Roundup

• The Care market has seen domestic player activity increase, following the large cross-border platform deals in 2025, with domestic REITs and institutional investors forward-funding new stock while PE-backed operators have been utilising bolt-on strategies.

• The CMA launched an investigation into Welltower's 2025 UK acquisitions, with its Phase 1 findings concluding that the transactions may lessen competition. The regulator is considering a remedies package involving care home disposals and operator transfers across 30 local markets, with a final decision on whether to accept the proposals expected by 17 September 2026.

• Although completing just outside the H1 2026 window (July 2026), Blue Owl Capital's c. £1.3 billion acquisition of the 12-asset Spire hospital portfolio from Malaysia's Employees Provident Fund is worth flagging as a defining transaction for the UK hospital real estate market. The deal marks Blue Owl's entry into the sector and underlines continued institutional appetite for long-lease, inflation-linked healthcare assets.

• PHP has received offers from credible investors to establish a new joint venture on its private hospital portfolio, with GIC selected to be its preferred partner, alongside an expanded primary care joint venture with USS.

• Debt markets remained supportive of the UK Care Home sector in H1 2026, with both alternative lenders and traditional banks actively supporting the market, funding Care Home development, operator M&A, and Specialist and Complex Care portfolios.

• Care Home development economics are improving, with general building cost inflation moderating, strong private fee growth and broader debt appetite, providing an improving backdrop for delivery. Read more in the full report here: Savills Care Home Development report 2026.

Care Market

• Domestic private equity and established operators have been active in H1 2026, with the majority of M&A targeting specialist care. On the PE side, Downing-backed Fortava Healthcare, Ancala-backed Iris Care Group and STAR Capital have all completed acquisitions in specialist care. Strategic operator consolidation has continued alongside, with TL Management-backed CGEN Care Group, Potens and Nouvita Healthcare all deploying.

• Domestic REITs and institutional investors have forward-funded new stock in H1 2026, with funding targeting modern, purpose-built, ESG-compliant elderly care schemes. Target Healthcare REIT, Octopus Capital and Elevation Healthcare Properties have all committed capital.

• US REITs remained active but with an expected fall-off given the large platform activity seen in 2025 and the CMA investigation surrounding Welltower, creating a more cautious backdrop for further large-scale US REIT deployment. Care Trust REIT acquired four homes in April 2026 for c.£42 million with a fifth planned for c. £9 million.

• In January 2026, the CMA opened investigations into Welltower's acquisitions of portfolios operated by Barchester, HC-One, Aria Care and Danforth Care, concluding that competition concerns could arise in 30 local markets. While the CMA indicated in May that divestment and operator reallocation commitments offered by Welltower and Apex Healthcare Properties may address these concerns, the regulator has extended its consideration of the proposed undertakings until 17 September 2026 and has not yet reached a final decision on their acceptance.

• Three large debt and refinancing packages were completed in H1 2026, backing both operators and developers. Starwood Capital provided £235 million to Porthaven Care Homes for its 14-home elderly care portfolio; Leumi UK provided a £100 million revolving credit facility to LNT Care Developments supporting five schemes; and HIG Bayside Capital Europe provided a £90 million refinancing to Lifeways, the specialist care provider.

Cure Market Update

• Spire Healthcare became the subject of renewed takeover interest in H1 2026. Following unsuccessful discussions with Bridgepoint and Triton, Toscafund Asset Management submitted a non-binding 250p-per-share proposal, valuing the group at approximately £1.0 billion. The offer represented a c.66% premium to Spire's undisturbed share price, with the Board indicating it would be minded to recommend a firm offer on those terms unanimously. The deadline for Toscafund Asset Management to make a formal takeover offer has now been extended for a third time, from 9 July to 6 August 2026, to allow ongoing due diligence and negotiations.

• In April 2026, Bupa and Spire Healthcare announced a new four-year strategic partnership, highlighting continued demand growth in the private healthcare market and supporting the expansion of specialist clinical pathways, particularly in oncology and musculoskeletal care.

• At the beginning of July, Blue Owl Capital acquired a 12-asset UK private hospital portfolio, operated by Spire Healthcare under long leases, from Malaysia's Employees Provident Fund for c. £1.3 billion.

• Primary Health Properties (PHP) selected Singapore sovereign wealth fund GIC as its preferred partner for a new private hospitals joint venture. The proposed 50/50 partnership is expected to be seeded with PHP's portfolio of 33 long-income UK hospital assets, valued at more than £700 million, including some assets acquired as part of the Assura transaction. The partnership is expected to be agreed before the end of August, with ambitions to grow the platform to £2–3 billion over time. PHP also expanded its existing joint venture with USS (Universities Superannuation Scheme), transferring a £103 million portfolio of primary care assets into the partnership as part of its wider post-Assura capital recycling and deleveraging programme.

