The biggest private healthcare groups in the UK, 2026
The UK's biggest independent healthcare and hospital operators ranked by the turnover in their own filed accounts — acute private hospitals, mental-health hospitals, NHS-funded surgical providers and specialist eye and imaging companies. Tagged by funding source, because "private healthcare" means two very different things depending on who's paying.
What the filings show
Three names define the top: Nuffield Health, Spire and Circle, each over £1.2B, all running acute private hospitals you can pay to walk into. But the surprise of this list is what sits just behind them — the mental-health hospital groups. Priory, Cygnet and Elysium bill £2.02B between them, and most of that is not private money at all: it's the NHS and local councils paying private companies to house and treat patients the public system has no room for. Nuffield, the leader, isn't even a private company in the usual sense — it's a charity.
That's the thing this table teaches that the phrase "private healthcare" hides: it's two industries wearing one name. The acute hospitals (Spire, HCA, Cleveland Clinic) live on patients and insurers. The NHS-funded providers — SpaMedica, HCRG Care Services, Practice Plus Group, Community Health and Eyecare — live entirely on NHS contracts, paid per cataract removed or hip replaced to clear the waiting lists the NHS can't clear itself. Same list, opposite business models, and the fastest growth is on the NHS-funded side.
And almost none of it is British-owned. Circle answers to a US insurer, Ramsay to an Australian group, Cygnet to America's largest hospital company, HCA and Cleveland Clinic to US parents — Cleveland Clinic London grew 25% as it scaled a brand-new hospital. The exceptions are the ones with no shareholders at all: Nuffield, The London Clinic, Benenden, Horder — charities and mutuals, quietly among the biggest healthcare operators in the country.
Top UK private healthcare groups by filed turnover
Latest accounts filed as of June 2026 · refreshed monthly
| # | Firm | Turnover | YoY | Staff | Accounts |
|---|---|---|---|---|---|
| 01 | Nuffield Health Healthcare charity and hospital operator A charity — the UK’s largest healthcare charity — running private hospitals alongside fitness and wellbeing centres; turnover is patient and member fees. | £1.45B | +7% | 19,361 | FY to Dec 2024 |
| 02 | Spire Healthcare Private healthcare and hospital operator Spire Healthcare Ltd — stock-market-listed acute private hospitals. | £1.33B | +5% | 10,489 | FY to Dec 2024 |
| 03 | Circle Health Private hospital operator Circle Health Group Ltd — the former BMI Healthcare, now owned by US insurer Centene; the largest private hospital network by site count. | £1.21B | +7% | 7,560 | FY to Dec 2024 |
| 04 | Priory mental health Mental healthcare and rehabilitation provider Priory Group UK 1 Ltd — mental-health and addiction hospitals, owned by US group MEDIAN/Waterland; most beds are NHS-funded placements. | £794M | -3% | 14,971 | FY to Dec 2025 |
| 05 | Ramsay Health Care UK UK private hospital operator UK operating company of Australia’s Ramsay Health Care. | £739M | +7% | 6,848 | FY to Jun 2025 |
| 06 | Cygnet mental health Private mental health services provider Cygnet Health Care — mental-health and secure hospitals, owned by US group Universal Health Services; largely NHS-funded. | £681M | +11% | 12,354 | FY to Dec 2024 |
| 07 | HCA Healthcare UK UK private hospital operator HCA International Ltd — US-owned premium central-London hospitals (The Wellington, London Bridge, Harley Street). | £658M | +4% | 5,366 | FY to Dec 2024 |
| 08 | Elysium Healthcare mental health Mental healthcare provider holding company Elysium Healthcare Holdings 1 Ltd, consolidated — mental-health and neurological hospitals (Ramsay-owned); largely NHS-funded. | £542M | +8% | 7,719 | FY to Jun 2025 |
| 09 | SpaMedica NHS-funded ophthalmology Private ophthalmology clinic operator NHS-funded cataract and ophthalmology — the NHS pays it per procedure to clear waiting lists. | £282M | +0% | 1,999 | FY to Dec 2024 |
| 10 | HCRG Care Services NHS-funded community Private community healthcare provider Community health services delivered under NHS contracts (the former Virgin Care). | £277M | +4% | 2,999 | FY to Mar 2025 |
| 11 | Practice Plus Group NHS-funded provider Independent hospital and healthcare operator Practice Plus Group Hospitals Ltd — NHS-contracted surgical and diagnostic centres; the wider group is larger. | £250M | +9% | 2,810 | FY to Sept 2025 |
