According to Forbes, Narayana Health—the Indian hospital chain founded by billionaire cardiac surgeon Devi Shetty—has agreed to acquire Practice Plus Group Hospitals for £189 million ($248 million), marking its first entry into the U.K. market. The Bangalore-based company will acquire all 60,001 shares at £3,146 apiece through its unit Narayana Hrudayalaya U.K. Practice Plus Group is the fourth-largest provider for the U.K.’s National Health Service (NHS), with NHS patients accounting for 93% of its £229-million revenue in the year ended September 2024, operating 10 hospitals and surgical centers with 330 beds and 2,500 employees. Narayana Health currently operates 18 hospitals across India with over 5,200 beds and projects this deal will place it among India’s top three healthcare providers by revenue. This strategic acquisition represents a significant expansion of Shetty’s healthcare empire beyond its Indian stronghold.
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The Volume Economics Playbook
What makes this acquisition particularly strategic is how perfectly it aligns with Narayana Health’s core business model—high-volume, low-margin healthcare delivery. Shetty has built his fortune and reputation on applying industrial principles to healthcare, similar to how Walmart revolutionized retail. Practice Plus Group’s existing NHS contracts provide exactly the kind of volume foundation Narayana needs to deploy its operational efficiency playbook. With NHS patients comprising 93% of Practice Plus Group’s revenue, Narayana immediately gains access to a massive, predictable patient flow that can be optimized through their proven systems.
Navigating the NHS Crisis
The timing of this acquisition is no accident—it positions Narayana Health to capitalize on the growing strain on Britain’s National Health Service. With NHS waiting lists at record highs and the system struggling with post-pandemic backlogs, private providers who can deliver NHS-funded care efficiently are in high demand. Practice Plus Group’s established position as the fourth-largest NHS provider gives Narayana immediate scale and credibility to capture more of this growing market. Rather than competing with premium private healthcare, they’re targeting the massive middle ground of patients who need timely care but can’t afford traditional private sector prices.
Cross-Border Operational Synergies
This acquisition represents more than just geographic expansion—it’s about transferring operational DNA. Narayana’s success in India stems from radical efficiency innovations: standardizing procedures, optimizing surgeon schedules, and leveraging economies of scale to drive down costs while maintaining quality. The UK acquisition provides a platform to export this operational expertise to a developed market. We can expect to see Narayana implement their proven models for increasing surgical throughput, optimizing bed utilization, and reducing procedure costs while maintaining the quality standards expected in the UK market.
Strategic Imperative Beyond India
For Narayana Health, this move addresses a critical strategic challenge: demonstrating that their model works beyond emerging markets. Their Cayman Islands hospital was the first test of exporting the model internationally, but the UK represents a much larger, more competitive, and more regulated market. Success here would validate Narayana’s approach in developed economies and potentially pave the way for further international expansion. The company’s projection that this deal will make them a top-three Indian healthcare provider by revenue shows how significantly this expands their scale and diversifies their revenue streams beyond their home market.
Market Implications and Competitive Landscape
This acquisition could trigger significant disruption in the UK healthcare market. Traditional private providers have typically focused on premium services for those who can pay out-of-pocket or through insurance. Narayana’s entry with a volume-focused, efficiency-driven model could create a new segment: affordable private healthcare that complements rather than competes with the NHS. If successful, we might see other Indian healthcare giants exploring similar international expansions, potentially creating a new wave of global healthcare providers focused on operational efficiency rather than premium pricing.
