClaremont Hospital LLP
\n!^
\nHealth provision
N/A
\nClassic Hospitals Group Limited
\n#
\nHolding company
Ordinary
\nClassic Hospitals Limited
\n#
\nNon-trading company
Ordinary
\nClassic Hospitals Property Limited
Property company
Ordinary
\nDidsbury MSK Limited\u00b0
Health provision
Ordinary
\nFox Healthcare Acquisitions Limited
Leasing company
Ordinary
\nFox Healthcare Holdco 2 Limited
\n#
\nHolding company
Ordinary
\nLifescan Limited
\n#
\nNon-trading company
Ordinary
\nMaitland Medical Service Limited
Health provision
Ordinary
\nMedicainsure Limited
Non-trading company
Ordinary
\nMontefiore House Limited
\n+
\nHealth provision
Ordinary
\nSHC Holdings Limited
\n#
\nHolding company
Ordinary
\nSoma Health Limited
Health provision
Ordinary
\nSpire Cambridge (Disposal) Limited
\n#
\nNon-trading company
Ordinary
\nSpire Fertility (Disposal) Limited
\n#
\nNon-trading company
Ordinary
\nSpire Healthcare (Holdings) Limited
Holding company
Ordinary
\nSpire Healthcare Finance Limited*
Holding company
Ordinary
\nSpire Healthcare Group UK Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 1
\n&#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 2 Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Holdings 3 Limited
\n#
\nHolding company
Ordinary
\nSpire Healthcare Limited
Health provision
Ordinary
\nSpire Healthcare Properties Limited
Property company
Ordinary
\nSpire Healthcare Property Developments Limited
Development company
Ordinary
\nSpire Property 1 Limited
Property company
Ordinary
\nSpire Property 4 Limited
Property company
Ordinary
\nSpire Property 5 Limited
Property company
Ordinary
\nSpire Property 6 Limited
Property company
Ordinary
\nSpire Property 13 Limited
Property company
Ordinary
\nSpire Property 16 Limited
Property company
Ordinary
\nSpire Property 18 Limited
Property company
Ordinary
\nSpire Property 19 Limited
Property company
Ordinary
\nSpire Property 23 Limited
Property company
Ordinary
\nSpire Thames Valley Hospital Limited
\n#
\nNon-trading company
Ordinary
\nSpire Thames Valley Hospital Propco Limited
Property company
Ordinary
\nSpire UK Holdco 2A Limited
\n#
\nHolding company
Ordinary
\nSpire UK Holdco 4 Limited
Holding company
Ordinary
\nThe Doctors Clinic Group Ltd
Holding company and
\nhealth provision
\nOrdinary
\nThe London Doctors Clinic Ltd
Non-trading company
Ordinary
\n\u00b0
Ownership interest is 51.0%.
\n+
Ownership interest is 50.1%.
\n*
Direct shareholding of the company.
\n&
Spire Healthcare Holdings 1 is an undertaking with unlimited liability.
\n!
The LLP has \u2018Members\u2019 capital classi\ufb01ed as equity\u2019 in lieu of \u2018Class of shares\u2019.
\n#
In liquidation and expected to be dissolved during 2023.
\n
\n\n
\n
\n\nIn the prior year, in order to simplify the structure of the group and reduce costs, the group undertook a
\nprocess in which a number of companies within the group were identi\ufb01ed for members\u2019 voluntary liquidation.
\nThe entities in members\u2019 voluntary liquidation at year end are shown above and they are expected to be
\nformally dissolved at Companies House during 2023.
\nNon-controlling interest
\nFinancial information of subsidiaries that have a material non-controlling interest is provided below. The
\nentities, as set out above, are Monte\ufb01ore House Limited, Didsbury MSK Limited and Claremont Hospital LLP.
\nOn the initial acquisition of Claremont Hospital LLP on 30 November 2021, the group owned c 88%. Following
\nthe exercise of a put option during the period, Spire Healthcare acquired the remaining interest in the LLP on
\n31 March 2022, and now owns 100% of this entity. The accumulated interest relating to Claremont has
\ntherefore been reclassi\ufb01ed to retained earnings.
\nAccumulated balances of material non-controlling interest:
\n(\u00a3m)
2022
2021
\nProfit/(loss) allocated to material non-controlling interests:
\nMontefiore House Limited
(0.8)
0.3
\nDidsbury MSK Limited
0.4
0.5
\nClaremont Hospital LLP
\u2013
\u2013
\nAccumulated balances of material non-controlling interest:
\nMontefiore House Limited
(6.4)
(5.6)
\nDidsbury MSK Limited
0.5
0.3
\nClaremont Hospital LLP
\u2013
0.5
\nWithin the entities, the most material assets and liabilities relate to right of use assets and lease liabilities in
\nrespect of property. Except for the lease rental payments, the majority of cash \ufb02ows are generated through
\noperations.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfSignificantInvestmentsInSubsidiariesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22416": {
"value": "17. Inventories (\u00a3m)
2022
2021
\nProstheses, drugs, medical and other consumables
40.6
40.2
\nCost of sales for the year ended 31 December 2022 includes inventories recognised as an expense amounting
\nto \u00a3244.0 million (2021: \u00a3216.1 million).",
"dimensions": {
"concept": "ifrs-full:DisclosureOfInventoriesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22428": {
"value": "18. Trade and other receivables (\u00a3m)
2022
2021
\nAmounts falling due within one year:
\nTrade receivables
59.8
54.7
\nUnbilled receivables
18.2
12.3
\nPrepayments
15.7
18.4
\nOther receivables
11.8
17.9
\n105.5
103.3
\nAllowance for expected credit losses
(5.0)
(4.1)
\nTotal current trade and other receivables
100.5
99.2
\nUnbilled receivables re\ufb02ects work in progress where a patient had treatment, or was receiving treatment, at
\nthe end of the period and the invoice had not yet been raised.
\nOther receivables includes the \u00a35.4 million insurance reimbursement right (2021: \u00a37.4 million); as well as
\n\u00a32.6 million (2021: \u00a37.9 million) reimbursement right related to the new Paterson fund, which is being held
\nby solicitors on account until payments are made, with any amount not paid out being returned to Spire
\nHealthcare. During the year, \u00a35.3 million was paid out of this fund. The amounts paid to the new Paterson
\nfund do not re\ufb02ect an investment in a \ufb01nancial asset, but merely a right to reimbursement should the fund
\nnot be utilised in full.
\nIn the prior year, as well as the \u00a37.4 million insurance reimbursement right, other receivables includes a
\n\u00a32.2 million receivable from the vendor of Claremont Hospital, which was acquired by the group during the
\nyear, and is the difference between the original estimated purchase price of \u00a319.1 million and the \ufb01nal agreed
\npurchase price of \u00a316.9 million.
\nTrade and other receivables of \u00a31.5 million have been recognised on the acquisition of The Doctors Clinic Group
\nduring the year (Note 32).
\nTrade receivables comprise amounts due from private medical insurers, the NHS, self-pay patients, consultants
\nand other third parties who use the group\u2019s facilities. Invoices to customers fall due within 60 days of the date
\nof issue.
\nThe group was successful in its bid to be included on the NHSE Framework for purchasing additional activity
\nfrom the independent sector, which commenced in April 2021. Inclusion on the Framework is at an agreed
\nprice for activity, based on the NHS tariff, but carries no guaranteed volumes. For contracts under the
\nframework that include an estimated contract value, billing is in advance for the expected volume, with a
\nquarterly true-up for actual volumes undertaken. For contracts under the framework without an estimated
\ncontract value (which can include local agreements), billing is in arrears based on actual volumes only.
\nThe ageing of trade receivables is shown below and shows amounts that are past due at the reporting date
\n(excluding payments on account where there is no right to offset these at the reporting date). A provision for
\nexpected credit losses has been recognised at the reporting date through consideration of the ageing pro\ufb01le
\nof the group\u2019s trade receivables and the perceived credit quality of its customers re\ufb02ecting net debt due. The
\ncarrying amount of trade receivables, net of expected credit losses, is considered to be an approximation to
\nits fair value.
\n
\n\n
\n
\n\nThe loss allowance as at 31 December 2022 for trade receivables was determined as follows:
\nCurrent
0-30 days
31-90 days
91-364 days
1-2 years
Total
\nExpected loss rate
0.0%
1.8%
8.3%
29.2%
17.5%
7.2%
\nGross debt (\u00a3m)
27.8
16.8
8.4
8.9
8.0
69.9
\nLess payments on account (\u00a3m)
(10.1)
\nCarrying amount of trade receivables (\u00a3m)
59.8
\nLoss allowance (\u00a3m)
\u2013
0.3
0.7
2.6
1.4
5.0
\nThe loss allowance as at 31 December 2021 for trade receivables was determined as follows:
\nCurrent
0-30 days
31-90 days
91-364 days
1-2 years
Total
\nExpected loss rate
0.7%
2.2%
5.1%
19.5%
23.6%
5.5%
\nGross debt (\u00a3m)
27.1
22.9
13.7
7.7
5.5
76.9
\nLess payments on account (\u00a3m)
(22.2)
\nCarrying amount of trade receivables (\u00a3m)
54.7
\nLoss allowance (\u00a3m)
0.2
0.5
0.7
1.5
1.2
4.1
\nTrade receivables are written off when there is no longer a reasonable expectation of recovery. Indicators that
\nthere is no reasonable expectation of recovery include, amongst others, the failure of a debtor to engage in a
\nrepayment plan with the group, and failure to make contractual payments for a period of greater than two
\nyears past due.
\nThe group assesses on a forward looking basis expected credit losses associated with its debt instruments
\ncarried at amortised cost. The impairment methodology applied for trade receivables is the simpli\ufb01ed
\napproach, which requires expected lifetime losses to be recognised from initial recognition of the trade
\nreceivables.
\nTrade receivables after expected credit losses comprise the following wider customer/payor groups:
\n(\u00a3m)
2022
2021
\nPrivate medical insurers
30.4
27.4
\nNHS
8.2
9.2
\nPatient debt
7.2
8.9
\nOther
9.0
5.1
\n54.8
50.6
\nThe movement in the allowance for impairment in respect of trade receivables during the year was as follows:
\n(\u00a3m)
2022
2021
\nAt 1 January
4.1
5.3
\nProvided in the year
1.1
\u2013
\nUtilised during the year
(0.2)
(0.2)
\nReleased during the year
\u2013
(1.0)
\nAt 31 December
5.0
4.1
\nThe group applies the IFRS 9 simpli\ufb01ed approach to measuring Expected Credit Losses (ECLs) for trade
\nreceivables. Under this standard, lifetime ECL provisions are recognised for trade receivables using a matrix
\nof rates dependant on age thresholds and customer types. The ECL rates are determined with reference to
\nhistorical performance of each payor age group during the last two years.
\nTo develop the ECL matrix, trade receivables were grouped according to shared characteristics (payor/payor
\ntype) and the days past due. As the majority of the group\u2019s debt is receivable from large, well-funded insurance
\ncompanies, the National Health Service or from a large number of individuals, the group has concluded that
\nhistorical debt performance of the portfolio during the last two reporting periods provides a reasonable
\napproximation of the future expected loss rates for each payor age category.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfTradeAndOtherReceivablesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22645": {
"value": "19. Cash and cash equivalents (\u00a3m)
2022
2021
\nCash at bank
67.1
165.5
\nShort-term deposits
7.1
37.1
\n74.2
202.6
\nCash and cash equivalents comprise cash balances, short-term deposits and other short-term highly liquid
\ninvestments (including money market funds) with maturities not exceeding three months placed with
\ninvestment grade counterparties which are subject to an insigni\ufb01cant risk of change in value.
\nCash and cash equivalents of \u00a30.3 million has been added on the acquisition of The Doctors Clinic Group during
\nthe year (Note 32). ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfCashAndCashEquivalentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22665": {
"value": "20. Non-current assets held for sale During the year the group completed the sale of its Spire St Saviours property and received proceeds of
\n\u00a33.2 million. In June 2022 an impairment of \u00a30.5 million was recognised on the property, as the sales price less
\ncosts to sell on the property was lower than the carrying value. No impairment was recognised in the prior year
\n(see Note 10).
