Primary Health acquired Assura PLC in a £1.8 billion ($2.4 billion) takeover, tightening its grip on Britain’s healthcare real estate sector and setting the stage for a portfolio worth a staggering £6 billion. The FTSE 250-listed Primary Health Properties (PHP) now controls more than 92% of Assura’s shares, a threshold that triggers a mandatory “squeeze-out” under the Companies Act 2006.

Squeeze-Out in Motion

With this move, PHP will soon dispatch compulsory acquisition notices to the remaining holdout shareholders, ensuring that within six weeks all Assura stock is forcibly purchased. The acquisition paves the way for Assura to be delisted from both the London Stock Exchange and Johannesburg Stock Exchange, effectively turning the firm private.

A Battle for Control

PHP’s victory came after a fierce contest with U.S. private equity giant Kohlberg Kravis Roberts & Co. (KKR). KKR launched a series of aggressive bids starting in August 2024, teaming up with Universities Superannuation Scheme Ltd. and later with Stonepeak to raise offers as high as £1.6 billion. Despite briefly winning Assura’s board over, KKR ultimately secured just 16.56% shareholder support—far short of what was needed.

The Winning Formula

PHP played the long game, raising its bid incrementally from £1.5 billion in April to £1.79 billion by June. The final offer—comprising 0.3865 new PHP shares, 12.5 pence in cash per share, and a 0.84 pence special dividend—proved more attractive than KKR’s straight cash bid of 50.42 pence per share.

Building a Healthcare Powerhouse

Both PHP and Assura specialize in owning and leasing primary healthcare facilities such as GP surgeries and medical centers, most of which serve the National Health Service. By consolidating forces, PHP gains unprecedented control over U.K. medical property assets, positioning itself as the dominant landlord for NHS-backed infrastructure.

Regulatory Scrutiny Ahead

The Competition and Markets Authority is now reviewing the mega-merger, though PHP has expressed confidence in securing approval.

Legal Counsel

Primary Health Properties is being guided by CMS Cameron McKenna Nabarro Olswang LLP in the deal.