Our Health & Social Care team provides specialist accountancy and business advice to a full spectrum of private, public and non-profit health and social care organisations. We are co-founders of the Care Conversation networking forum and hold regular discussions with leading care providers, regulators and government policymakers.

Our clients include elderly care home groups, specialist adult disability and mental health care providers, children’s services businesses including fostering agencies and residential care and education providers, Local Authority commissioning bodies, NHS Clinical Commissioning Groups, Housing Associations and charities.

Our approach to helping you achieve your organisational goals is distinct; we are responsive to your needs and take a hands-on approach in supporting you to achieve your ambitions. There are major challenges facing all types of health and social care providers, including:

• An ageing population and growing demand for healthcare
• Increasing numbers of Children and Young People requiring specialist support
• Delivering integrated health and social care systems
• Labour cost pressures including the National Living Wage
• Legal and tax risks around issues such as “sleep ins” and VAT registration
• Responding to new government initiatives and regulatory changes
• Responding to increasing consolidation and how to access the right funding.

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We work collaboratively across our sector specialist teams in across our Advisory practice to provide a full suite of services including but not limited to:

• Corporate Finance services:
  • Mergers & Acquisitions - Lead advisor services
  • Financial Due Diligence
  • Strategy and Commercial Due Diligence
• Restructuring and insolvency services including pensions advice

Corporate Finance services

M&A

We are a specialist corporate finance team that has advised on a large number of transactions across all sectors of health and social care.

We have advised on fundraisings, acquisitions and disposals, working directly with private shareholders, charities, corporates, REITs and private equity funders. We advise on all aspects of transactions, including providing advice regarding valuation, negotiation, building financial models, identifying potential investors and acquirors, securing access to funding, and project management of the deal process.

The type of corporate finance advice we offer to clients includes the following:

• Advice on selling your business: The ongoing consolidation of the fragmented health and social care markets provides opportunities for owners to exit at attractive valuations. However, it is important to get specialist advice on exit as appetites for acquisitions have been subject to the Living Wage, Brexit and the impact of significant inbound Infrastructure Fund and REIT investment. We have extensive knowledge of the investors active in the sector and have successfully advised a number of vendors on exiting their businesses.
• Acquisitions: We have significant experience of working with investors and corporates to acquire businesses. We work closely with funders to ensure that these complex acquisitions can be completed in an efficient timescale. Recently, we have worked with a number of private equity funders looking at a range of acquisitions across the specialist healthcare sector.
• Funding/re-finance: There has been a significant increase in the funding options available. You might consider number of private equity options as well as bank finance, unitranche and REIT finance available. New entrants in recent years have included European and North American private equity funds, and North American, Australian, European and UK REITs and Infrastructure Funds.

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Financial Due Diligence

Our Transaction Services team can help you to identify key areas of focus and risk for both you and other stakeholders, such as funders, in the transaction. We have a strong track record of providing a range of services to clients across health and social care, including:

Buy side diligence: Working on your behalf to carry out financial and tax diligence on potential acquisitions.

Vendor due diligence: If you and your advisers anticipate a competitive sales process, commissioning a Financial Due Diligence (“FDD”) report is an effective way to:

1. Allow the bidding process to remain competitive for longer
2. Reduce the time period between granting exclusivity and completion and the opportunities for any price chips
3. Allow bidders to provide fully qualified bids and reduce the opportunity for “diligence”led chip

Vendor assistance: Our independent review of financial information before it is provided to bidders, is a cost-effective solution for smaller transactions.
 

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Commercial Due Diligence and Growth Strategy

BDO’s Healthcare & Life Sciences Commercial Due Diligence and Growth Strategy team has strong expertise and credentials across health and social care. We work with a wide variety of clients ranging from care homes and homecare groups, private hospitals, special educational needs schools and digital health providers through to private equity and financial institutions.

Our experienced team is differentiated by being made up of a combination of ex-industry professionals and healthcare practitioners such as doctors and pharmacists, who also have top level commercial experience.

We interact and collaborate with policy makers, commissioners and market analysts on a regular basis, adding to our large network in the area.

We are comfortable working with advisors across all areas of the deal, including corporate finance, business restructuring, tax and financial due diligence.

Select experience includes:

• Care sector:
  • CDD on large care homes group
  • Strategy development for large care homes group
  • Care market review: HR vs. quality review
  • Local demand vs. provision/future vision review for care homes group
• Special Educational Needs (“SEN”) schools / residential care for children:
  • CDD on multiple SEN school operators
  • CDD on providers of residential care for vulnerable young people
• Private hospitals/clinics:
  • CDD on large clinic groups
  • CDD on large private hospital group
  • Strategy for multiple overseas private hospital groups in the UK
  • CDD on stem cell biobank
  • CDD on multiple fertility providers
  • Strategy and CDD projects in animal health
• Medical devices/digital health:
  • CDD on multiple digital health providers
  • CDD on orthopaedic and ophthalmology devices
  • CDD and strategy projects in wound care for multiple large pharma and medical device clients
  • NPD development strategy for large med device co.

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Restructuring and insolvency services

BDO’s Business Restructuring team have the industry experience, skills and technical expertise necessary to implement practical solutions on a national and regional basis. Our clients include operators, landlords, CQC, Department of Health, CI Wales, CI Scotland, CCGs, Banks and other financial institutions. We work in collaboration with healthcare policy-makers, commissioners, providers and regulators.

To find out more about how our team can help you, download our service guide below.

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We are familiar with the regulatory requirements and have registered a number of facilities under the Health & Social Care Act 2008. Key services we offer include:

• Business and cash flow reviews
• Refinancing and restructurings
• Contingency planning
• Formal insolvency appointments including operating a number of facilities within Administration
• Accelerated merger & acquisition processes
• Turnaround and efficiency reviews
• Support for landlord and tenant negotiations
• Assistance liaising with HMRC
• Pension advisory assignments.

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