Full year results 2025 - statement

Financial performance	March 2025	March 2024	Change
Net rental income	£167.1m	£143.3m	16.6%
IFRS profit/(loss) before tax	£166.0m	£(28.7)m
IFRS profit/(loss) per share	5.3p	(1.0)p
EPRA earnings	£111.8m	£102.3m	9.3%
EPRA earnings per share	3.5p	3.4p	2.9%
Dividend per share	3.34p	3.24p	3.1%
Property valuation and performance	March 2025	March 2024	Change
Investment property	£3,099m	£2,708m	14.4%
Diluted EPRA NTA per share	50.4p	49.3p	2.2%
Rent roll	£177.9m	£150.6m	18.1%
Financing	March 2025	March 2024	Change
Net debt to EBITDA	9.8x	9.4x
Net debt to EBITDA (run rate)2	9.1x
Weighted average cost of debt	2.90%	2.30%	60bps

¹ Weighted average annual uplift on all settled reviews

² Run rate calculation based on EBITDA in the second half of the year, i.e. accounting for a full year impact of the income from the independent hospitals acquired

 

Alternative Performance Measures (“APMs”)
The highlights page and summary results table above include a number of financial measures to describe the financial performance of the Group, some of which are considered APMs as they are not defined under IFRS. Further details are provided in the CFO Review, notes to the accounts and glossary.

For further information, please contact:

Assura plc
Jayne Cottam, CFO
David Purcell, Investor Relations Director
Tel: 0161 515 2043
Email:[email protected]
 
FGS Global

Gordon Simpson

Grace Whelan 
Tel: 0207 251 3801
Email: [email protected]
 

Notes to Editors
Assura plc is the UK’s leading diversified healthcare REIT. Assura enables better health outcomes through its portfolio of more than 600 healthcare buildings, from which over six million patients are served. A UK REIT based in Altrincham, Assura is a constituent of the FTSE 250 and the EPRA* indices and has a secondary listing on the Johannesburg Stock Exchange. As at 31 March 2025, Assura’s portfolio was valued at £3.1 billion and has a strong track record of growing financial returns and dividends for shareholders.

At Assura we BUILD for health and as the first FTSE 250 certified B Corp we are committed to keeping ESG at the heart of our strategy, creating Healthy Environments (E) and Healthy Communities (S) and maintaining a Healthy Business (G). Further information is available at www.assuraplc.com Assura plc LEI code: 21380026T19N2Y52XF72 *EPRA is a registered trademark of the European Public Real Estate Association.

Forward looking statements
This Announcement and other information published by Assura contain statements about Assura and other members of the Assura Group that are or may be deemed to be forward looking statements. All statements other than statements of historical facts included in this Announcement may be forward looking statements. Such forward looking statements are prospective in nature and are not based on historical facts, but rather on current expectations and projections of the management of Assura about future events and are therefore subject to risks and uncertainties that could significantly affect expected results and are based on certain key assumptions.

Although Assura believes that the expectations reflected in such forward-looking statements are reasonable, neither Assura nor the Assura Group, nor any of their respective associates or directors, officers or advisers, provides any representation, assurance or guarantee that the occurrence of the events expressed or implied in any forward- looking statements in this Announcement will actually occur. Due to such uncertainties and risks, readers are cautioned not to place any reliance on such forward-looking statements, which speak only as of the date hereof. All subsequent oral or written forward looking statements attributable to any member of the Assura Group, or any of their respective associates, directors, officers, employees or advisers, are expressly qualified in their entirety by the cautionary statement above.

Assura and the Assura Group expressly disclaim any obligation to update any forward looking or other statements contained herein, except as required by applicable law or by the rules of any competent regulatory authority, whether as a result of new information, future events or otherwise.

No profit forecasts, profit estimates or quantified financial benefits statements
No statement in this Announcement is intended as a profit forecast, profit estimate or quantified financial benefits statement for any period and no statement in this Announcement should be interpreted to mean that earnings or earnings per share for Assura for the current or future financial years would necessarily match or exceed the historical published earnings or earnings per Assura share.

Bases and sources
In this Announcement, unless otherwise stated or the context otherwise requires, the following key bases and sources have been used:

• financial information relating to March 2024 has been extracted from the audited consolidated financial statements of Assura for the financial year ended 31 March 2024, prepared in accordance with IFRS;
• references to diluted EPRA NTA per share has been calculated on the basis of a fully diluted share capital figure of 3,256,393,191 Assura shares, comprising: (i) 3,250,608,887 Assura shares currently in issue, and (ii) 5,784,304 (being the maximum number issued pursuant to the Assura performance share plan); and
• a reconciliation of EPRA NTA per Assura share as at 31 March 2025 against the valuations set out in the reports prepared by Assura for the purposes of Rule 29 of the Takeover Code is set out page 67 of the Revised Offer Document published on 27 June 2025 and available on Assura's website. The valuation of property assets as set out in this report of £3,117.2 million is consistent with the Rule 29 valuation, and consists of £3,099.1 million for the investment property portfolio (which is the investment property value figure referred to in this announcement) and £18.1 million for assets held for sale, as set out in Note 7.

