Following their landmark partnership with London Gynaecology, Phoenix Equity’s Ally Vey and Barry Robinson explain why clinical excellence is the ultimate driver of commercial success.
The surge of private equity interest in women’s health over the past decade is a shift that Healthcare Today has tracked closely. While many firms have focused narrowly on the IVF and fertility markets, private equity firm Phoenix has taken a broader, data-driven approach by addressing the gaps in general gynaecological care across the UK.
Here, origination and research director Ally Vey and partner Barry Robinson discuss why the clinical-first model is the only sustainable way to drive commercial growth. They also explore the integration of AI in patient care, the challenges of scaling a founder-led culture, and how the growing representation of women on investment committees is finally bringing women’s health to the forefront of the private equity (PE) agenda.
Phoenix first met with London Gynaecology founders Narendra and Pradnya Pisal long before the deal closed in December 2024. What made this the right time?
Ally Vey: When looking at healthcare providers – specifically where independent providers outside of the NHS have been successful – we noticed that the NHS was largely struggling to keep up. About seven years ago, we took a methodical approach and realised there was a massive waiting list of women wanting to see a gynaecologist in the NHS.
That was when I came across Narendra Pisal. When we met, we got on so well; we had a clear, shared vision of what good women’s health should look like. We spoke over a number of years after that; at the time, the business was just too small for us to partner with.
Eventually, London Gynaecology reached a position where it was a business in which we could finally invest and support. They really wanted to scale what they felt was a fantastic proposition, while also providing an exceptional place for gynaecologists to work.
How do you balance the clinical autonomy of the 35 specialist consultants at London Gynaecology with the commercial growth required by a private equity partner?
Ally Vey: Our view is that clinical governance and clinical excellence are paramount. The clinical side has to come first. We track clinical governance incredibly closely. While the doctors must be able to act independently and do what they feel is best, there is strict governance around how they work. Because it is a growing group of doctors, the clinical governance has to be scaled to be suitable for that. Evidently, that filters through the rest of the company. It has to be a well-run organisation, of course, but the business simply doesn’t exist without excellent clinical standards.
Barry Robinson: Ultimately, we believe that high clinical quality and standards drive good commercials; it results in happy patients, repeat customers, a happy clinical team, and a happy workforce, which ultimately drives growth. You find yourself in a very different spot if you start cutting corners, it really does destroy value quite quickly. While we want to back terrific, ambitious founders, our number one assumption is that the clinical quality and standards are sector-leading – then we have something to work with.
“The vision is to become the go-to women’s health brand.”
Can you make sure that the mindset of the founders grows as quickly as the company?
Barry Robinson: This is one of the key reasons why founders come to us; the conversation resonates when they talk to us. Often, they are either scientifically led or clinically led, and growing a business – the back office and the support functions – isn’t typically in their wheelhouse. We simply have a lot of experience in doing that, so it works well.
What we get tested on in those conversations is our understanding of the importance of clinical standards. When we can speak that language and demonstrate that we have built other clinically led businesses with that same culture and quality ethos, the conversation becomes a positive one very quickly. It is a privilege of what we do, and it reflects a shared passion.
While many PE firms have jumped at IVF and fertility, Phoenix has gone for a broader gynaecological platform. What is the strategy? Is the strategy to build a cradle-to-menopause model?
Ally Vey: At the moment, our focus is on gynaecology alone; there is so much to go for in that area that it remains our primary priority. Longer term, the vision is to become the go-to women’s health brand. While we would love to eventually extend our service offering, the focus for now is purely gynaecology. There is so much work to be done there.
How did you think about valuation and structuring this deal in a sector where revenues are tied to medical services rather than traditional products or tech metrics?
Barry Robinson: We have invested in some healthcare product businesses, but most of our healthcare investments are ultimately about backing people and clinicians. Depending on the sub-sector, there tend to be precedent transactions that we look at, but at this level – where things are a bit smaller – we explore what the founders want and go on that journey with them.
Sometimes it is easier to arrive at a valuation because there are precedent transactions elsewhere; there have been plenty of private clinic transactions in orthopaedics, cardiovascular, and private cancer care that you can point to. However, the valuation on day one is only part of the story. We invest alongside the founders, and what they are really investing in is the opportunity to move faster and benefit from that growth in the end.
Consequently, a lot of our discussion around valuation centres on the economics of how we are going to invest together. That is a slightly nuanced way of looking at it, because the actual entry valuation – especially when they are putting so much back into the company – isn’t as important as how we help them reach the endpoint.
“Women are now in the room making investment decisions.”
Phoenix recently published thoughts on how AI is changing healthcare delivery. Where do you see alpha for a gynaecology group?
Ally Vey: We are already using an AI transcription tool called Heidi within London Gynaecology. As you book, you are informed that this will be used. It is very important to have a human in the loop because Heidi doesn’t always understand the specific nuances; however, London Gynaecology is already using it in that capacity. The benefit isn’t just efficiency. For me, having spoken to the clinicians, the biggest advantage is that the consultant can really listen and engage. We’ve all been in a doctor’s surgery where they are tapping away, trying to capture everything the patient is saying.
That is one key example of driving efficiencies, but we will be assessing everything very closely before introducing further AI into a healthcare business.
Barry Robinson: We are using it elsewhere too. We’re using it in our dental business to improve the scheduling experience for our patients, and we’re using it in our clinical trial business to drive automation around patient recruitment. Unsurprisingly, we think about this in every investment we make. Sometimes it manifests as small point solutions, but in time, it will start to join up more of the workflow and the value flow. However, it obviously needs to be done with real thought and sensitivity, especially where clinical information is concerned.
Given the exploding nature of this market, what does the exit landscape look like? Is the end goal a trade sale to a global healthcare provider, or do you see the potential for a larger women’s health consolidator?
Ally Vey: In some businesses where we invest, there might only be one or two clear options for the future, but with women’s health, and with London Gynaecology specifically, there are likely many. There are lots of different healthcare providers out there that want to improve women’s health; they are approaching it from various angles, but they don’t have the physical clinics. That is the missing piece of the puzzle. London Gynaecology is the largest private gynaecology clinic in the country, and I am sure there will be other investors like us who see the same huge opportunity and the potential for growth.
Barry Robinson: Ultimately, our proposition is based on partnering with founders, and therefore the exit route is heavily dependent on what those founders want to do.
For example, I was on the board of a drug discovery business working with a founder who wanted to keep going. In that case, we ended up exiting to another investor; the business has since gone on to do things more globally with a bigger chequebook. That is one avenue. Other founders may want to transition out, and in those cases, we help them find a chief executive to replace them. The team might then buy from them, which is a slightly different path.
We sell to trade buyers less often than the norm because, ultimately, many of the founders we back are on a mission to do something really meaningful. We are often just the first big stepping stone to help them in that direction.
Have we crossed the Rubicon? Are people now taking women’s health seriously?
Ally Vey: I believe they are; I really hope so. I also think it is worth considering the makeup of investment committees across various funds – what percentage of those committees are women? That number is growing, and it will continue to grow.
Women like me are now in the room making investment decisions. Don’t get me wrong: we are making sensible, commercial investment decisions – but those decisions now can, will, and do include women’s health. That is fantastic, but there is still so much to do in so many different areas. Let’s hope the momentum continues.