\nAs at 31 December 2022 the group\u2019s management have committed to sell a parcel of land at Bostocks Lane as
\nthe group has accepted an offer on the property. The sale is considered highly probable and the assessment
\nhas not changed. It therefore remains as classi\ufb01ed as held for sale.
\n(\u00a3m)
2022
2021
\nSpire St Saviours Hospital property
\u2013
3.7
\nBostocks Lane (East Midlands Cancer Centre)
1.1
1.1
\n1.1
4.8",
"dimensions": {
"concept": "ifrs-full:DisclosureOfNoncurrentAssetsHeldForSaleAndDiscontinuedOperationsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22721": {
"value": "21. Share capital and reserves 2022
2021
\nAuthorised shares
\nOrdinary share of \u00a30.01 each
404,108,470
401,104,036
\n404,108,470
401,104,036
\n\u00a30.01 ordinary shares
\nShares
\u00a3\u2019000
\nIssued and fully paid
\nAt 31 December 2022
404,108,470
4,041
\nAt 31 December 2021
401,104,036
4,010
\nDuring the year, the authorised share capital was increased by \u00a331,000 by the issue of 3,004,434 ordinary
\nshares of \u00a30.01 each.
\nShare premium
\nShare premium
2022
2021
\nAt 1 January
826.9
826.9
\nIssue of new shares
3.1
\u2013
\nAt 31 December
830.0
826.9
\nDuring the year the group issued 3,004,434 shares to settle share awards of which 2,916,000 shares were
\nexercised under the save as you earn 2019 scheme at an exercise price of \u00a31.09 per share. The proceeds from
\nthe issue of shares were \u00a33.1 million.
\nCapital reserves
\nThis reserve represents the loans of \u00a3376.1 million due to the former ultimate parent undertaking and
\nmanagement that were forgiven by those counterparties as part of the reorganisation of the group prior to
\nthe IPO in 2014.
\nEBT share reserves
\nEquiniti Trust (Jersey) Limited is acting in its capacity as trustee of the company\u2019s Employee Bene\ufb01t Trust (\u2018EBT\u2019).
\nThe purpose of the EBT is to further the interests of the company by bene\ufb01ting employees and former
\nemployees of the group and certain of their dependants. The EBT is treated as an extension of the group
\nand the company.
\nDuring the year, the EBT purchased 88,354 shares and exercised 300,491 (2021: nil shares acquired and nil
\nexercised) in order to settle share awards in relation to the directors\u2019 share bonus award and Long-Term
\nIncentive Plan.
\nWhere the EBT purchases the company\u2019s equity share capital the consideration paid, including any directly
\nattributable incremental costs, is deducted from equity attributable to the company\u2019s equity holders until the
\nshares are cancelled or reissued. As at 31 December 2022, 27,146 shares (2021: 239,283) were held by the EBT in
\nrelation to the directors\u2019 share bonus award and Long-Term Incentive Plan. The EBT share reserve represents the
\nconsideration paid when the EBT purchases the company\u2019s equity share capital, until the shares are reissued.
\n(Number of shares)
2022
2021
\n(\u00a3m)
(Number of shares)
(\u00a3m)
(Number of shares)
\nAt 1 January
0.8
239,283
0.8
239,283
\nPurchased
\u2013
88,354
\u2013
\u2013
\nExercised
(0.8)
(300,491)
\u2013
\u2013
\nAt 31 December
\u2013
27,146
0.8
239,283
\nHedging reserve
\nThe balance of \u00a36.6 million at 31 December 2022 (2021: (\u00a30.5 million)) re\ufb02ects the \u00a31.2 million (2021: \u00a32.5 million)
\nrecycled in the period, the fair value credit of \u00a38.1 million (2021: \u00a30.8 million credit) and the \u00a32.2 million tax charge
\non the pro\ufb01t (2021: \u00a30.6 million tax charge on the pro\ufb01t) to give a net movement of an increase of \u00a37.1 million
\nduring the year (2021: a decrease of \u00a32.7 million) on a hedged transaction. See note 22 for further information.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfReservesAndOtherEquityInterestExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22722": {
"value": "21. Share capital and reserves 2022
2021
\nAuthorised shares
\nOrdinary share of \u00a30.01 each
404,108,470
401,104,036
\n404,108,470
401,104,036
\n\u00a30.01 ordinary shares
\nShares
\u00a3\u2019000
\nIssued and fully paid
\nAt 31 December 2022
404,108,470
4,041
\nAt 31 December 2021
401,104,036
4,010
\nDuring the year, the authorised share capital was increased by \u00a331,000 by the issue of 3,004,434 ordinary
\nshares of \u00a30.01 each.
\nShare premium
\nShare premium
2022
2021
\nAt 1 January
826.9
826.9
\nIssue of new shares
3.1
\u2013
\nAt 31 December
830.0
826.9
\nDuring the year the group issued 3,004,434 shares to settle share awards of which 2,916,000 shares were
\nexercised under the save as you earn 2019 scheme at an exercise price of \u00a31.09 per share. The proceeds from
\nthe issue of shares were \u00a33.1 million.
\nCapital reserves
\nThis reserve represents the loans of \u00a3376.1 million due to the former ultimate parent undertaking and
\nmanagement that were forgiven by those counterparties as part of the reorganisation of the group prior to
\nthe IPO in 2014.
\nEBT share reserves
\nEquiniti Trust (Jersey) Limited is acting in its capacity as trustee of the company\u2019s Employee Bene\ufb01t Trust (\u2018EBT\u2019).
\nThe purpose of the EBT is to further the interests of the company by bene\ufb01ting employees and former
\nemployees of the group and certain of their dependants. The EBT is treated as an extension of the group
\nand the company.
\nDuring the year, the EBT purchased 88,354 shares and exercised 300,491 (2021: nil shares acquired and nil
\nexercised) in order to settle share awards in relation to the directors\u2019 share bonus award and Long-Term
\nIncentive Plan.
\nWhere the EBT purchases the company\u2019s equity share capital the consideration paid, including any directly
\nattributable incremental costs, is deducted from equity attributable to the company\u2019s equity holders until the
\nshares are cancelled or reissued. As at 31 December 2022, 27,146 shares (2021: 239,283) were held by the EBT in
\nrelation to the directors\u2019 share bonus award and Long-Term Incentive Plan. The EBT share reserve represents the
\nconsideration paid when the EBT purchases the company\u2019s equity share capital, until the shares are reissued.
\n(Number of shares)
2022
2021
\n(\u00a3m)
(Number of shares)
(\u00a3m)
(Number of shares)
\nAt 1 January
0.8
239,283
0.8
239,283
\nPurchased
\u2013
88,354
\u2013
\u2013
\nExercised
(0.8)
(300,491)
\u2013
\u2013
\nAt 31 December
\u2013
27,146
0.8
239,283
\nHedging reserve
\nThe balance of \u00a36.6 million at 31 December 2022 (2021: (\u00a30.5 million)) re\ufb02ects the \u00a31.2 million (2021: \u00a32.5 million)
\nrecycled in the period, the fair value credit of \u00a38.1 million (2021: \u00a30.8 million credit) and the \u00a32.2 million tax charge
\non the pro\ufb01t (2021: \u00a30.6 million tax charge on the pro\ufb01t) to give a net movement of an increase of \u00a37.1 million
\nduring the year (2021: a decrease of \u00a32.7 million) on a hedged transaction. See note 22 for further information.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfIssuedCapitalExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22723": {
"value": "21. Share capital and reserves 2022
2021
\nAuthorised shares
\nOrdinary share of \u00a30.01 each
404,108,470
401,104,036
\n404,108,470
401,104,036
\n\u00a30.01 ordinary shares
\nShares
\u00a3\u2019000
\nIssued and fully paid
\nAt 31 December 2022
404,108,470
4,041
\nAt 31 December 2021
401,104,036
4,010
\nDuring the year, the authorised share capital was increased by \u00a331,000 by the issue of 3,004,434 ordinary
\nshares of \u00a30.01 each.
\nShare premium
\nShare premium
2022
2021
\nAt 1 January
826.9
826.9
\nIssue of new shares
3.1
\u2013
\nAt 31 December
830.0
826.9
\nDuring the year the group issued 3,004,434 shares to settle share awards of which 2,916,000 shares were
\nexercised under the save as you earn 2019 scheme at an exercise price of \u00a31.09 per share. The proceeds from
\nthe issue of shares were \u00a33.1 million.
\nCapital reserves
\nThis reserve represents the loans of \u00a3376.1 million due to the former ultimate parent undertaking and
\nmanagement that were forgiven by those counterparties as part of the reorganisation of the group prior to
\nthe IPO in 2014.
\nEBT share reserves
\nEquiniti Trust (Jersey) Limited is acting in its capacity as trustee of the company\u2019s Employee Bene\ufb01t Trust (\u2018EBT\u2019).
\nThe purpose of the EBT is to further the interests of the company by bene\ufb01ting employees and former
\nemployees of the group and certain of their dependants. The EBT is treated as an extension of the group
\nand the company.
\nDuring the year, the EBT purchased 88,354 shares and exercised 300,491 (2021: nil shares acquired and nil
\nexercised) in order to settle share awards in relation to the directors\u2019 share bonus award and Long-Term
\nIncentive Plan.
\nWhere the EBT purchases the company\u2019s equity share capital the consideration paid, including any directly
\nattributable incremental costs, is deducted from equity attributable to the company\u2019s equity holders until the
\nshares are cancelled or reissued. As at 31 December 2022, 27,146 shares (2021: 239,283) were held by the EBT in
\nrelation to the directors\u2019 share bonus award and Long-Term Incentive Plan. The EBT share reserve represents the
\nconsideration paid when the EBT purchases the company\u2019s equity share capital, until the shares are reissued.
\n(Number of shares)
2022
2021
\n(\u00a3m)
(Number of shares)
(\u00a3m)
(Number of shares)
\nAt 1 January
0.8
239,283
0.8
239,283
\nPurchased
\u2013
88,354
\u2013
\u2013
\nExercised
(0.8)
(300,491)
\u2013
\u2013
\nAt 31 December
\u2013
27,146
0.8
239,283
\nHedging reserve
\nThe balance of \u00a36.6 million at 31 December 2022 (2021: (\u00a30.5 million)) re\ufb02ects the \u00a31.2 million (2021: \u00a32.5 million)
\nrecycled in the period, the fair value credit of \u00a38.1 million (2021: \u00a30.8 million credit) and the \u00a32.2 million tax charge
\non the pro\ufb01t (2021: \u00a30.6 million tax charge on the pro\ufb01t) to give a net movement of an increase of \u00a37.1 million
\nduring the year (2021: a decrease of \u00a32.7 million) on a hedged transaction. See note 22 for further information.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfShareCapitalReservesAndOtherEquityInterestExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22816": {
"value": "22. Borrowings The group has borrowings in two forms, bank borrowings and lease liabilities as disclosed on the consolidated
\nbalance sheet. Total borrowings at 31 December 2022 were \u00a31,190.8 million (2021: \u00a31,265.3 million). More
\ndetail in respect of these two forms of borrowings are set out below.
\nBank borrowings
\nThe bank loans are secured on \ufb01xed and \ufb02oating charges over both the present and future assets of material
\nsubsidiaries of the group. On 24 February 2022, the group successfully re\ufb01nanced its debt facilities with a
\nsyndicate of existing and new lenders. As part of the exercise and in recognition of the fact that the group
\nhad substantial cash reserves at 31 December 2021, the group repaid \u00a3100.0 million of the Senior Loan Facility.
\nThe new arrangement has a maturity of four years. The \ufb01nancial covenants relating to this new agreement
\nare materially unchanged. The loan is non-amortising and carries interest at a margin of 2.05% over SONIA
\n(2021: 2.25% over LIBOR).
