(ShareCast News) - Jefferies downgraded Spire Healthcare to 'hold' from 'buy' and slashed the price target to 285p from 400p following the company's second profit warning in three months last week.It said the warning highlights the increasing uncertainty Spire faces as the NHS adjusts to the current funding squeeze.On Thursday, Spire cut its full year revenue guidance as it said revenues from NHS Local contracts continued to decline in the four months to the end of October.Spire said NHS Local contract revenues were down 39% for the four months ended 31 October.The company said it now expects full year revenues to show growth of 3% to 3.7%, or between £882m and £888m, down from previous guidance of 4% to 6% or £890m to £907m."Whilst excellent cost control helps mitigate some of the impact, we await clarity on the National Tariff decision in January 2016 before reassessing long-term prospects," Jefferies said.The NHS Tariff sets a value for every consultation, test or operation.At 1120 GMT, Spire shares were up 0.3% to 4.30p.