NHS Waiting Lists

Elective pressures remain elevated but have broadly stabilised. The RTT waiting list stood at 7.22 million pathways in April 2026, with c. 2.53 million patients waiting more than 18 weeks and c. 100,000 waiting over one year. The average waiting list size between January 2024 and December 2025 was 7.47 million pathways, highlighting the challenge the NHS still faces in expanding capacity sufficiently to return to pre-pandemic levels of c. 4.5 million pathways (2019 average).

While the number of patients waiting more than 52 weeks increased from c. 94,000 in March 2026, it remains a significant improvement on the 2025 average of c. 182,000, reflecting the NHS's targeted efforts to reduce the longest waits. However, median waiting times remain well above pre-pandemic levels, at 11.9 weeks to start treatment in April 2026, compared with 7.2 weeks in April 2019.

These sustained backlogs underpin growing need for private hospitals and outpatient services, as well as growing patient willingness to pay for faster access to treatment and the increasing use of independent capacity by the NHS to help reduce waiting lists. Together, these factors support strong demand fundamentals and a positive long-term outlook for the independent healthcare sector. However, while patient demand and procedure volumes remain well supported, there are concerns that pressure on NHS reimbursement rates and commissioning budgets, alongside broader cost inflation, could continue to put pressure on operator margins.

Private Healthcare In-patient/Day-case Market Activity

Strong demand for independent healthcare continued into 2025, as patients seek faster access to hospital services. The total number of UK private elective admissions in 2025 was 953,000, 1% above 2024, meaning the private sector had more admissions than in any previous year on record for the fourth year in a row.

Private medical insurance admissions were up 1% to a new record level and self-pay admissions were up slightly to reach the second highest ever annual total. Q1 2025 was the highest quarter ever for admissions (174,920) paid for with private medical insurance.

Growth in both insured and self-pay admissions highlights the resilience of demand for independent healthcare, even as NHS waits over 52 weeks have fallen. This demonstrates that private providers are increasingly viewed as a complementary part of the UK healthcare ecosystem, supporting patient choice and underpinning a strong long-term outlook for the market.

Regulation and Policy

• Following Wes Streeting's resignation as Secretary of State for Health and Social Care in May 2026, James Murray briefly led the department before the appointment of Andy Burnham as Prime Minister in July triggered a wider cabinet reshuffle. Yvette Cooper has now been appointed Secretary of State for Health and Social Care and will oversee delivery of the 10-Year Health Plan, the abolition of NHS England and the government's response to the Casey Commission on Adult Social Care during a period of significant reform across the health and care system.

• The Government published a 10-year capital plan to support neighbourhood health centres and NHS estate modernisation, alongside longer-term funding commitments and reforms to adult social care.

• Implementation of the 10-Year Health Plan continued through neighbourhood care, commissioning and funding reforms, while the Casey Commission drove initial changes to adult safeguarding and wider social care policy.

• Workforce and immigration: Care England's January 2026 parliamentary wrap-up confirmed the permanent closure of overseas recruitment routes for social care and continued strict enforcement against providers as sponsors.

Outlook

• Compared with H1 2026, we are seeing a growing number of healthcare, care home and specialist care assets either in-market, coming to market or under offer, meaning we expect stronger transaction volumes in H2 2026.

• The Health and Social Care investor base is deepening and diversifying. Alongside maintained US REIT engagement, H1 2026 has seen domestic private equity, strategic operators and REITs active across care and specialist care, while sovereign and alternative capital has stepped up on the hospital side. This broader buyer base is increasing liquidity and creating a more attractive investment environment

• The Health and Social Care sectors face significant policy change against the backdrop of recent political developments, including Andy Burnham's appointment as Prime Minister and Yvette Cooper's appointment as Health Secretary. The Government is advancing major NHS and social care reforms, including the 10-Year Health Plan and a new long-term capital investment programme. While these initiatives signal continued support for the sector, questions remain around delivery, workforce availability and whether funding will be sufficient to meet growing demand.

• Healthcare demand fundamentals remain exceptionally supportive. Ongoing NHS elective pressures and growth in private activity reinforce the increasingly structural role of independent providers within the UK healthcare system. With underlying requirements growing faster than available capacity, the case for continued investment and expansion across the sector remains compelling. However, the key challenge is likely to be one of pricing rather than volume, with pressure on reimbursement rates and cost inflation continuing to test operator margins.

• Development economics have improved over the last two years and forward-funding by domestic REITs and institutions is returning to modern, ESG-compliant elderly care stock. Against a projected requirement for c. 139,000 additional beds over the next decade, the delivery gap remains one of the clearest structural opportunities in UK real estate.

Read our latest market insights:

2026 UK Care Home Development

UK & European Hospitals 2026

Savills Healthcare: 2026 UK Market Roundup and Outlook

FURTHER INFORMATION:

Savills Operational Capital Markets