\nFor accounting purposes the loan and associated deferred and amortised fees have been treated as an
\nextinguishment under IFRS 9, as a result \u00a33.1 million has been recognised within \ufb01nance costs in the
\nincome statement.
\n(\u00a3m)
2022
2021
\nAmount due for settlement within 12 months
2.9
5.7
\nAmount due for settlement after 12 months
321.4
421.8
\nTotal bank borrowings
324.3
427.5
\nTerms and debt repayment schedule
\nThe maturity date is the date on which the relevant bank loans are due to be fully repaid.
\n
\n\n
\n
\n\n\nThe carrying amounts drawn (after issue costs and including interest accrued) under facilities in place at the
\nbalance sheet date were as follows:
\n(\u00a3m)
Maturity
Margin over SONIA
2022
2021
\nSenior finance facility
\n(1)
\nFebruary 2026
2.05%
324.3
\u2013
\nSenior finance facility
\n(1)
\nJuly 2023
2.25%
\n(2)
\n\u2013
428.2
\n1.
In the prior period the difference between the carrying amount of the facility and the value of the debt repayment schedule is
\na modi\ufb01cation fee on the loan extension and is deferred and amortised in accordance with IFRS 9 loan modi\ufb01cation accounting.
\nOn re\ufb01nancing in the current period, these amounts have been accelerated and recognised in the Income Statement as a result
\nof the re\ufb01nancing being treated as an extinguishment for accounting purposes.
\n2.
Margin over LIBOR.
\nNet debt for the purposes of the covenant test in respect of the Senior Loan Facility was \u00a3250.8 million
\n(December 2021: \u00a3222.4 million) and the net debt to EBITDA ratio was 2.2x (December 2021: 2.3x). The net
\ndebt for covenant purposes comprises the senior facility of \u00a3325.0 million less cash and cash equivalents of
\n\u00a374.2 million. EBITDA for covenant purposes comprises Adjusted EBITDA for Last Twelve Months (LTM) of
\npre-IFRS 16 Adjusted EBITDA of \u00a3123.9 million (December 2021: 106.0 million) less the rental of a \ufb01nance lease
\npre-IFRS 16 of \u00a39.5 million (2021: \u00a39.1 million).
\nThe interest cover for covenant purposes was 8.5x (2021: 4.5x 2020: 4.0x, 2019 4.8x) and is calculated as the
\npre-IFRS 16 EBITDA described above over pre-IFRS 16 \ufb01nance costs paid.
\nThe new facilities include a sustainability-linked element connected to environmental and quality factors.
\nThe group also has access to a further \u00a3100.0 million through a committed and undrawn revolving credit
\nfacility to February 2026.
\nLease liabilities
\nObligations under \ufb01nance leases
\nThe group has \ufb01nance in respect of hospital properties, vehicles, of\ufb01ce and medical equipment. The leases
\nare secured on \ufb01xed and \ufb02oating charges over both the present and future assets of material subsidiaries in
\nthe group. Leases, with a present value liability of \u00a3866.5 million (2021: \u00a3837.8 million), expire in various years
\nto 2046 and carry incremental borrowing rates in the range 3.1\u201314.6% (2021: 3.1\u201314.6%). Rent in respect of
\nhospital property leases are reviewed annually with reference to RPI or CPI, subject to assorted \ufb02oors and caps.
\nThe discount rates used are calculated on a lease by lease basis, and are based on estimates of incremental
\nborrowing rates. A movement in the incremental borrowing rate of 1% would result is an 8% movement in
\nlease liability.
\nIn the year, the group recognised charges of \u00a313.6 million (2021: \u00a312.3 million) of lease expenses relating to
\nshort term and low value leases for which the exemption under IFRS 16 has been taken. Cash out\ufb02ows in
\nrespect of these are materially in line with the expense recognised, resulting in a total cash out\ufb02ow of \u00a3105.6
\nmillion (2021: \u00a338.3 million). The group has not made any variable lease payments in the year. The group is not
\na lessor for any leases to external parties. There has been no (2021: one) sale and leaseback transaction in this
\nperiod. Where new leases have the right to extend and management is not reasonably certain to exercise the
\nextension option, those future cash \ufb02ows are not re\ufb02ected in the above. The new leases do not include any
\nrestrictions or covenants.
\nSome leases receive RPI increases on an annual basis which affects both the cash \ufb02ow and interest charged on
\nthose leases. Except for this increase, cash \ufb02ows and charges are expected to remain in line with current year.
\nThe cash \ufb02ows above do not re\ufb02ect any termination or extension options as management is reasonably certain
\nthat the options will not be exercised. There are no signi\ufb01cant restrictions or covenants which impact the cash
\n\ufb02ows in respect of these leases.
\nSee note 13 for more detail on the depreciation of the Right of Use (ROU) assets and note 8 for more detail on
\nthe interest expense relating to leases.
\nChanges in bank borrowings and lease liabilities arising from \ufb01nancing activities
\n(\u00a3m)
1 January
Cash flows
\nNon cash
\nchanges
\n1
\nAdditions
\n3
\n31 December
\n2022
\nBank loans
427.5
(121.1)
17.9
\u2013
324.3
\nLease liabilities
837.8
(93.7)
73.5
48.9
866.5
\nTotal
1,265.3
(214.8)
91.4
48.9
1,190.8
\n(\u00a3m)
1 January
Cash flows
\nNon cash
\nchanges
\n1
\nLoan
\nmodification
\n2
\nAdditions
\n3
\nDisposals
31 December
\n2021
\nBank loans
420.8
(13.2)
18.8
1.1
\u2013
\u2013
427.5
\nLease liabilities
749.5
(26.0)
67.7
\u2013
48.4
(1.8)
837.8
\nTotal
1,170.3
(39.2)
86.5
1.1
48.4
(1.8)
1,265.3
\n1.
Non-cash changes re\ufb02ect interest charged on the loan.
\n2.
The loan modi\ufb01cation relates to the fees incurred on the loan extensions, which are amortised in accordance with IFRS 9.
\n3.
Additions include both new leases entered into, indexation of existing leases, sale and leaseback transactions and acquisitions
\nof subsidiaries.
\nDerivatives
\nThe following derivatives were in place at 31 December:
\nInterest rate
Maturity date
Notional amount
\nCarrying value
\nliability/(Asset)
\n31 December 2022 (\u00a3m)
\nInterest rate swaps
2.7780%
Feb 2026
243.8
(8.6)
\n31 December 2021 (\u00a3m)
\nInterest rate swaps
1.2168%
July 2022
213.0
0.7
\n(\u00a3m)
2022
2021
\nAmount due for settlement within 12 months
(3.6)
0.7
\nAmount due for settlement after 12 months
(5.0)
\u2013
\nTotal derivatives (asset)/liability
(8.6)
0.7
\nThe interest rate swap from the prior year matured on 22 July 2022. The group entered into new interest
\nrate swaps on the 25 July 2022. The movement in respect of derivatives re\ufb02ects \u00a31.2 million (December 2021:
\n\u00a31.2 million) recycled in the period and a \u00a38.1 million credit (December 2021: \u00a30.4 million credit) in fair value.
\nAll movements are re\ufb02ected within other comprehensive income. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfBorrowingsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22822": {
"value": "Bank borrowings The bank loans are secured on \ufb01xed and \ufb02oating charges over both the present and future assets of material
\nsubsidiaries of the group. On 24 February 2022, the group successfully re\ufb01nanced its debt facilities with a
\nsyndicate of existing and new lenders. As part of the exercise and in recognition of the fact that the group
\nhad substantial cash reserves at 31 December 2021, the group repaid \u00a3100.0 million of the Senior Loan Facility.
\nThe new arrangement has a maturity of four years. The \ufb01nancial covenants relating to this new agreement
\nare materially unchanged. The loan is non-amortising and carries interest at a margin of 2.05% over SONIA
\n(2021: 2.25% over LIBOR).
\nFor accounting purposes the loan and associated deferred and amortised fees have been treated as an
\nextinguishment under IFRS 9, as a result \u00a33.1 million has been recognised within \ufb01nance costs in the
\nincome statement.
\n(\u00a3m)
2022
2021
\nAmount due for settlement within 12 months
2.9
5.7
\nAmount due for settlement after 12 months
321.4
421.8
\nTotal bank borrowings
324.3
427.5
\nTerms and debt repayment schedule
\nThe maturity date is the date on which the relevant bank loans are due to be fully repaid.
\n
\n\n
\n
\n\n\nThe carrying amounts drawn (after issue costs and including interest accrued) under facilities in place at the
\nbalance sheet date were as follows:
\n(\u00a3m)
Maturity
Margin over SONIA
2022
2021
\nSenior finance facility
\n(1)
\nFebruary 2026
2.05%
324.3
\u2013
\nSenior finance facility
\n(1)
\nJuly 2023
2.25%
\n(2)
\n\u2013
428.2
\n1.
In the prior period the difference between the carrying amount of the facility and the value of the debt repayment schedule is
\na modi\ufb01cation fee on the loan extension and is deferred and amortised in accordance with IFRS 9 loan modi\ufb01cation accounting.
\nOn re\ufb01nancing in the current period, these amounts have been accelerated and recognised in the Income Statement as a result
\nof the re\ufb01nancing being treated as an extinguishment for accounting purposes.
\n2.
Margin over LIBOR.
\nNet debt for the purposes of the covenant test in respect of the Senior Loan Facility was \u00a3250.8 million
\n(December 2021: \u00a3222.4 million) and the net debt to EBITDA ratio was 2.2x (December 2021: 2.3x). The net
\ndebt for covenant purposes comprises the senior facility of \u00a3325.0 million less cash and cash equivalents of
\n\u00a374.2 million. EBITDA for covenant purposes comprises Adjusted EBITDA for Last Twelve Months (LTM) of
\npre-IFRS 16 Adjusted EBITDA of \u00a3123.9 million (December 2021: 106.0 million) less the rental of a \ufb01nance lease
\npre-IFRS 16 of \u00a39.5 million (2021: \u00a39.1 million).
\nThe interest cover for covenant purposes was 8.5x (2021: 4.5x 2020: 4.0x, 2019 4.8x) and is calculated as the
\npre-IFRS 16 EBITDA described above over pre-IFRS 16 \ufb01nance costs paid.
\nThe new facilities include a sustainability-linked element connected to environmental and quality factors.
\nThe group also has access to a further \u00a3100.0 million through a committed and undrawn revolving credit
\nfacility to February 2026.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfLoansAndAdvancesToBanksExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f22938": {
"value": "Lease liabilities Obligations under \ufb01nance leases
\nThe group has \ufb01nance in respect of hospital properties, vehicles, of\ufb01ce and medical equipment. The leases
\nare secured on \ufb01xed and \ufb02oating charges over both the present and future assets of material subsidiaries in
\nthe group. Leases, with a present value liability of \u00a3866.5 million (2021: \u00a3837.8 million), expire in various years
\nto 2046 and carry incremental borrowing rates in the range 3.1\u201314.6% (2021: 3.1\u201314.6%). Rent in respect of
\nhospital property leases are reviewed annually with reference to RPI or CPI, subject to assorted \ufb02oors and caps.
\nThe discount rates used are calculated on a lease by lease basis, and are based on estimates of incremental
\nborrowing rates. A movement in the incremental borrowing rate of 1% would result is an 8% movement in
\nlease liability.
\nIn the year, the group recognised charges of \u00a313.6 million (2021: \u00a312.3 million) of lease expenses relating to
\nshort term and low value leases for which the exemption under IFRS 16 has been taken. Cash out\ufb02ows in
\nrespect of these are materially in line with the expense recognised, resulting in a total cash out\ufb02ow of \u00a3105.6
\nmillion (2021: \u00a338.3 million). The group has not made any variable lease payments in the year. The group is not
\na lessor for any leases to external parties. There has been no (2021: one) sale and leaseback transaction in this
\nperiod. Where new leases have the right to extend and management is not reasonably certain to exercise the
\nextension option, those future cash \ufb02ows are not re\ufb02ected in the above. The new leases do not include any
\nrestrictions or covenants.