Rule 26.1 information
In accordance with Rule 26.1 of the Takeover Code, a copy of this Announcement will be made available free of charge, subject to certain restrictions relating to persons resident in restricted jurisdictions, on Assura's website at www.assuraplc.com/investor-relations/shareholder-information/offer-from-php and www.assuraplc.com/investor- relations/shareholder-information/offer-from-kkr-and-stonepeak no later than 12 noon (London time) on the business day following the date of this Announcement. For the avoidance of doubt, the contents of the website referred to in this Announcement are not incorporated into, and do not form part of, this Announcement.

Rounding
Certain figures included in this Announcement have been subjected to rounding adjustments. Accordingly, figures shown for the same category presented in different tables may vary slightly and figures shown as totals in certain tables may not be an arithmetic aggregation of the figures that precede them.

Chair’s statement

Delivering growth for our shareholders

I am pleased to be reporting on another year in which Assura has delivered for all stakeholders in the ways that only we can. Delivery of fantastic buildings that enable health providers to deliver amazing services across the UK and Ireland. Delivery of improvements to existing buildings to enhance the clinical space or improve energy efficiency. Generating social value through our bespoke community programmes and the amazing work of the Assura Community Fund. Delivery of opportunities for our people to improve their skills and volunteer in our community. Delivery of earnings and dividend growth for shareholders.

This year has been particularly significant for our long-term aspirations with the completion of two strategically important transactions. Both the joint venture with USS and the acquisition of the £500 million independent hospital portfolio offer diversity for the Group – either through adding additional funding sources for our long-term plans or enhancing our portfolio through increasing our presence in an exciting growth market.

The health service in the UK remains at centre of the political agenda and funding decisions, and the pressures that the NHS faces remain constant. Long waiting lists, an ageing population with increasingly complex health needs, budgetary pressures, ageing infrastructure and a wave of medical and technological innovations.
Whilst the NHS continues to be a system of which we, in the UK, are rightly proud, it is also a system that needs help to continue to adapt and deliver the changes a fit-for-purpose health service requires.

There are many improvements that can be made to achieve this. Moving services out of hospital into a community- setting. Shifting the focus to prevention from treatment. Investing in an estate which has a growing maintenance backlog. Training the staff needed to deliver the healthcare of the future. Harnessing the power of digital delivery and access. Thinking about sustainability as an investment for improved long-term cost efficiency. All areas that can be enabled through Assura’s expertise and experience.

Increasingly, the NHS is supported by, or patients choose to be seen by, the private sector. Embracing the help of the private sector from capacity to expertise can enable the health system as a whole to become more efficient. What is most important is that patients get early diagnoses and then are treated promptly and efficiently – something that Assura enables by creating standout quality facilities that provide capacity to support high-quality patient care and improved patient outcomes.
Assura remains well placed to support the health system of the future, through the provision of high-quality buildings for the best healthcare providers.

Our ESG strategy, The Bigger Picture, offers us with a lens through which to frame our decision-making – aiming to ensure that everything we do benefits all of our stakeholders, working toward a Healthy Environment, Healthy Communities and a Healthy Business. We were delighted that this approach received a high level of validation, being certified as the first FTSE 250 B Corp – demonstrating the high value we place on positively contributing to society as a whole.

As in every year, and in particular one in which the business has made a huge stride forward in our long-term ambition, I am thankful for the staggering contribution from every one of our employees. We would not be where we are without them.

This annual report has been written as far as possible on a ‘business as usual’ basis, reflecting our performance for the year ended 31 March 2025 and including some forward-looking statements as required to satisfy reporting requirements. The ongoing Offer situation has not been referred to unless absolutely necessary to describe each particular section of the report. The latest in respect of the Offer can be seen in regulatory announcements, on our website under the specific Offer pages and in the latest shareholder communications.


Ed Smith CBE
Non-Executive Chair
18 July 2025
 
CEO statement

This has been a transformational year for Assura

We have made significant progress against our long-term objectives completing two strategically important transactions: the first diversified our funding sources, and the second materially increased our participation in independent healthcare, a structurally supported growth market.
Following shareholder approval of over 99% at the AGM, our certification as the first FTSE 250 B Corp was confirmed, a true testament to the strength of our ESG strategy and how this is integral to our business model.

