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Optima Health's £100m acquisition of PAM Healthcare is a transformational deal, boosting scale, EPS, and targeting over £5m in synergies.
This article covers information on Optima Health PLC.
LON:OPTOptima Health has agreed to buy PAM Healthcare for approximately £100 million in cash, in a move the company calls “transformational”. Only one condition stands between signing and completion: clearance under Ireland’s foreign direct investment regime, which Optima expects within 90 days. Once over the line, this will mark an exit for PAM’s private equity backer, LDC.
The pitch is simple: bigger scale, broader services, and faster progress towards Optima’s stated medium-term targets of £200 million revenue and £40 million adjusted EBITDA. Management also expects the deal to be accretive to adjusted earnings per share after the first full year, rising to over 25% accretion by year three.
The acquisition is on a debt-free, cash-free, normalised working capital basis. Funding is a blend of new bank debt and a short-term bridge from a related party, with a plan to refinance the bridge through an equity raise:
Assuming the bridge is repaid via the Open Offer, Optima guides to pro forma net debt to EBITDA of 2.7x on the trailing 12 months, with a plan to deleverage rapidly to below 1x by year three. The only completion condition is Irish FDI clearance.
PAM is a top-tier provider of outsourced occupational health and wellbeing services across the UK and Ireland, supporting over 1.5 million employees and more than 1,500 organisations. It brings a long-standing customer base (average 7.8 years among its top ten), a proprietary platform (OHIO), and a substantial in-house clinical workforce.
On the numbers, PAM delivered unaudited 2025 revenue of £66.6 million and adjusted EBITDA of £8.2 million, with margin improvement to 12.3%. Over 90% of budgeted FY26 revenue is underpinned by existing contracts, and free cash conversion is over 60%.
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| Key item | Figure |
|---|---|
| Purchase price | ~£100 million (cash-free, debt-free, normalised working capital) |
| Completion condition | Irish FDI clearance (expected within 90 days) |
| Funding mix | £70 million secured debt + £30 million bridge |
| Open Offer (intended) | £35 million at 175p, 17.8% discount to 213p; underwritten |
| Pro forma EBITDA (pre-synergies) | >£26 million |
| Synergies | >£5 million p.a. by end of year 3; ~£1.5 million in year 1 |
| Pro forma leverage | 2.7x net debt/EBITDA (assuming bridge repaid) |
| Target leverage | <1x by year 3 |
| PAM 2025 (unaudited) | Revenue £66.6m; adj. EBITDA £8.2m; margin 12.3% |
| PAM net assets (Dec-25, unaudited) | £21.3 million |
| Market share | ~15% pro forma; target 25% |
Optima sees cost and revenue upsides from combining the businesses. The plan includes aligning central functions, rationalising the estate, and leveraging prior technology investment. On the top line, cross-selling and lower churn are expected to support growth. Management guides to more than £5 million per annum of synergies by the end of year three, with around £1.5 million in the first year.
Importantly, the deal pushes Optima to an estimated 15% market share in a £1.6 billion UK and Ireland market that’s forecast to grow by up to 9% per year. With only about 45% of UK workers currently covered by occupational health services versus over 80% in peer European markets, there’s headroom for expansion – and room for further consolidation.
The new bank facilities are committed for three years, with options to extend by up to two more. Margins step down as leverage improves, which aligns incentives. Covenants include:
The bridge is the time-critical piece: three months to repay it interest-free, or 10% per annum thereafter. The intention is to clear it with the underwritten Open Offer.
The company plans to raise £35 million at 175 pence per share. That’s a 17.8% discount to the most recent reference price disclosed. The offer will be underwritten by Deacon Street. Because the underwriter is a related party and could surpass 30% of voting rights if it had to pick up the shares, Optima will seek a Rule 9 waiver (Rule 9 of the Takeover Code requires a mandatory bid at 30%+). Independent shareholders will be asked to approve this on a poll via a circular after completion.
Translation: existing shareholders get a chance to participate at a discount. If they don’t, there’s potential dilution – but the underwrite gives certainty that the bridge can be repaid.
This is a bold, well-signalled move that accelerates Optima’s strategy. The financial profile of PAM is solid, the market tailwinds are real, and the synergy plan looks grounded in operational levers Optima already knows how to pull. The debt terms are sensible, and the underwritten equity backstop reduces funding risk.
The trade-offs are clear: near-term dilution for those who don’t participate in the Open Offer, related party sensitivities, and the usual integration execution risk. On balance, though, the combination should enhance Optima’s growth, margin potential, and market leadership. If management delivers the >£5 million synergy run-rate and the deleveraging plan, the deal should earn its “transformational” label.
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