| 12 | Alliance Medical diagnostic imaging Diagnostic imaging services provider Diagnostic imaging (MRI, CT, PET) for the NHS and private sector. | £212M | +5% | 1,014 | FY to Sept 2025 |
| 13 | The London Clinic Charitable private hospital operator Trustees of The London Clinic Ltd — a charitable private hospital in Marylebone. | £186M | +7% | 1,287 | FY to Dec 2024 |
| 14 | Cleveland Clinic London Private hospital operator The UK hospital of the US Cleveland Clinic. | £185M | +25% | 1,687 | FY to Dec 2024 |
| 15 | Optegra ophthalmology Specialist eye hospital operator Eye hospitals and clinics, NHS and private. | £100M | +8% | 489 | FY to Dec 2024 |
The next 4
Firms ranked 16–19
| 16 | Community Health and Eyecare NHS-funded ophthalmology | £94M | +18% | FY to Jun 2025 |
| 17 | Phoenix Hospital Group | £51M | — | FY to Dec 2024 |
| 18 | Benenden Hospital private (mutual) | £47M | -2% | FY to Dec 2024 |
| 19 | Horder Healthcare private (charity) | £39M | +3% | FY to Jun 2024 |
The firms we can't rank
The missing names here are insurers (who pay for care, not provide it) and groups that file audit-exempt.
- King Edward VII’s Hospital — a Royal Charter hospital, not a Companies House company
- GenesisCare UK — restructured through administration; its UK entities file audit-exempt without disclosed turnover
- Transform / Pall Mall and the cosmetic groups — file audit-exempt or below scope
- Bupa, AXA Health, VitalityHealth (insurers) — health insurers, not hospital operators — they pay for care rather than provide it
How this list is built
Source. The latest annual accounts each firm filed at Companies House. Where a firm files consolidated group accounts, the group figure is used; the entity ranked is named under each firm. Where a firm filed a transition period longer or shorter than twelve months (flagged in the Accounts column), the table shows the filed figure but the firm is ranked on its annualised equivalent.
Who counts as a private healthcare group. Independent (non-NHS-owned) operators of hospitals and clinics — acute private, mental-health, NHS-funded surgical and community, and specialist ophthalmology and imaging — tagged by type and funding source. We exclude medical-device manufacturers, pharmaceutical companies, health insurers (including Bupa, whose filing is its global insurance group), and social-care providers.
Scope. Each group is ranked on its main UK operating or group entity; property and sub-division entities are excluded. The mental-health hospital groups noted as an adjacent market in our care home operators list are ranked here. Royal Charter hospitals (King Edward VII's) and groups that restructured into audit-exempt filings (GenesisCare) are named in the firms we can't rank.
Cadence. Rebuilt monthly as new accounts land. Spot a operator we've missed or misread? Tell us — the methodology only works if it's challenged.
Quick answers
- Is 'private healthcare' all paid for privately?
- No — and that's the key to reading this list. Some of these companies are paid by patients and their insurers (Spire, HCA, Nuffield); others are paid by the NHS to treat NHS patients and clear waiting lists (SpaMedica, Practice Plus, HCRG). Both are private companies, but their money comes from opposite places. We tag each by funding source.
- Why are mental-health hospitals so big on this list?
- Because the state pays them. Priory, Cygnet and Elysium bill £2.02B between them, and the majority of it is NHS and local-authority placements — the public sector commissioning private companies to care for some of its most vulnerable patients, often for want of its own capacity.
- Who owns Britain's private hospitals?
- Largely not Britain. Circle is owned by US insurer Centene, Ramsay by an Australian group, Cygnet by America's Universal Health Services, HCA and Cleveland Clinic by US groups. The conspicuous exceptions are the charities — Nuffield Health and The London Clinic — which are among the largest operators of all.
- Why isn't Bupa number one?
- Bupa is a health insurer that also runs some clinics, and its filed accounts are its worldwide insurance group — billions of pounds of premiums, not UK hospital revenue. Ranking it here would compare insurance with hospital operations. It, AXA Health and VitalityHealth are insurers, named in the firms we can't rank.