\nSome leases receive RPI increases on an annual basis which affects both the cash \ufb02ow and interest charged on
\nthose leases. Except for this increase, cash \ufb02ows and charges are expected to remain in line with current year.
\nThe cash \ufb02ows above do not re\ufb02ect any termination or extension options as management is reasonably certain
\nthat the options will not be exercised. There are no signi\ufb01cant restrictions or covenants which impact the cash
\n\ufb02ows in respect of these leases.
\nSee note 13 for more detail on the depreciation of the Right of Use (ROU) assets and note 8 for more detail on
\nthe interest expense relating to leases.
\nChanges in bank borrowings and lease liabilities arising from \ufb01nancing activities
\n(\u00a3m)
1 January
Cash flows
\nNon cash
\nchanges
\n1
\nAdditions
\n3
\n31 December
\n2022
\nBank loans
427.5
(121.1)
17.9
\u2013
324.3
\nLease liabilities
837.8
(93.7)
73.5
48.9
866.5
\nTotal
1,265.3
(214.8)
91.4
48.9
1,190.8
\n(\u00a3m)
1 January
Cash flows
\nNon cash
\nchanges
\n1
\nLoan
\nmodification
\n2
\nAdditions
\n3
\nDisposals
31 December
\n2021
\nBank loans
420.8
(13.2)
18.8
1.1
\u2013
\u2013
427.5
\nLease liabilities
749.5
(26.0)
67.7
\u2013
48.4
(1.8)
837.8
\nTotal
1,170.3
(39.2)
86.5
1.1
48.4
(1.8)
1,265.3
\n1.
Non-cash changes re\ufb02ect interest charged on the loan.
\n2.
The loan modi\ufb01cation relates to the fees incurred on the loan extensions, which are amortised in accordance with IFRS 9.
\n3.
Additions include both new leases entered into, indexation of existing leases, sale and leaseback transactions and acquisitions
\nof subsidiaries.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfLeasesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23040": {
"value": "Derivatives The following derivatives were in place at 31 December:
\nInterest rate
Maturity date
Notional amount
\nCarrying value
\nliability/(Asset)
\n31 December 2022 (\u00a3m)
\nInterest rate swaps
2.7780%
Feb 2026
243.8
(8.6)
\n31 December 2021 (\u00a3m)
\nInterest rate swaps
1.2168%
July 2022
213.0
0.7
\n(\u00a3m)
2022
2021
\nAmount due for settlement within 12 months
(3.6)
0.7
\nAmount due for settlement after 12 months
(5.0)
\u2013
\nTotal derivatives (asset)/liability
(8.6)
0.7
\nThe interest rate swap from the prior year matured on 22 July 2022. The group entered into new interest
\nrate swaps on the 25 July 2022. The movement in respect of derivatives re\ufb02ects \u00a31.2 million (December 2021:
\n\u00a31.2 million) recycled in the period and a \u00a38.1 million credit (December 2021: \u00a30.4 million credit) in fair value.
All movements are re\ufb02ected within other comprehensive income.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfDerivativeFinancialInstrumentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23113": {
"value": "23. Deferred tax (\u00a3m)
\nProperty,
\nplant and
\nequipment
\nIFRS 16
\nleases \u2013
\nspreading
IFRS 16
\nShare-
\nbased
\npayments
Losses
\nProvisions
\nand other
\ntemporary
\ndifferences
Total
\nAt 1 January 2021
73.3
(38.3)
25.0
(1.1)
(2.2)
(2.8)
53.9
\n(Credit)/charge to the profit or loss
(12.7)
1.9
(2.6)
\u2013
(1.9)
0.3
(15.0)
\n(Credit)/charge to other
\ncomprehensive income and equity
\u2013
\u2013
\u2013
(3.0)
\u2013
0.6
(2.4)
\nPrior year adjustment
4.1
0.2
(0.8)
\u2013
\u2013
\u2013
3.5
\nChange in tax rates
22.6
(10.8)
7.1
(0.1)
(0.7)
(0.4)
17.7
\nAt 1 January 2022
87.3
(47.0)
28.7
(4.2)
(4.8)
(2.3)
57.7
\n(Credit)/charge to the profit or loss
(7.1)
1.8
2.8
0.1
(0.8)
0.6
(2.6)
\n(Credit)/charge to other
\ncomprehensive income and equity
\u2013
\u2013
\u2013
0.1
\u2013
2.1
2.2
\nAdjustment in respect of prior year
(2.2)
\u2013
1.5
\u2013
(0.6)
0.2
(1.1)
\nAt 31 December 2022
78.0
(45.2)
33.0
(4.0)
(6.2)
0.6
56.2
\nDisclosed within liabilities
78.0
(45.2)
33.0
(4.0)
(6.2)
0.6
56.2
\nDeferred tax on property, plant and equipment has arisen on differences between the carrying value of the
\nrelevant assets and the tax base. Included in this amount is a one off credit to the pro\ufb01t and loss of \u00a39.0 million
\nin respect of the change in useful life and residual value of the freehold properties. The credit arises as a result
\nof the ability to take into account additional tax basis and indexation for future capital disposals when
\ncalculating the deferred tax liability on property.
\nDeferred tax assets and liabilities are measured at the tax rates that are expected to apply in the period when
\nthe asset is realised or the liability settled, based on tax rates that have been enacted, or substantively enacted,
\nat the balance sheet date. The group has separately calculated the tax rates applicable in respect of adjusting
\nitems for the period. The prior year change in tax rates re\ufb02ects the reassessment of deferred tax assets and
\nliabilities to 25% from 19%. Deferred tax in the current period continues to be measured at 25%.
\nDeferred tax assets are recognised on the basis that the deferred tax liabilities represent forecast pro\ufb01ts of the
\nappropriate type (either capital or trading) and therefore represent a suitable taxable pro\ufb01t against which the
\nreversal of the deferred tax assets can be offset. Deferred tax assets and liabilities in relation to property are
\nonly offset to the extent that they relate to the same site.
\nThe group has unrecognised deferred tax assets (which do not expire) as follows:
\n2022
2021
\n(\u00a3m)
Gross
Tax effected
Gross
Tax effected
\nTrading losses
8.0
2.0
9.9
2.5
\nCapital losses
\u2013
\u2013
1.2
0.3
\nTax basis for future capital disposals
11.6
2.9
34.4
8.6
\nTotal
19.6
4.9
45.5
11.4
\nThese amounts are the expected tax value of the gross temporary difference at the enacted long-term tax rate
\nof 25% (2021: 25%) following the substantive enactment of the increased corporation tax rate of 25% effective
\nfrom 1 April 2023. A deferred tax asset has not been recognised in respect of these amounts due to
\nuncertainties as to the timing of future pro\ufb01ts that the trading losses could be offset against and whether
\ncapital gains will arise against which the capital losses and tax basis for capital disposals could be utilised.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfDeferredTaxesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23271": {
"value": "24. Provisions (\u00a3m)
\nMedical
\nmalpractice
\nBusiness
\nrestructuring
\nand other
Total
\nAt 1 January 2022
42.0
2.8
44.8
\nIncrease in existing provisions
7.9
0.5
8.4
\nProvisions utilised
(30.1)
(1.0)
(31.1)
\nProvisions released
(0.4)
\u2013
(0.4)
\nAt 31 December 2022
19.4
2.3
21.7
\nMedical malpractice relates to estimated liabilities arising from claims for damages in respect of services
\npreviously supplied to patients. During the period \u00a36.4 million was added due to additional claims received,
\nand \u00a39.1 million utilised. Amounts are shown gross of insured liabilities. Any such insurance recoveries of
\n\u00a35.4 million (December 2021: \u00a37.4 million) are recognised in other receivables. This drives the majority of the
\nmovement in the medical malpractice provision with the exception of the insurer settlement and the Paterson
\nactions following the Public Inquiry. Following the Court of Appeal judgment in H2 2021, relating to the
\nongoing legal action between the group and its insurer, \ufb01nding in favour of the insurer, Spire Healthcare
\nprovided for \u00a313.0 million in the prior period, and settled \u00a313.0 million in the current period which is re\ufb02ecting
\nas utilised during the period.
\nFollowing the completion of the criminal proceedings against Ian Paterson, a consultant who previously had
\npracticing privileges at Spire Healthcare, management agreed settlement with all current and known civil
\nclaimants (and the other co-defendants) and made a provision for the expected remaining costs in FY20. The
\nprovision is being utilised, including \u00a35.3 million in patient claim settlements. The provision to complete the
\nreviews, settle any claims and costs in respect of other Paterson items has been increased by \u00a30.9 million. This
\nprovision remains subject to ongoing review following the publication of the Public Inquiry report on Paterson
\nissued on 4 February 2020, as the group continues to assess the potential impact of the recommendations. The
\nproject is complex and the process for review and settlement takes some time. It is possible that, as further
\ninformation becomes available, an adjustment to this provision will be required, but at this time, it re\ufb02ects
\nmanagement\u2019s best estimate of the costs and settlement of claims at this point. The variables include the
\nnumber of patients which are found to have been harmed following review, the level of harm, and the
\nassociated compensation claim, as well as the time to review each case can vary signi\ufb01cantly.
\nThe provision in relation to the Ian Paterson costs has been determined before taking account of any potential
\nfurther recoveries from insurers.
\nAs at 31 December 2022, the remaining business restructuring and other provisions primarily includes
\nnon-patient claims made against the group. The group is in the process of settling or defending such claims
\nas appropriate. Management have sought external counsel, where appropriate, to determine the appropriate
\nprovision levels.
\nProvisions as at 31 December 2022 are materially considered to be current and expected to be utilised at any
\ntime within the next twelve months, subject to external factors beyond the group\u2019s control.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfProvisionsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23365": {
"value": "25. Trade and other payables (\u00a3m)
2022
2021
\nTrade payables
67.2
51.7
\nAccrued expenses
58.4
52.6
\nSocial security and other taxes
9.7
8.3
\nOther payables
29.2
46.5
\nTrade and other payables
164.5
159.1
\nTrade and other payables of \u00a31.9 million have been added on the acquisition of The Doctors Clinic Group during
\nthe year (see Note 32)
\nAccrued expenses includes general operating expenses incurred but not invoiced as at the year end, as well
\nas holiday pay accrued of \u00a35.2 million (2021: \u00a39.1 million) due to staff deferring leave to maintain operations
\nthroughout the COVID-19 pandemic, and bonuses accrued during the year and paid during the following year
\nof \u00a37.0 million (FY21: \u00a36.4 million).
\nOther payables include an accrual for pensions and payments on account. Revenue is not recognised in respect
\nof payments on account until the performance obligation has been met. At year end the balance of payments
\non account was \u00a311.9 million (2021: \u00a39.9 million) partly, and other credit balances reclassed from trade debtors
\nwere \u00a328.2 million (2021: \u00a325.8 million), which largely relate to NHS credits. Payments on account are expected
\nto be utilised against patient procedures within the following 12 months. The balance of payments on account
\nas at 31 December 2021 have been fully utilised in the current year. However, this is subject to the patient
\nattending for the procedure, and not cancelling or deferring treatment, which could result in repayment to
\nthe patient should they request so.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfTradeAndOtherPayablesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23401": {
"value": "26. Dividends During the year Didsbury MSK Limited declared and paid an interim dividend of \u00a30.4 million to its shareholders
\nof which \u00a30.2 million was paid to the non-controlling interests. In addition \u00a30.1 million of dividends were paid
\nto the executive directors in respect of grants under the LTIP share scheme that have vested and are currently
\nsubject to a two-year holding period.
\nSince the end of the \ufb01nancial year, the directors have proposed a \ufb01nal dividend of approximately 0.5 pence per
\nshare. The dividend is subject to approval by shareholders at the Annual General Meeting and is therefore not
\nincluded in the balance sheet as a liability at 31 December 2022. ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfDividendsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23412": {
"value": "27. Share-based payments The group operates a number of share-based payment schemes for executive directors and other employees,
\nall of which are equity settled.