We delivered a strong operational performance over the period with improved rent review results, we reduced our EPRA Cost Ratio, and made good progress with our development programme. EPRA earnings are up 4% and we have increased our dividend for the 11th consecutive year.
In the second half of the year, our focus was on executing our disposals programme, targeting net debt to EBITDA below nine times and LTV below 45%, and we have made strong progress.

These incredible achievements were only possible due to the substantial contributions from each and every one of our employees.

Market overview and outlook
The changes currently being seen in the UK healthcare market mean there are substantial and varied opportunities for Assura to take advantage of.
The NHS is in crisis. An ageing population, increasingly complex long-term medical conditions and cost inflation, all of which can be seen in the well-documented increase in waiting lists, mean the pressure and challenges faced by the NHS today are greater than ever. This has been highlighted extensively by senior politicians in the new Labour Government.

The report published by Lord Darzi painted a bleak picture of the NHS, and highlighted how the material underinvestment in NHS buildings and primary care in general had contributed to the problem. The Spending Review published in June 2025 saw a significant increase in revenue funding for the NHS and the infrastructure strategy published in June highlighted the role of private capital in supporting the development of new community health infrastructure.

New investment in modern primary care capacity can provide services that are more convenient for patients and more cost effective for the healthcare system. NHS data shows that primary care treatment can be up to ten times less expensive than emergency hospital treatment. Assura has the skills and track record to deliver primary care buildings that meet these needs.
Meanwhile, the independent sector has continued to experience a surge in demand. The independent market in the UK has grown substantially to £6.8 billion per annum in revenue, following a 6.3% compound annual growth rate over the past 20 years. Growth prospects are particularly favourable at this time. The UK independent sector remains very small in proportion to the NHS budget, and in comparison to other European countries.

The sector creates additional capacity for the health system, with a payor mix split across three main strands: NHS referrals, private medical insurance (‘PMI’) and self-pay. Patients are increasingly turning to private providers given the delays to treatment resulting from NHS waiting lists. Each individual asset is bespoke to the local healthcare needs with some focusing on NHS-referred work, while others have a higher proportion of PMI or self-pay.
These independent providers generally offer specialisms that are well suited to specialist day-case and outpatient facilities. In particular ophthalmology and orthopaedics are well established, with a focus on efficient treatment for patients as well as high levels of customer service. It also means they are willing to invest in technology to improve operating metrics and seek a specialist healthcare landlord alongside whom they can develop their long-term plans.

 

Against this healthcare market backdrop, we successfully executed two strategically important transactions in the first half of the year.
 
In May we announced a £250 million joint venture with the Universities Superannuation Scheme (‘USS’). Seeded with an initial portfolio of seven assets valued at £107 million, the joint venture will invest in assets let to the NHS or GPs with fixed or index-linked rent reviews. The joint venture is seeking to reach £250 million within three years, with the option to extend the partnership to £400 million over time, and has already reached £159 million by year end.

We are delighted to have partnered with USS, a long-term investor looking to increase their exposure to inflation- linked assets like healthcare that align to their long-term pension promises, and that can also offer a positive social impact to the communities they serve. The joint venture will grow through a combination of acquiring existing Assura assets, new assets and developments.

For Assura, this arrangement provides a further a new source of funding for future growth and, with the retention of a 20% equity share and management role, maintains our strong relationships with tenants and enables us to explore further potential opportunities.
Then in August we completed the acquisition of 14 independent hospitals for £500 million from Northwest Healthcare Properties, funded through a combination of cash, newly issued shares and debt, including a new term loan.

The assets have a weighted average unexpired lease term of 26 years, and all leases are fully tenant repairing and insuring (‘FRI’). The tenants are all major hospital operators in the UK, comprising mainly Nuffield Health, Spire Healthcare and Circle Group, and the assets benefit from a strong average rent cover of 2.3 times. The leases are reviewed annually by reference to either RPI or CPI, and we saw a 3.2% uplift to the rent in January.

As a result of the acquisition, some 25% of Assura’s rent roll is now in independent healthcare, delivering on our stated strategy to diversify into targeted new healthcare sectors, by adding high-quality fully operational assets spread across the UK at attractive prices. We were pleased that our valuers have determined a 5% uplift in the asset value recorded in our books.

Financial and operational performance
Assura’s business is built on reliability and resilience over the long term, with secure cash flows from our high- quality £3.1 billion portfolio of 603 properties all supported by our conservative and efficient capital structure.

We strive to grow the rental income generated from our portfolio…

Assura has consistently demonstrated an ability to identify and secure new opportunities for growth, building on our market-leading capabilities to manage, invest in and develop outstanding spaces for health services in our communities.

