Overview
HPE Europe convened more than 300 top-tier investors, executive management teams, investment bankers, and lenders. Our in-depth panels explored the future of the industry and the critical trends shaping deal activity for the year ahead.
During our session on “Accelerating value creation” we discussed how, in a market that’s finally warming up, value creation that actually prices is grounded in facts, not fanfare. Healthcare sellers who show a defendable “new normal,” tie KPIs to cash, and pick the right exit track, from GP-leds to well-timed trade sales, are getting deals done. The playbook now is disciplined underwriting, credible internationalisation (often US traction), and evidence over anecdotes.
Our expert panel was moderated by partners Kristian Werling and Eleanor West who spoke with Christian Fellowes, Managing Director of Inflexion and Matthew Norton, General Partner at Ampersand Capital.
In Depth
So what did you miss?
1) Exit windows are reopening – but discipline wins.
After a muted few years, deal flow is building as macro conditions stabilise and rate cuts begin to feed through. That said, buyers remain choosy. The cost of capital has reset and underwriting is tighter, so sellers need to evidence resilient, repeatable cash generation rather than rely on multiple expansion alone.
2) Prove the “new normal” with data, not narrative.
Healthcare experienced a longer tail of post-pandemic volatility than many sectors, making it harder to define a defendable base EBITDA. The solution is rigorous exit readiness: a crisp equity story, KPIs that align to that story, and a fact base that ties operational drivers to financial outcomes. If it isn’t measured and tracked, it won’t price.
“You only need one outlier to do the deal… we’re seeing instances of very eye-watering numbers being paid—great for the vendor, good luck to the buyer.” – Christian Fellowes, Manager Director, Inflexion
3) Deployment pressure ≠ valuation floor.
Funds need to return capital, and they also need to deploy. That tension is unclogging processes, and in some cases producing “outlier” bids from teams under deployment pressure. Sellers should welcome that dynamic, but not mistake isolated bids for a new market clearing level. Credible processes still clear only where value is supported by evidence.
4) The fourth exit track is now mainstream.
GP-led secondaries/continuation vehicles have evolved from end-of-life clean-ups into a strategic tool: providing DPI to existing LPs, fresh capital to proven assets, and time to finish multi-year value plans (e.g., completing pipelines, scaling in the United States, or finishing systems/people upgrades). They’re powerful, if used judiciously. Governance, price validation and positioning matter to avoid the perception of “keeping the winners and selling the rest.”
“Higher rates require greater confidence in valuations – more expensive capital at the outset means less room for error to hit LP return targets.” – Kristian Werling, Partner, McDermott Will & Schulte
5) Internationalisation, especially a credible US angle, expands the buyer pool.
For many healthcare platforms, demonstrating traction in the United States or other priority geographies is a value lever in its own right. Local presence, regulatory navigation, and commercial proof points de-risk the story and broaden strategic demand at exit.
6) Strategics require earlier, sharper preparation. IPOs remain the exception.
Selling to private equity is process-driven; selling to trade is calendar-driven. The logical buyer set may be small and on its own timetable, so preparation starts at day one. IPOs can be a good home for the right asset but remain capital-intensive, slower to monetise, and not the default path.
“Fortune-scale corporates buying now means shareholder pressure to divest later — the cycle comes back to carve-outs.”” – Eleanor West, Partner, McDermott Will & Schulte
Bottom line: Value creation that prices today looks like this – measure what matters, lock in operational proof, and choose the exit path (including GP-led options) that best matches the maturity of the plan and the breadth of the buyer universe.