\nThe group has no legal or constructive obligation to repurchase or settle any of the options in cash. The total
\ncost in respect of LTIPs and SAYE recognised in the income statement was \u00a32.3 million in the year ended
\n31 December 2022 (2021: \u00a32.8 million). Employer\u2019s National Insurance is being accrued, where applicable, at
\nthe rate of 14.3%, which management expects to be the prevailing rate at the time the options are exercised,
\nbased on the share price at the reporting date. The total National Insurance charge for the year was \u00a30.3 million
\n(2021: \u00a30.4 million).
\nThe following table analyses the total cost between each of the relevant schemes, together with the number
\nof options outstanding:
\n2022
2021
\nCharge
\n\u00a3m
\nNumber of
\noptions
\n(thousands)
\nCharge
\n\u00a3m
\nNumber of
\noptions
\n(thousands)
\nLong Term Incentive Plan
1.8
12,787
2.5
11,449
\nDeferred Share Bonus Plan
\u2013
525
\u2013
383
\nSave As You Earn (SAYE)
0.5
3,652
0.3
3,114
\n2.3
16,964
2.8
14,946
\nA summary of the main features of the scheme is shown below:
\nLong Term Incentive Plan
\nThe Long Term Incentive Plan (\u2018LTIP\u2019) is open to executive directors and designated senior managers, and
\nawards are made at the discretion of the remuneration committee. Awards are subject to market and
\nnon-market performance criteria.
\nAwards granted under the LTIP vest subject to achievement of performance conditions measured over a period
\nof at least three years, unless the committee determines otherwise. Awards may be in the form of conditional
\nshare awards or nil-cost options or any other form allowed by the plan rules.
\nVesting of awards will be dependent on a range of \ufb01nancial, operational or share price measures, as set by
\nthe committee, which are aligned with the long-term strategic objectives of the group and shareholder value
\ncreation. No less than 30% of an award will be based on share price measures. The remainder will be based on
\neither \ufb01nancial and/or operational measures. At the threshold performance, no more than 25% of the award
\nwill vest, rising to 100% for maximum performance.
\nOn 6 April 2020, the company granted a total of 5,638,223 options to the executive directors and other senior
\nmanagement. The options will vest based on earnings per share (\u2018EPS\u2019) (20%) targets for the \ufb01nancial year
\nending 31 December 2022, relative total shareholder return (\u2018TSR\u2019) (40%) targets on performance over the
\nthree year period to 31 December 2022 and operational excellence (\u2018OE\u2019) (40%) targets based on employee
\nengagement targets and regulatory ratings for the current portfolio of hospitals, subject to continued
\nemployment. Upon vesting, the options will remain exercisable until 1 April 2030.
\nOn 18 March 2021, the company granted a total of 3,595,102 options to the executive directors and other
\nsenior management. The options will vest based on return on capital employed (\u2018ROCE\u2019) (35%) targets for the
\n\ufb01nancial year ending 31 December 2023, relative total shareholder return (\u2018TSR\u2019) (35%) targets on performance
\nover the three year period to 31 December 2023 and operational excellence (\u2018OE\u2019) (30%) targets based on
\nemployee engagement targets and regulatory ratings for the current portfolio of hospitals, subject to
\ncontinued employment. Upon vesting, the options will remain exercisable until March 2031. The executive
\ndirectors are subject to a 2 year holding period, whilst other senior management are not.
\nOn 14 March 2022, the company granted a total of 3,097,060 options to the executive directors and other
\nsenior management. The options will vest based on return on capital employed (\u2018ROCE\u2019) (35%) targets for the
\n\ufb01nancial year ending 31 December 2024, relative total shareholder return (\u2018TSR\u2019) (35%) targets on performance
\nover the three year period to 31 December 2024 and operational excellence (\u2018OE\u2019) (30%) targets based on
\nemployee engagement targets and regulatory ratings for the current portfolio of hospitals, subject to continued
\nemployment. Upon vesting, the options will remain exercisable until March 2032. The executive directors are
\nsubject to a two year holding period, whilst other senior management are not.
\n
\n\n
\n
\n\nDeferred Share Bonus Plan
\nThe Deferred Share Bonus Plan is a discretionary executive share bonus plan under which the remuneration
\ncommittee determines that a proportion of a participant\u2019s annual bonus will be deferred. The market value of
\nthe shares granted to any employee will be equal to one-third of the total annual bonus that would otherwise
\nhave been payable to the individual. The awards will be granted on the day after the announcement of the
\ngroup\u2019s annual results. The awards will normally vest over a three-year period.
\nOn 6 April 2020, the company granted a total of 243,973 options to executive directors, with a vesting date
\nof 6 April 2023. The options will vest based on a target EBITDA net debt leverage ratio for the year ending
\n31 December 2021, and subject to continued employment.
\nOn 18 March 2021, the company granted a total of 138,888 options to executive directors, with a vesting date
\nof 18 March 2024. The options will vest based on a target EBITDA net debt leverage ratio for the year ending
\n31 December 2022, and subject to continued employment.
\nOn 14 March 2022, the company granted a total of 142,427 options to executive directors, with a vesting
\ndate of 14 March 2025. There are no performance conditions in respect of the scheme and is subject to
\ncontinued employment.
\nSave As You Earn
\nThe Save As You Earn (\u2018SAYE\u2019) is open to all Spire Healthcare employees. Vesting will be dependent on continued
\nemployment for a period of 3 years from grant. The requirement to save is a non-vesting condition. On 3 May
\n2019, the company launched the SAYE scheme. There are no performance conditions in respect of the scheme
\nand the scheme vested on 1 June 2022. The options remained exercisable for 6 months to 31 December 2022.
\nOn the 24 April 2022, the company granted 3,800,557 options to employees with a vesting date of 1 June 2025.
\nThere are no performance conditions in respect of the scheme. Upon vesting, the options will remain
\nexercisable for six months. The IFRS 2 charge has been calculated using an adjusted Black Scholes model
\nwith judgements including leavers of the scheme (employees who may cease to save) and dividend yields.
\nThe aggregate number of share awards outstanding for the group and their weighted average contractual life
\nis shown below:
\n2022
\nLTIP (ROCE
\ncondition)
\n(thousands)
\nLTIP (TSR
\ncondition)
\n(thousands)
\nLTIP (EPS
\ncondition)
\n(thousands)
\nLTIP (OE
\ncondition)
\n(thousands)
\nDeferred Share
\nBonus Plan
\n(thousands)
\nSAYE
\n(thousands)
\nAt 1 January
1,133
4.175
1,975
4,166
383
3,114
\nGranted
1,084
1,079
\u2013
925
142
3,811
\nExercised
\u2013
(208)
\u2013
(93)
\u2013
(2,916)
\nSurrendered
\n1
\n(48)
(205)
(77)
(198)
\u2013
\u2013
\nCancelled
\n2
\n\u2013
(115)
(358)
(457)
\u2013
(357)
\nAt 31 December
2,169
4,731
1,540
4,347
525
3,652
\nExercisable at 31 December
\u2013
\u2013
\u2013
\u2013
\u2013
37
\nWeighted average contractual life
2.4 years
3.2 years
0.4 years
2.8 years
1.1 years
2.5 years
\n2021
\nLTIP (ROCE
\ncondition)
\n(thousands)
\nLTIP (TSR
\ncondition)
\n(thousands)
\nLTIP (EPS
\ncondition)
\n(thousands)
\nLTIP (OE
\ncondition)
\n(thousands)
\nDeferred Share
\nBonus Plan
\n(thousands)
\nSAYE
\n(thousands)
\nAt 1 January
\u2013
3,854
2,727
3,612
244
3,222
\nGranted
1,258
1,258
\u2013
1,079
139
\u2013
\nExercised
\u2013
\u2013
\u2013
\u2013
\u2013
(23)
\nSurrendered
\n1
\n(106)
(217)
(55)
(201)
\u2013
\u2013
\nCancelled
\n2
\n(19)
(720)
(697)
(324)
\u2013
(85)
\nAt 31 December
1,133
4,175
1,975
4,166
383
3,114
\nExercisable at 31 December
\u2013
39
\u2013
326
\u2013
37
\nWeighted average contractual life
2.2 years
2.2 years
1.2 years
2.2 years
3.0 years
0.9 years
\n1.
These are shares where the participants are considered to be good leavers and forfeit a proportion of their shares on pro-rata basis.
\n2.
These are shares where the participants forfeit all share options.
\nThe weighted average remaining contractual life for the share options outstanding as at 31 December 2022
\nwas 2.2 years (2021: 2.2 years) in respect of LTIPs, and 2.5 years for SAYE (2021: 0.9 years).
\n
\n\n\n
\n
\n\n\nShare options outstanding at the end of the year have the following expiry date:
\nGrant \u2013 vest
Expiry date
\nExercise price
\n(\u00a3)
\nShare options
\nthousands
\n2022
2021
\nLTIP grants
\n30/09/2014 \u2013 December 2016
30/09/2024
\u2013
32
32
\n30/03/2018 \u2013 March 2021
30/03/2028
\u2013
2
7
\n30/03/2018 \u2013 March 2021
30/03/2028
\u2013
326
326
\n30/03/2019 \u2013 March 2022
30/03/2029
\u2013
1,118
2,702
\n30/03/2020 \u2013 March 2023
30/03/2030
\u2013
5,112
5,145
\n30/03/2021 \u2013 March 2024
30/03/2031
\u2013
3,199
3,237
\n01/04/2022 \u2013 March 2025
01/01/2032
\u2013
2,997
\u2013
\nDeferred Share Bonus Plan
\n06/04/2020 \u2013 April 2023
05/04/2030
\u2013
244
244
\n18/03/2021 \u2013 March 2024
17/03/2031
\u2013
139
139
\n01/04/2022 \u2013 April 2025
01/04/2032
142
\u2013
\nSave As You Earn
\n03/05/2019 \u2013 June 2022
01/12/2022
1.09
18
3,114
\n26/04/2022 \u2013 May 2025
01/11/2025
1.98
3,634
\u2013
\nDuring the year, 300,491 shares, relating to LTIPs, were exercised from the company\u2019s Employee Bene\ufb01t Trust
\n(\u2018EBT\u2019), during the year (see note 21 for more information). Where considered the most appropriate use of
\nsurplus cash, the company will continue to fund the Spire Healthcare Employee Bene\ufb01t Trust (\u2018EBT\u2019), a
\ndiscretionary trust held for the bene\ufb01t of the group\u2019s employees, for the ongoing acquisition of shares to
\nsatisfy the exercise of share plan awards by employees.
\nThe following information is relevant to the determination of the fair value of the awards granted for the years
\nended 31 December 2022 and 2021, respectively, under the schemes:
\n2022
\nLTIP
\n(TSR condition)
\nLTIP
\n(ROCE condition)
\nLTIP
\n(OE condition)
\nDeferred Share
\nBonus Plan
Save as you Earn
\nOption pricing model
\nMonte Carlo
\nFair value
\nat grant date
\nFair value
\nat grant date
n/a
\nBlack-Sch\u00f6les
\nmodel
\nFair value at grant date (\u00a3)
1.75
2.44
2.44
n/a
0.71
\nFair value at grant date for
\nshares subject to holding
\nperiod(\u00a3)
1.48
2.06
2.06
n/a
n/a
\nWeighted average share price
\nat grant date (\u00a3)
2.44
2.44
2.44
n/a
2.21
\nExercise price (\u00a3)
Nil
Nil
Nil
Nil
1.98
\nWeighted average contractual
\nlife
2.2 years
2.2 years
0.2 years
3.0 years
2.5 years
\nExpected dividend yield
n/a
n/a
n/a
n/a
n/a
\nRisk-free interest rate
1.4%
n/a
n/a
n/a
n/a
\nVolatility
\n(1)
\n53%
53%
53%
n/a
n/a
\n2021
\nLTIP
\n(TSR condition)
\nLTIP
\n(EPS condition)
\nLTIP
\n(OE condition)
\nDeferred Share
\nBonus Plan
\nOption pricing model
\nMonte Carlo
\nFair value
\nat grant date
\nFair value
\nat grant date
n/a
\nFair value at grant date (\u00a3)
1.17
1.65
1.65
n/a
\nFair value at grant date for shares subject to
\nholding period(\u00a3)
1.00
1.41
1.41
n/a
\nWeighted average share price at grant date (\u00a3)
1.65
1.65
1.65
n/a
\nExercise price (\u00a3)
Nil
Nil
Nil
Nil
\nWeighted average contractual life
2.2 years
2.2 years
2.2 years
3.0 years
\nExpected dividend yield
n/a
n/a
n/a
n/a
\nRisk-free interest rate
0.2%
n/a
n/a
n/a
\nVolatility
\n(1)
\n49%
49%
49%
n/a
\n1.
