Spire Healthcare plc is the second largest provider of private healthcare in the United Kingdom.

In 2021 it generated about 30% of its revenues from contracts with the NHS.

The company alleged in 2013 that a block contract agreed between Blackpool Teaching Hospitals NHS Foundation Trust and the Clinical Commissioning Groups in Blackpool, and Fylde and Wyre offered a “clear incentive” for GPs to refer patients to the foundation trust and that this was anti-competitive behaviour. The contract provided the trust with a guaranteed income regardless of the number of patients that chose to use its services. Monitor conducted an investigation and decided that there was no evidence to support the claim though they did conclude that Blackpool CCG’s plans did not “go far enough” to ensure patients would be offered a choice, or that the right to choose would be “publicised and promoted”.[14]

Its NHS business grew from £262 million in 2015 to £293 million in 2016. 20% is directly commissioned by NHS trusts and 80% comes from patients using the NHS e-Referral Service. Income from medical insurers reduced 1.3% to £429 million. Direct payments by patients increased 9% to £170 million. In 2017 turnover increased 0.6% to £932 million, but NHS-funded income fell 1.9% to £287.8 million. The company’s pre-tax profit in 2018 fell by 64% because of lower NHS income and higher costs.