Narayana Health Cayman rebound contrasts with UK decline

Narayana Health reported divergent overseas performance in Q2 FY27. NH’s Cayman business lifted operating revenue 8.9% sequentially to US$63.4 million and EBITDA 46.4% to US$22.1 million, while its UK business recorded a 0.9% revenue decline to GBP64.4 million and an 18.5% fall in post-IFRS EBITDA to GBP4.7 million.

How did NH’s Cayman business perform in Q2 FY27?

NH’s Cayman business increased revenue, EBITDA and profit after tax in Q2 FY27. HCCI, the Cayman business reported in the presentation, generated operating revenue of US$63.4 million, up from US$58.2 million in Q1 FY27 and US$49.5 million in Q2 FY26. The sequential increase was 8.9%, while year-on-year growth was 28.2%.

HCCI EBITDA rose to US$22.1 million from US$15.1 million in Q1 FY27 and US$17.9 million in Q2 FY26. This represented sequential growth of 46.4% and year-on-year growth of 23.8%. Profit after tax was US$16.6 million, compared with US$10.2 million in the preceding quarter and US$13.7 million a year earlier.

The reported percentage shown below HCCI profit after tax was 26.2% in Q2 FY27, compared with 17.5% in Q1 FY27 and 27.8% in Q2 FY26. Thus, the Q2 FY27 result recovered materially from the prior quarter, although the reported percentage remained below the prior-year quarter’s level.

What drove NH’s Cayman revenue growth?

NH’s Cayman revenue growth came from both hospital and insurance operations. Hospital revenue reached US$49.3 million in Q2 FY27, up 9.9% from US$44.8 million in Q1 FY27 and 18.4% from US$41.6 million in Q2 FY26. Insurance revenue at CIHL reached US$16.8 million, rising 8.8% sequentially and 80.2% year on year.

CIHL recorded EBITDA of negative US$1.1 million in Q2 FY27, while combined hospital and insurance EBITDA was US$22.1 million. The sum of reported hospital revenue and CIHL insurance revenue was US$66.1 million, but HCCI consolidated revenue was US$63.4 million after a US$2.7 million inter-company elimination disclosed for Q2 FY27.

Patient volumes were mixed across the periods shown. Out-patient visits were 12,979 in Q2 FY27, below 13,194 in Q1 FY27 but above 12,301 in Q2 FY26. Discharges rose to 823 from 780 in Q1 FY27 and 785 in Q2 FY26, meaning the quarter’s higher hospital revenue coincided with increased inpatient discharges.

Why did NH’s UK profitability decline in Q2 FY27?

NH’s UK profitability declined as EBITDA fell faster than hospital revenue. UK hospital revenue was GBP64.4 million in Q2 FY27, down 0.9% from GBP65.0 million in Q1 FY27 and below GBP67.6 million in Q4 FY26. The presentation does not provide a Q2 FY26 UK revenue comparison.

Post-International Financial Reporting Standards, or IFRS, EBITDA fell 18.5% sequentially to GBP4.7 million from GBP5.7 million. Pre-IFRS EBITDA declined 41.7% to GBP1.9 million from GBP3.3 million. Both measures include losses from new centres, while the presentation says one-time acquisition costs are excluded from EBITDA.

Post-IFRS EBITDA margin declined to 7.2% in Q2 FY27 from 8.8% in Q1 FY27 and 10.5% in Q4 FY26. New-centre losses were GBP0.8 million in Q2 FY27. NH’s UK business also reported a loss after tax of GBP2.7 million, compared with a GBP2.2 million loss in Q1 FY27, with the reported percentage row moving to negative 4.2% from negative 3.4%.

How did NH’s Cayman and UK businesses compare?

NH’s overseas businesses moved in opposite directions during Q2 FY27. HCCI operating revenue increased 8.9% quarter on quarter and EBITDA rose 46.4%, whereas UK hospital revenue decreased 0.9% and post-IFRS EBITDA decreased 18.5%. HCCI reported US$16.6 million of profit after tax, while the UK business reported a GBP2.7 million loss after tax.

The margin measures also moved differently. HCCI’s reported percentage row increased by 8.7 percentage points from 17.5% in Q1 FY27 to 26.2% in Q2 FY27. The UK post-IFRS EBITDA margin fell 1.6 percentage points from 8.8% to 7.2% over the same period. The currencies differ, so the reported figures cannot be added without an exchange-rate conversion.

The balance-sheet positions disclosed at 30 September 2026 also differed. Cayman Islands had gross debt of Rs 1,080.5 crore and cash and cash equivalents of Rs 1,758.6 crore, resulting in net cash of Rs 678.1 crore. The United Kingdom had gross debt of Rs 1,899.1 crore and cash and cash equivalents of Rs 188 crore, resulting in net debt of Rs 1,711.1 crore.

What did the overseas results mean for NH’s consolidated quarter?

NH reported consolidated operating income of Rs 2,844 crore in Q2 FY27, up 6.0% from Rs 2,683.6 crore in Q1 FY27 and 73.0% from Rs 1,643.8 crore in Q2 FY26. Consolidated EBITDA rose 19.8% sequentially to Rs 605.4 crore, while profit after tax increased 45.3% to Rs 301.2 crore.

NH India reported operating revenue of Rs 1,440.2 crore in Q2 FY27, compared with Rs 1,324.7 crore in Q1 FY27. Its EBITDA increased 22.3% sequentially to Rs 354.8 crore and profit after tax rose 44.2% to Rs 189.9 crore. NH Group excluding the UK recorded EBITDA of Rs 545.2 crore, up 26.1% from Rs 432.5 crore in Q1 FY27.

The consolidated financial statement reported total operating revenue of Rs 2,844 crore, total expenses of Rs 2,290.1 crore and other income of Rs 51.5 crore for Q2 FY27. It reported EBITDA of Rs 605.4 crore, depreciation and amortisation of Rs 162.9 crore, finance costs of Rs 96.7 crore and profit before tax of Rs 343.3 crore.

Conclusion

NH’s Q2 FY27 results show a clear divergence between its overseas operations. Cayman delivered higher hospital and insurance revenue, increased discharges and a US$7 million sequential increase in EBITDA. The UK business, in contrast, recorded declining revenue, lower pre- and post-IFRS EBITDA, a 7.2% post-IFRS EBITDA margin and a wider loss after tax.

What to watch next is whether Cayman can sustain its Q2 FY27 recovery while CIHL remains EBITDA-negative, and whether UK new-centre losses continue after the GBP0.8 million reported in Q2 FY27. Separately, NH’s disclosed India capacity plan targets more than 7,800 beds by FY30, from 5,879 beds at 30 September 2026.