The expected volatility is based on the historical volatility of the company and a comparator group of other international
\nhealthcare companies.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfSharebasedPaymentArrangementsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23971": {
"value": "28. Commitments Consignment stock
\nAt 31 December 2022, the group held consignment stock on sale or return of \u00a324.3 million (2021: \u00a323.5 million).
\nThe group is only required to pay for the equipment it chooses to use and therefore this stock is not recognised
\nas an asset.
\nCapital commitments
\nCapital commitments comprise amounts payable under capital contracts which are duly authorised and in
\nprogress at the consolidated balance sheet date. They include the full cost of goods and services to be provided
\nunder the contracts through to completion. The group has rights within its contracts to terminate at short
\nnotice and, therefore, cancellation payments are minimal.
\nCapital commitments at the end of the year were as follows:
\n(\u00a3m)
2022
2021
\nContracted but not provided for
27.0
29.1",
"dimensions": {
"concept": "ifrs-full:DisclosureOfCommitmentsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f23991": {
"value": "29. Contingent liabilities The group had the following guarantees at 31 December 2022:
\n\u2013
The bankers to Spire Healthcare Limited have issued a letter of credit in the maximum amount of \u00a31.5 million
\n(2021: \u00a31.5 million) in relation to contractual pension obligations
\n\u2013
Under certain lease agreements entered into on 26 January 2010, the group has given undertakings relating
\nto obligations in the lease documentation and the assets of the group are subject to a \ufb01xed and \ufb02oating charge
\n\u2013
See note C11 for details of contingent liability in respect of lease arrangements and agreements ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfContingentLiabilitiesExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24038": {
"value": "30. Financial risk management and impairment of \ufb01nancial assets The group has exposure to the following risks from its use of \ufb01nancial instruments:
\n\u2013
Credit risk
\n\u2013
Liquidity risk
\n\u2013
Market risk
\nThis note presents information about the group\u2019s exposure to each of the above risks, the group\u2019s objectives,
\npolicies and processes for measuring and managing risk. Further quantitative disclosures are included
\nthroughout these \ufb01nancial statements.
\nThe directors have overall responsibility for the establishment and oversight of the group\u2019s risk management
\nframework.
\nThe group\u2019s risk management policies are established to identify and analyse the risks faced by the group,
\nto set appropriate risk limits and controls, and to monitor risks and adherence to limits.
\nCredit risk and impairment
\nCredit risk is the risk of \ufb01nancial loss to the group if a customer or counterparty to a \ufb01nancial instrument fails
\nto meet its contractual obligations, and arises principally from the group\u2019s receivables from customers and
\ninvestment securities.
\nTrade and other receivables
\nThe group\u2019s exposure to credit risk is in\ufb02uenced mainly by the individual characteristics of each customer.
\nThe group\u2019s exposure to credit risk from trade receivables is considered to be low because of the nature of
\nits customers and policies in place to prevent credit risk occurring in normal circumstances.
\nMost revenues arise from insured patients\u2019 business and the NHS. Insured revenues give rise to trade
\nreceivables which are mainly due from large insurance institutions, which have high credit worthiness.
\nThe remainder of revenues arise from individual self-pay patients and consultants.
\nDuring the period, trade receivables have increased as private work has increased as a result of COVID-19
\nrestrictions being removed, but aged debt has reduced. Individual self-pay patients continues to be the largest
\nrisk for the group given the current economic uncertainty. Given the COVID-19 induced economic uncertainty,
\nthe group has considered the provision required, speci\ufb01cally for self-pay patients, and maintained a provision
\naccordingly through the expected loss rate percentages. The Expected Credit Loss (ECL) as at year end is
\n\u00a35.0 million (December 2021: \u00a34.1 million).
\nThe group establishes an allowance for impairment that represents its ECL in respect of trade and other
\nreceivables.
\nThis allowance is composed of speci\ufb01c losses that relate to individual exposures and also an ECL component
\nestablished using rates re\ufb02ecting historical information for payor groups, and forward looking information.
\nGiven the continued economic uncertainty, the group has considered the provision required, speci\ufb01cally for
\nself-pay patients and maintained an adjustment to the provision accordingly, which is in line with the position
\nat December 2021.
\nNote 18 shows the ageing and customer pro\ufb01les of trade receivables outstanding at the year end.
\nUnbilled receivables are considered for expected credit losses, but these are not considered material and
\ntherefore not recognised.
\nInvestments
\nThe group limits its exposure to credit risk by only investing in short-term money market deposits with large
\n\ufb01nancial institutions, which must be rated at least Investment Grade by key rating agencies.
\nMarket risk
\nMarket risk is the risk that changes in market prices, such as interest rates, will affect the group\u2019s income or
\nthe value of its holdings of \ufb01nancial instruments. The objective of market risk management is to manage
\nand control market risk exposures within acceptable parameters, while optimising the return on risk.
\nInterest rate risk
\nThe group is exposed to interest rate risk arising from \ufb02uctuations in market rates. This affects future cash
\n\ufb02ows from money market investments and the cost of \ufb02oating rate borrowings.
\nFrom time-to-time, the group considers the cost bene\ufb01t of entering into derivative \ufb01nancial instruments to
\nhedge its exposure to interest rate volatility based on existing variable rates, current and predicted interest
\nyield curves and the cost of associated medium-term derivative \ufb01nancial instruments.
\nInterest rates on variable rate loans are determined by SONIA (2021: LIBOR) \ufb01xings on a quarterly basis.
\nInterest is settled on all loans in line with agreements and is settled at least annually.
\nVariable
Total
Undrawn facility
\n1
\n31 December 2022 (\u00a3m)
325.0
325.0
100.0
\nEffective interest rate (%)
4.85%
4.85%
\n31 December 2021 (\u00a3m)
425.0
425.0
100.0
\nEffective interest rate (%)
2.96%
2.96%
\n1.
If this facility was drawn the interest rate would be in line with the variable rate loans.
\nThe group has an interest rate swap derivative asset of \u00a38.6 million (2021: \u00a30.7 million liability) in place (refer
\nto note 22).
\nThe fair value of this instrument is considered the same as its carrying value and level 2 of the fair value
\nhierarchy is used to measure the fair value of the instrument. The variable rate consideration received by the
\ngroup is Sterling three month SONIA, being lower than the hedged rate, resulting in some exposure on the
\nhedged amount.
\nSensitivity analysis
\nA change of 25 basis points (\u2018bp\u2019) in interest rates at the reporting date would have increased/(decreased)
\nequity and reported results by the amounts shown below. This analysis assumes that all other variables
\nremain constant.
\n
\n\n
\n
\n\n\n(\u00a3m)
\nProfit or loss
Equity
\n25bp increase
25bp decrease
25bp increase
25bp decrease
\nAt 31 December 2022
\nVariable rate instruments
(0.2)
0.2
(0.2)
0.2
\nAt 31 December 2021
\nVariable rate instruments
(0.5)
0.5
(0.5)
0.5
\nLiquidity risk
\nLiquidity risk is the risk that the group will not be able to meet its \ufb01nancial obligations as they fall due.
\nThe group\u2019s approach to managing liquidity is to ensure, as far as possible, that it will always have suf\ufb01cient
\nliquidity to meet its liabilities when due, under both normal and stressed conditions, without incurring
\nunacceptable losses or risking damage to the group\u2019s reputation.
\nLiquidity is managed across the group and consideration is taken of the segregation of accounts for regulatory
\npurposes. Short-term operational working capital requirements are met by cash in hand and overdraft facilities.
\nTypically the group ensures that it has suf\ufb01cient cash on demand to meet expected operational expenses for
\na period of at least 90 days, including the servicing of \ufb01nancial obligations. In addition to cash on demand,
\nthe group has available the following line of credit:
\n\u2013
\u00a3100.0 million of revolving credit facility, which was undrawn as at 31 December 2022 (2021: \u00a3100.0 million
\nundrawn)
\nThe following are contractual maturities, at as the balance sheet date, of \ufb01nancial liabilities, including interest
\npayments and excluding the impact of netting agreements:
\nAt 31 December 2022
\n(\u00a3m)
\nMaturity analysis
\nCarrying
\namount
\nContractual
\ncash flows
\nWithin
\n1 year
\nBetween 1
\nand 2 years
\nBetween 2
\nand 3 years
\nBetween 3
\nand 4 years
\nBetween 4
\nand 5 years
\nMore than 5
\nyears
\nTrade and other payables
154.8
154.8
154.8
\u2013
\u2013
\u2013
\u2013
\u2013
\nBank borrowings
324.3
394.4
20.2
22.1
20.5
331.6
\u2013
\u2013
\nLease liabilities
866.5
1,819.1
92.8
93.2
93.6
92.2
92.2
1,355.1
\n1,345.6
2,368.3
267.8
115.3
114.1
423.8
92.2
1,355.1
\nDerivative financial assets
\nInterest rate swaps
(8.6)
(9.2)
(2.9)
(3.6)
(2.1)
(0.6)
\u2013
\u2013
\n(8.6)
(9.2)
(2.9)
(3.6)
(2.1)
(0.6)
\u2013
\u2013
\nAt 31 December 2021
\n(\u00a3m)
\nMaturity analysis
\nCarrying
\namount
\nContractual
\ncash flows
\nWithin 1
\nyear
\nBetween 1
\nand 2 years
\nBetween 2
\nand 3 years
\nBetween 3
\nand 4 years
\nBetween 4
\nand 5 years
\nMore than 5
\nyears
\nTrade and other payables
150.8
150.8
150.8
\u2013
\u2013
\u2013
\u2013
\u2013
\nBank borrowings
427.5
449.6
12.8
436.8
\u2013
\u2013
\u2013
\u2013
\nLease liabilities
837.8
1,819.3
86.8
87.0
87.7
87.9
86.5
1,383.4
\nFinancial liability
1.9
1.9
1.9
\u2013
\u2013
\u2013
\u2013
\u2013
\n1,418.0
2,421.6
252.3
523.8
87.7
87.9
86.5
1,383.4
\nDerivative financial
\nliabilities
\nIinterest rate swap
0.7
1.2
1.2
\u2013
\u2013
\u2013
\u2013
\u2013
\n0.7
1.2
1.2
\u2013
\u2013
\u2013
\u2013
\u2013
\nCapital management
\nThe group\u2019s objective is to maintain an appropriate balance of debt and equity \ufb01nancing to enable the group
\nto continue as a going concern, to continue the future development of the business and to optimise returns
\nto shareholders and bene\ufb01ts to other stakeholders.
\nThe board closely manages trading capital, de\ufb01ned as net assets plus net debt. The group\u2019s net assets at
\n31 December 2022 were \u00a3725.1 million (2021: \u00a3704.8 million) and net debt, calculated as borrowings, less cash
\nand cash equivalents and the amortised fees of \u00a33.6 million (2021: \u00a30.7 million) that was recorded at the date
\nof the loan extensions, amounted to \u00a3253.7 million (2021: \u00a3225.6 million).
