Healthcare Hacks Event: Trends, Growth and Insights

CP’s eighth annual Healthcare Hacks event brought together healthcare leaders, operators and investors to share real-world experience of building businesses, navigating sector challenges and understanding current market dynamics. Discussion spanned personal leadership journeys, scaling healthcare organisations, and the broader economic and regulatory backdrop shaping the sector today.

A Sector Full of Opportunity. But Under Pressure

The event opened by highlighting healthcare as a consistently attractive sector, driven by strong demographics, innovation and sustained investor interest. However, this growth sits alongside mounting challenges: increasing regulation, labour shortages, inflationary pressures, funding constraints and a fragmented commissioning landscape. At the same time, demand is accelerating rapidly, particularly in high-acuity and specialist services, creating both opportunity and strain across the system.

Building Success Through Resilience and Customer Focus

Sandie Foxall-Smith shared a remarkable career story, illustrating that traditional routes into leadership aren’t essential. Rising from a modest background without a university education, she built a career across pharmaceuticals, healthcare and private equity-backed businesses.

Her career was defined by a “buy, build and grow” approach, scaling businesses rapidly. Highlights included transforming a pharmaceutical start-up into a £9 million business within 18 months and contributing to the commercialisation of a major cosmetic treatment.

In later roles, she focused on operational turnaround and culture. At Regard, a learning disabilities provider, she doubled the organisation twice and expanded to 167 homes. Her approach centred on:

• Putting clients and staff first, equally
• Investing heavily in training and culture
• Creating direct accountability, with open communication across the organisation

She emphasised that sustainable success in healthcare comes from total commitment to the service being delivered. Financial performance follows when quality and culture are prioritised.

Scaling a Specialist Healthcare Platform

Donald Fowler, CEO of Onebright, offered a contrasting route into healthcare leadership. With a background in law and banking, he moved into operational leadership without being a clinician. Highlighting that strong management skills can translate effectively into healthcare when paired with the right expertise.

Under private equity backing, Onebright scaled more than tenfold in seven years, becoming a major player in mental health and neurodevelopmental services. The group now serves over 100,000 patients annually.

Key factors behind this growth included:

• Clear strategic focus on mental health and neurodevelopmental conditions
• Maintaining a patient-first culture, prioritising clinical outcomes over financial metrics at operational level
• Building integrated systems and data capabilities to improve service delivery

Donald highlighted several core challenges in scaling:

• Growth without foundations – rapid expansion can create operational strain if systems and processes lag behind
• Maintaining clinical quality while increasing capacity
• Aligning multiple business units with different cultures and practices
• Complex commissioning environments, particularly within NHS-funded services

One major success factor was having easy to understand strategic goals: excellent clinical outcomes, great patient experience, improved employee engagement and financial discipline. This clarity drove measurable improvements, including reduced staff turnover and faster patient access to treatment.

Market Trends and Investment Landscape

James Silk of CIL Strategy Consultants provided an overview of the healthcare market and investor environment.

Strong Demand. But System Constraints

Demand across healthcare and social care remains robust, driven by demographics and unmet need. However, the ability to convert that demand into accessible services is constrained by funding limitations and inefficiencies in system design.

James noted that headline improvements in overall waiting lists can mask other underlying issues, such as increasing waiting lists in particular parts of the system (e.g. diagnostics).

Increasing Uncertainty

Three major sources of uncertainty are shaping the market:

• Regulatory scrutiny across sectors
• Ongoing government reviews and policy changes
• Structural disruption in commissioning and NHS organisation

These factors create a challenging environment for both investors and operators.

Investment Environment: Pressure Building

Although investor appetite for healthcare remains strong, deal activity has slowed due to macroeconomic conditions and market uncertainty. Private equity firms are holding significant “dry powder” (capital ready to invest), but execution has been delayed.

This has led to, and will likely need:

• More selective investment requirements
• Particular focus on risk and sustainability
• Creativity in deal structuring

At the same time, pressure is building for transactions, which points to a positive longer term outlook for deal activity.

What Drives Value in Healthcare Today

There are several critical factors influencing valuations and investment decisions:

• Clarity of Strategy – Businesses need to articulate clear, credible growth stories, underpinned by quality of care and long-term demand.
• Strong Execution – Operational performance is under greater scrutiny than ever.
• Evidence and Data – Investors increasingly expect detailed proof of performance.
• Market Positioning – External factors can affect value significantly at any given time.

Key Sector Challenges Discussed

Our lively panel and Q&A session identified several structural issues:

• Dysfunctional Commissioning Many operators face disjointed or under-resourced commissioning bodies, with limited clarity and slow decision-making.
• Resource Allocation A recurring theme was that healthcare systems attempt to deliver too much, creating inefficiencies. Better prioritisation and patient responsibility were suggested as potential solutions.
• Workforce and Quality Maintaining high clinical standards while scaling remains a core challenge, especially in areas experiencing rapid demand growth.
• Margins and Sustainability There was debate around appropriate profit levels in healthcare. While high margins can be difficult to justify publicly, they are often necessary to fund innovation, technology and service expansion.

FINAL THOUGHTS

A unifying theme across all our speakers was the importance of quality of care as the foundation of sustainable success. Whether scaling a private equity-backed business or navigating public sector contracts, organisations that prioritise outcomes, invest in people and maintain strong cultures are best positioned to succeed.

Despite system dysfunction, regulatory complexity and funding challenges, the sector remains rich with opportunity. Demand is undeniable, innovation is accelerating, and investor interest persists.

The key takeaway: success in healthcare requires resilience, clarity of purpose and the ability to operate effectively within an imperfect system.

If you want to know more about scaling your healthcare business through external investment or acquisition or thinking about succession planning or your eventual exit, get in touch