It is another swing and a miss for independent hospital group Spire Healthcare (SPI) which has warned again today, triggering a 12.8% slump in the shares to a near all-time low of 101.7p.

After several warnings last year, Spire is now forecasting adjusted earnings for the year to 31 December 2018 of between £119m and £120m, down from a range of £120m to £125m flagged in the half-year results in September.

The company has offered no guidance for this year.

No reasons have been disclosed for the profit warning but lower NHS referrals and ‘significantly declining’ admissions are hurting the firm.

Spire is also trying to juggle higher investment while boosting growth in its private admissions.

UNCERTAINTY TO CONTINUE INTO 2019

Liberum analyst Graham Doyle says the earnings miss wasn’t entirely unexpected, arguing uncertainty remains for this year.

Doyle flagged last September that Spire was at risk of breaching its banking covenant of 4 times net debt to earnings before interest, depreciation and amortisation (Ebitda) if it missed guidance by 5%.

Today's 3% earnings miss leaves Spire's net debt to Ebitda ratio at 3.7 times which means concerns are not going away anytime soon.

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Issue Date: 15 Jan 2019