\nThe principal focus of capital management revolves around working capital management and compliance
\nwith externally imposed \ufb01nancial covenants see note 22 for more detail.
\nMajor investment decisions are based on reviewing the expected future cash \ufb02ows and all major capital
\nexpenditure requires approval by the board.
\nAt the balance sheet date, the group\u2019s committed undrawn facilities, and cash and cash equivalents were
\nas follows:
\n(\u00a3m)
2022
2021
\nCommitted undrawn revolving credit facility
100.0
100.0
\nCash and cash equivalents
74.2
202.6
\nFair value measurement
\nAs of 31 December 2022, except for an interest rate swap and \ufb01nancial asset relating to a gross pro\ufb01t share,
\nthe group did not hold \ufb01nancial instruments that are included in level 1, 2 or 3 of the hierarchy.
\nManagement assessed that cash and short-term deposits, trade and other receivables, unbilled receivables,
\ntrade payables and other current liabilities approximate their carrying amounts largely due to the short-term
\nmaturities of these instruments. The carrying value of debt is approximately equal to its fair value. During the
\nyear ended 31 December 2022, there were no transfers between the levels in the fair value hierarchy.
\n
\n\n
\n
\n
\n\n\nIn determining fair value measurement, the impact of potential climate-related matters, including legislation,
\nwhich may affect the fair value measurement of assets and liabilities in the \ufb01nancial statements has been
\nconsidered.
\nA derivative is a \ufb01nancial instrument whose value is based on one or more underlying variables. The group
\nuses derivative \ufb01nancial instruments to hedge its exposure to interest rate risk. Derivatives are not held for
\nspeculative reasons. Fair values are obtained from market observable pricing information including interest
\nrate yield curves and have been calculated as follows; fair value of interest rate swaps is determined as the
\npresent value of the estimated future cash \ufb02ows based on observable yield curves.
\nThe \ufb01nancial asset re\ufb02ects a pro\ufb01t share arrangement with a partner. There are no market observable prices
\nfor the valuation. Management therefore assesses forward looking information and appropriate discount rates
\nand risk factors to determine the fair value. Sensitivities are also taken into account when reviewing the fair
\nvalue (note 15).
\nAs at 31 December 2022, the group held the following \ufb01nancial instruments measured at fair value:
\nFinancial instruments measured at fair value
\n(\u00a3m)
\nMaturity analysis
\nValue as at
\n31 December
\n2022
Level 1
Level 2
Level 3
\nFinancial assets at fair value through profit and loss
\nProfit share arrangement (Note 15)
4.6
\u2013
\u2013
4.6
\nInterest rate swaps
8.6
\u2013
8.6
\u2013
\nFinancial assets measured at fair value
13.2
\u2013
8.6
4.6
\nDuring the year, Spire Healthcare received a pro\ufb01t share in respect of the \ufb01nancial asset of \u00a30.7 million (2021:
\n\u00a30.4 million). In addition an unrealised fair value movement of \u00a33.0 million (2021: \u00a31.1 million) was recognised
\nin income upon review of the \ufb01nancial asset to increase the value of the \ufb01nancial asset on the balance sheet.
\nAs at 31 December 2021, the group held the following \ufb01nancial instruments measured at fair value:
\nFinancial instruments measured at fair value
\n(\u00a3m)
\nMaturity analysis
\nValue as at
\n31 December
\n2022
Level 1
Level 2
Level 3
\nFinancial assets at fair value through profit and loss
\nProfit share arrangement (Note 15)
2.3
\u2013
\u2013
2.3
\nFinancial assets measured at fair value
2.3
\u2013
\u2013
2.3
\nFinancial liabilities at fair value through profit and
\nloss and using hedge accounting
\nInterest rate swaps
0.7
\u2013
0.7
\u2013
\nFinancial liabilities at fair value on acquisition of a
\nsubsidiary
\nShare put options
1.9
\u2013
\u2013
1.9
\nFinancial liabilities measured at fair value
2.6
\u2013
0.7
1.9
\nCash \ufb02ow hedge
\nThe group designate, as cash \ufb02ow hedges, interest rate swaps entered into with three counterparties maturing
\nin February 2026. These interest rate swaps convert \ufb02oating interest rate liabilities into \ufb01xed interest rate
\nliabilities. The swaps run concurrently with the hedged item, being the group\u2019s \ufb02oating rate liabilities under
\nthe senior \ufb01nance facility.
\nFor the years ended December 2022 and 2021, there were no signi\ufb01cant amounts recognised in the pro\ufb01t
\nor loss relating to the ineffective portion of hedges or portions excluded from the assessment of hedge
\neffectiveness. The movement in the interest rate swap relates to fair value movement and is recognised
\nthrough other comprehensive income.
\nFair value hierarchy
\nThe group uses the following hierarchy for determining and disclosing the fair value of \ufb01nancial instruments
\nby valuation technique:
\nLevel 1: quoted (unadjusted) prices in active markets for identical assets or liabilities;
\nLevel 2: other techniques for which all inputs which have a signi\ufb01cant effect on the recorded fair value are
\nobservable, either directly or indirectly; and
\nLevel 3: techniques which use inputs which have a signi\ufb01cant effect on the recorded fair value that are not
\nbased on observable market data.
\nAs at 31 December 2022, the group held \ufb01nancial instruments measured at fair value, being an asset of
\n\u00a313.2 million (2021: \u00a32.3 million) and a liabilities of nil (2021: \u00a32.6 million).",
"dimensions": {
"concept": "ifrs-full:DisclosureOfFinancialRiskManagementExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24055": {
"value": "Credit risk and impairment Credit risk is the risk of \ufb01nancial loss to the group if a customer or counterparty to a \ufb01nancial instrument fails
\nto meet its contractual obligations, and arises principally from the group\u2019s receivables from customers and
\ninvestment securities.
\nTrade and other receivables
\nThe group\u2019s exposure to credit risk is in\ufb02uenced mainly by the individual characteristics of each customer.
\nThe group\u2019s exposure to credit risk from trade receivables is considered to be low because of the nature of
\nits customers and policies in place to prevent credit risk occurring in normal circumstances.
\nMost revenues arise from insured patients\u2019 business and the NHS. Insured revenues give rise to trade
\nreceivables which are mainly due from large insurance institutions, which have high credit worthiness.
\nThe remainder of revenues arise from individual self-pay patients and consultants.
\nDuring the period, trade receivables have increased as private work has increased as a result of COVID-19
\nrestrictions being removed, but aged debt has reduced. Individual self-pay patients continues to be the largest
\nrisk for the group given the current economic uncertainty. Given the COVID-19 induced economic uncertainty,
\nthe group has considered the provision required, speci\ufb01cally for self-pay patients, and maintained a provision
\naccordingly through the expected loss rate percentages. The Expected Credit Loss (ECL) as at year end is
\n\u00a35.0 million (December 2021: \u00a34.1 million).
\nThe group establishes an allowance for impairment that represents its ECL in respect of trade and other
\nreceivables.
\nThis allowance is composed of speci\ufb01c losses that relate to individual exposures and also an ECL component
\nestablished using rates re\ufb02ecting historical information for payor groups, and forward looking information.
\nGiven the continued economic uncertainty, the group has considered the provision required, speci\ufb01cally for
\nself-pay patients and maintained an adjustment to the provision accordingly, which is in line with the position
\nat December 2021.
\nNote 18 shows the ageing and customer pro\ufb01les of trade receivables outstanding at the year end.
\nUnbilled receivables are considered for expected credit losses, but these are not considered material and
\ntherefore not recognised.
\nInvestments
\nThe group limits its exposure to credit risk by only investing in short-term money market deposits with large
\n\ufb01nancial institutions, which must be rated at least Investment Grade by key rating agencies.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfCreditRiskExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24088": {
"value": "Market risk Market risk is the risk that changes in market prices, such as interest rates, will affect the group\u2019s income or
\nthe value of its holdings of \ufb01nancial instruments. The objective of market risk management is to manage
\nand control market risk exposures within acceptable parameters, while optimising the return on risk.
\nInterest rate risk
\nThe group is exposed to interest rate risk arising from \ufb02uctuations in market rates. This affects future cash
\n\ufb02ows from money market investments and the cost of \ufb02oating rate borrowings.
\nFrom time-to-time, the group considers the cost bene\ufb01t of entering into derivative \ufb01nancial instruments to
\nhedge its exposure to interest rate volatility based on existing variable rates, current and predicted interest
\nyield curves and the cost of associated medium-term derivative \ufb01nancial instruments.
\nInterest rates on variable rate loans are determined by SONIA (2021: LIBOR) \ufb01xings on a quarterly basis.
\nInterest is settled on all loans in line with agreements and is settled at least annually.
\nVariable
Total
Undrawn facility
\n1
\n31 December 2022 (\u00a3m)
325.0
325.0
100.0
\nEffective interest rate (%)
4.85%
4.85%
\n31 December 2021 (\u00a3m)
425.0
425.0
100.0
\nEffective interest rate (%)
2.96%
2.96%
\n1.
If this facility was drawn the interest rate would be in line with the variable rate loans.
\nThe group has an interest rate swap derivative asset of \u00a38.6 million (2021: \u00a30.7 million liability) in place (refer
\nto note 22).
\nThe fair value of this instrument is considered the same as its carrying value and level 2 of the fair value
\nhierarchy is used to measure the fair value of the instrument. The variable rate consideration received by the
\ngroup is Sterling three month SONIA, being lower than the hedged rate, resulting in some exposure on the
\nhedged amount.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfMarketRiskExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24129": {
"value": "Sensitivity analysis A change of 25 basis points (\u2018bp\u2019) in interest rates at the reporting date would have increased/(decreased)
\nequity and reported results by the amounts shown below. This analysis assumes that all other variables
\nremain constant.
\n
\n\n
\n
\n\n\n(\u00a3m)
\nProfit or loss
Equity
\n25bp increase
25bp decrease
25bp increase
25bp decrease
\nAt 31 December 2022
\nVariable rate instruments
(0.2)
0.2
(0.2)
0.2
\nAt 31 December 2021
\nVariable rate instruments
(0.5)
0.5
(0.5)
0.5 ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfSensitivityAnalysisForActuarialAssumptionsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24204": {
"value": "Liquidity risk Liquidity risk is the risk that the group will not be able to meet its \ufb01nancial obligations as they fall due.
\nThe group\u2019s approach to managing liquidity is to ensure, as far as possible, that it will always have suf\ufb01cient
\nliquidity to meet its liabilities when due, under both normal and stressed conditions, without incurring
\nunacceptable losses or risking damage to the group\u2019s reputation.
\nLiquidity is managed across the group and consideration is taken of the segregation of accounts for regulatory
\npurposes. Short-term operational working capital requirements are met by cash in hand and overdraft facilities.