The independent hospital portfolio acquisition is a prime example of this. We demonstrated an ability to transact opportunistically to capture a high-quality portfolio in a sector where we have been keen to increase our weighting. This transaction was part-funded by the proceeds from the transfer of the first tranche of properties into our joint venture with USS, demonstrating our ability to recycle capital to improve shareholder returns.

Over the year we have disposed of £188 million of assets at an average yield of 5.1%, which has been recycled into the private hospitals at 5.9% (before taking into account leverage of debt used to finance the transaction).

The two developments at Fareham and Winchester are the first completed using Assura’s Net Zero Carbon Design Guide, being committed to achieving net zero carbon for both embodied and operational carbon. A significant achievement, and one that we aim to become standard on our future development projects.
 
These activities, including the first contribution from the acquired assets, are complementary to the revenue contribution from portfolio management. Overall, in the year we delivered 17% growth in net rental income to £167.1 million. Our passing rent roll stands at £177.9 million which is 18% higher than at March 2024.

 

An essential part of our growth strategy is the careful review of every asset for opportunities to increase its lifetime cash flows and positively impact the local community. Our portfolio management team seeks to enhance the value of our assets through agreeing rent reviews, completing lease re-gears, letting vacant space and undertaking physical property extensions.

We completed 348 rent reviews generating an 6.1% uplift on the rent reviewed (3.2% on an annual equivalent basis), 19 lease re-gears, and invested in eight capital projects. Collectively these added £4.9 million to our rent roll, offering attractive growth for modest capital outlay. Our total contracted rental income, which is a combination of our passing rent roll and lease length, stands at £2.5 billion, our weighted average unexpired lease term is 12.7 years and 97% of our income now comes from GPs, the NHS, the HSE, pharmacies and established independent sector healthcare operators.

…and carefully controlling our balance sheet and cost base…

Despite the impact of inflation and growth in our portfolio, we retained our focus on operational efficiency and reduced our EPRA Cost Ratio to 12%.

A positive valuation uplift of £57.9 million contributed to an IFRS profit of £166 million or 5.3 pence per share.
As a result of the independent hospital portfolio acquisition, our balance sheet metrics stand toward the higher end of our policy ranges, with LTV at 47%, which we are targeting bringing down to 45% through our disposal programme.

I am pleased to report we have made strong early progress with this programme, disposing of 29 assets for £188 million during the year at a slight premium to book value. These disposals were a combination of transfers into our newly established joint venture and disposals to third parties. We are in active discussions for disposal of a further
£19 million of assets.

All of our long-term drawn debt is fixed, at an average interest rate of 2.9%, has a weighted average maturity of 4.6 years with only a small proportion having maturities in the next two years. Our investment grade rating of A- was reaffirmed by Fitch Ratings Ltd in August 2024.

We have maintained our track record of growth year-on-year. Our EPRA earnings have increased by 9% to £111.8 million which translates to an EPRA EPS of 3.5 pence per share.
The strength of our income and earnings growth is reflected in our fully covered dividend payments, which we have now increased for 11 consecutive years. In this latest period, we announced a 2% increase in the quarterly dividend to 0.84 pence with effect from the July 2024 payment, equivalent to 3.36 pence per share on an annualised basis.
Assura outlook

Growth in the year has been driven mainly by activity in independent healthcare, where we were able to take the opportunity to buy high-quality assets strengthening our relationships with the tier 1 private hospital providers. We are already discussing ways to assist our tenants with future developments, asset enhancement and sustainability improvements. Prospects for the independent healthcare market remain strong.

In the GP and NHS space, new development opportunities have experienced delayed approvals over the past two years. However, the tone of the new Labour Government is encouraging and we are starting to see certain schemes unlocking. Their stated priorities of ‘three big shifts in the focus of healthcare, from hospital to community, analogue to digital and sickness to prevention’, all require investment in community healthcare buildings. Assura’s track record in delivering cutting edge buildings, working with the local NHS entities to adapt space for their requirements and embracing technological advancements, means we are well-placed to provide support through our development and asset enhancement capabilities.

All of our current on site projects are in Ireland, and the clear plan that the HSE has to deliver enhanced community care centres in specific locations means that this remains an attractive growth market. Assura’s skills in development and asset enhancement, and the growing presence that we have in Ireland, means we are well-placed to capture incremental opportunities in this market in both the short and long term.

At the date of this report, Assura is the subject of two potential takeover bids. Assura is a business with great people, an efficient operating platform, leadership positions in key growth healthcare markets, financial strength and excellent growth opportunities.

Jonathan Murphy CEO
18 July 2025