\nTypically the group ensures that it has suf\ufb01cient cash on demand to meet expected operational expenses for
\na period of at least 90 days, including the servicing of \ufb01nancial obligations. In addition to cash on demand,
\nthe group has available the following line of credit:
\n\u2013
\u00a3100.0 million of revolving credit facility, which was undrawn as at 31 December 2022 (2021: \u00a3100.0 million
\nundrawn)
\nThe following are contractual maturities, at as the balance sheet date, of \ufb01nancial liabilities, including interest
\npayments and excluding the impact of netting agreements:
\nAt 31 December 2022
\n(\u00a3m)
\nMaturity analysis
\nCarrying
\namount
\nContractual
\ncash flows
\nWithin
\n1 year
\nBetween 1
\nand 2 years
\nBetween 2
\nand 3 years
\nBetween 3
\nand 4 years
\nBetween 4
\nand 5 years
\nMore than 5
\nyears
\nTrade and other payables
154.8
154.8
154.8
\u2013
\u2013
\u2013
\u2013
\u2013
\nBank borrowings
324.3
394.4
20.2
22.1
20.5
331.6
\u2013
\u2013
\nLease liabilities
866.5
1,819.1
92.8
93.2
93.6
92.2
92.2
1,355.1
\n1,345.6
2,368.3
267.8
115.3
114.1
423.8
92.2
1,355.1
\nDerivative financial assets
\nInterest rate swaps
(8.6)
(9.2)
(2.9)
(3.6)
(2.1)
(0.6)
\u2013
\u2013
\n(8.6)
(9.2)
(2.9)
(3.6)
(2.1)
(0.6)
\u2013
\u2013
\nAt 31 December 2021
\n(\u00a3m)
\nMaturity analysis
\nCarrying
\namount
\nContractual
\ncash flows
\nWithin 1
\nyear
\nBetween 1
\nand 2 years
\nBetween 2
\nand 3 years
\nBetween 3
\nand 4 years
\nBetween 4
\nand 5 years
\nMore than 5
\nyears
\nTrade and other payables
150.8
150.8
150.8
\u2013
\u2013
\u2013
\u2013
\u2013
\nBank borrowings
427.5
449.6
12.8
436.8
\u2013
\u2013
\u2013
\u2013
\nLease liabilities
837.8
1,819.3
86.8
87.0
87.7
87.9
86.5
1,383.4
\nFinancial liability
1.9
1.9
1.9
\u2013
\u2013
\u2013
\u2013
\u2013
\n1,418.0
2,421.6
252.3
523.8
87.7
87.9
86.5
1,383.4
\nDerivative financial
\nliabilities
\nIinterest rate swap
0.7
1.2
1.2
\u2013
\u2013
\u2013
\u2013
\u2013
\n0.7
1.2
1.2
\u2013
\u2013
\u2013
\u2013
\u2013 ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfLiquidityRiskExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24376": {
"value": "Capital management The group\u2019s objective is to maintain an appropriate balance of debt and equity \ufb01nancing to enable the group
\nto continue as a going concern, to continue the future development of the business and to optimise returns
\nto shareholders and bene\ufb01ts to other stakeholders.
\nThe board closely manages trading capital, de\ufb01ned as net assets plus net debt. The group\u2019s net assets at
\n31 December 2022 were \u00a3725.1 million (2021: \u00a3704.8 million) and net debt, calculated as borrowings, less cash
\nand cash equivalents and the amortised fees of \u00a33.6 million (2021: \u00a30.7 million) that was recorded at the date
\nof the loan extensions, amounted to \u00a3253.7 million (2021: \u00a3225.6 million).
\nThe principal focus of capital management revolves around working capital management and compliance
\nwith externally imposed \ufb01nancial covenants see note 22 for more detail.
\nMajor investment decisions are based on reviewing the expected future cash \ufb02ows and all major capital
\nexpenditure requires approval by the board.
\nAt the balance sheet date, the group\u2019s committed undrawn facilities, and cash and cash equivalents were
\nas follows:
\n(\u00a3m)
2022
2021
\nCommitted undrawn revolving credit facility
100.0
100.0
\nCash and cash equivalents
74.2
202.6",
"dimensions": {
"concept": "ifrs-full:DisclosureOfObjectivesPoliciesAndProcessesForManagingCapitalExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24402": {
"value": "Fair value measurement As of 31 December 2022, except for an interest rate swap and \ufb01nancial asset relating to a gross pro\ufb01t share,
\nthe group did not hold \ufb01nancial instruments that are included in level 1, 2 or 3 of the hierarchy.
\nManagement assessed that cash and short-term deposits, trade and other receivables, unbilled receivables,
\ntrade payables and other current liabilities approximate their carrying amounts largely due to the short-term
\nmaturities of these instruments. The carrying value of debt is approximately equal to its fair value. During the
\nyear ended 31 December 2022, there were no transfers between the levels in the fair value hierarchy.
\n
\n
\n
\n
\n\n\nIn determining fair value measurement, the impact of potential climate-related matters, including legislation,
\nwhich may affect the fair value measurement of assets and liabilities in the \ufb01nancial statements has been
\nconsidered.
\nA derivative is a \ufb01nancial instrument whose value is based on one or more underlying variables. The group
\nuses derivative \ufb01nancial instruments to hedge its exposure to interest rate risk. Derivatives are not held for
\nspeculative reasons. Fair values are obtained from market observable pricing information including interest
\nrate yield curves and have been calculated as follows; fair value of interest rate swaps is determined as the
\npresent value of the estimated future cash \ufb02ows based on observable yield curves.
\nThe \ufb01nancial asset re\ufb02ects a pro\ufb01t share arrangement with a partner. There are no market observable prices
\nfor the valuation. Management therefore assesses forward looking information and appropriate discount rates
\nand risk factors to determine the fair value. Sensitivities are also taken into account when reviewing the fair
\nvalue (note 15).
\nAs at 31 December 2022, the group held the following \ufb01nancial instruments measured at fair value:
\nFinancial instruments measured at fair value
\n(\u00a3m)
\nMaturity analysis
\nValue as at
\n31 December
\n2022
Level 1
Level 2
Level 3
\nFinancial assets at fair value through profit and loss
\nProfit share arrangement (Note 15)
4.6
\u2013
\u2013
4.6
\nInterest rate swaps
8.6
\u2013
8.6
\u2013
\nFinancial assets measured at fair value
13.2
\u2013
8.6
4.6
\nDuring the year, Spire Healthcare received a pro\ufb01t share in respect of the \ufb01nancial asset of \u00a30.7 million (2021:
\n\u00a30.4 million). In addition an unrealised fair value movement of \u00a33.0 million (2021: \u00a31.1 million) was recognised
\nin income upon review of the \ufb01nancial asset to increase the value of the \ufb01nancial asset on the balance sheet.
\nAs at 31 December 2021, the group held the following \ufb01nancial instruments measured at fair value:
\nFinancial instruments measured at fair value
\n(\u00a3m)
\nMaturity analysis
\nValue as at
\n31 December
\n2022
Level 1
Level 2
Level 3
\nFinancial assets at fair value through profit and loss
\nProfit share arrangement (Note 15)
2.3
\u2013
\u2013
2.3
\nFinancial assets measured at fair value
2.3
\u2013
\u2013
2.3
\nFinancial liabilities at fair value through profit and
\nloss and using hedge accounting
\nInterest rate swaps
0.7
\u2013
0.7
\u2013
\nFinancial liabilities at fair value on acquisition of a
\nsubsidiary
\nShare put options
1.9
\u2013
\u2013
1.9
\nFinancial liabilities measured at fair value
2.6
\u2013
0.7
1.9",
"dimensions": {
"concept": "ifrs-full:DisclosureOfFairValueMeasurementExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24562": {
"value": "31. Related party transactions Key management personnel
\nKey management personnel are those persons having authority and responsibility for planning, directing and
\ncontrolling the activities of the group, directly or indirectly. They include the board and executive committee,
\nas identi\ufb01ed on pages 91 to 95.
\nCompensation for key management personnel is set out in the table below:
\nKey management compensation
\n(\u00a3m)
2022
2021
\nSalaries and other short term employee benefits
5.0
4.5
\nPost-employment benefits
0.5
0.5
\nTermination benefits
\u2013
\u2013
\nShare-based payments
1.1
1.0
\n6.6
6.0
\nFurther information about the remuneration of individual directors is provided in the audited part of the
\ndirectors\u2019 remuneration report on pages 112 to 119.
\nThere were no transactions with related parties external to the group in the year to 31 December 2022
\n(2021: nil).",
"dimensions": {
"concept": "ifrs-full:DisclosureOfRelatedPartyExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24565": {
"value": "Key management personnel Key management personnel are those persons having authority and responsibility for planning, directing and
\ncontrolling the activities of the group, directly or indirectly. They include the board and executive committee,
\nas identi\ufb01ed on pages 91 to 95.
\nCompensation for key management personnel is set out in the table below:
\nKey management compensation
\n(\u00a3m)
2022
2021
\nSalaries and other short term employee benefits
5.0
4.5
\nPost-employment benefits
0.5
0.5
\nTermination benefits
\u2013
\u2013
\nShare-based payments
1.1
1.0
\n6.6
6.0
\nFurther information about the remuneration of individual directors is provided in the audited part of the
\ndirectors\u2019 remuneration report on pages 112 to 119.
\nThere were no transactions with related parties external to the group in the year to 31 December 2022
(2021: nil). ",
"dimensions": {
"concept": "ifrs-full:DisclosureOfInformationAboutKeyManagementPersonnelExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24630": {
"value": "32. Business combinations and acquisition of non-controlling interests Acquisitions in 2022
\nAcquisition of The Doctors Clinic Group Limited (together \u2018Doctors Clinic Group\u2019)
\nOn 16 December 2022, the group acquired 100% of the voting shares of The Doctors Clinic Group Limited
\n(which in turn owns 100% of the shares of The London Doctors Clinic Limited, Maitland Medical Service Limited
\nand Soma Health Limited), a non-listed company based in England which operates GP and occupational health
\nservices in the UK, for \u00a311.6 million. The group acquired the companies to expand its offering for GP and
\noccupational health services in line with its strategic plan.
\nAssets acquired and liabilities assumed
\nThe fair values of the identi\ufb01able assets and liabilities of The Doctors Clinic Group Limited as at the date of
\nacquisition were:
\n(\u00a3m)
\nFair value
\nrecognised on
\nacquisition
\nAssets
\nPlant, property and equipment (Note 13)
0.6
\nTrade and other receivables (Note 18)
1.5
\nCash (Note 19)
0.3
\n2.4
\nLiabilities
\nPayables (Note 25)
(1.9)
\nTotal identifiable net assets at fair value
0.5
\nGoodwill arising on acquisition (Note 14)
11.1
\nPurchase consideration transferred
11.6
\nThe amounts recognised, are subject to adjustment in line with IFRS 3 for up to a 12 months from acquisition,
\nwith goodwill being adjusted accordingly.
\nThe fair value of the trade receivables amounts to \u00a31.5 million. The gross amount of trade receivables is
\n\u00a31.5 million and it is expected that the full contractual amounts can be collected.
\nFrom the date of acquisition, The Doctors Clinic Group contributed \u00a30.4 million of revenue and loss of \u00a30.1 to
\npro\ufb01t before tax from continuing operations of the group. If the combination had taken place at the beginning
\nof the year, revenue from continuing operations would have been \u00a310.0 million and loss before tax from
\ncontinuing operations for the group would have been \u00a32.5 million.
\nGoodwill has been recognised to re\ufb02ect the synergies which the group believes are available to expand its
\noffering for GP and occupational health services in line with its strategic plan which re\ufb02ect intangibles that
\ncannot be separately quanti\ufb01ed. This goodwill is not deductible for tax purposes.
\nPurchase consideration transferred
\n(\u00a3m)
\nCash flow on
\nacquisition
\nNet cash acquired with the subsidiary
0.3
\nCash paid
11.6
\nNet cash flow on acquisition
11.3
\nTransaction costs of \u00a31.7 million were expensed and are included within adjusting Items. The acquisition is
\nsubject to a completion accounts process which is due to take place during H1 2023. Following this, the \ufb01nal
\npurchase price adjustments will be agreed, and goodwill updated accordingly in line with IFRS 3, which allows
\n12 months from the acquisition date to \ufb01nalise the goodwill position.
\nPrior year Acquisition of Claremont Hospital Holdings Limited and Claremont Hospital LLP (together
\n\u2018Claremont Hospital\u2019)
\nDuring the year the group reviewed its goodwill position in respect of Claremont Hospital in line with IFRS 3
\nand adjustment of \u00a30.1 million has been recognised in respect of provisions originally recognised on acquisition",
"dimensions": {
"concept": "ifrs-full:DisclosureOfBusinessCombinationsExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
},
"f24694": {
"value": "33. Events after the reporting period There have been no other events to disclose after the reporting date.",
"dimensions": {
"concept": "ifrs-full:DisclosureOfEventsAfterReportingPeriodExplanatory",
"language": "en",
"entity": "scheme:213800IBJPW3SE2RA350",
"period": "2022-01-01T00:00:00/2023-01-01T00:00:00"
}
}
}
}